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Avoiding injury during your marathon training


There are simple methods which you can incorporate into your daily training to help keep you running comfortably without leaving you vulnerable to a significant risk of injury.

1. Keep your training varied

As with most things in life, moderation is key. Keep a healthy balance by varying your training and avoid excessive sessions concentrating on one element only i.e: avoid excessive hills, stairs, cambers, or track work, all of which can place unduly heavy loads on individual structures like the ITB.

2. Run in shoes that are comfortable

This may sound obvious, but don’t go for a pair of running shoes which are not comfortable to wear! By all means, have your feet analysed and take advice about the type of shoes that may be more suitable to your running style, but whatever you do, choose a pair which is comfortable to run in. If you wear comfortable running shoes you are at no greater risk of injury and, what’s more, you’ll enjoy your running. You can’t say the same about a pair which doesn’t fit you properly or is uncomfortable to wear.

3. No need to overdo the stretching before training

Despite what you were taught in PE lessons at school, stretching before running does not prevent injuries. Concentrate on actively warming up your muscles instead. Increasing your range of movements by stretching to the extremes is unlikely to provide protection against overuse injuries, which usually occur within the normal range of movements. Perhaps surprisingly, stretching before exercise can even increase your risk of injury by separating the muscle fibre links which are vital to effective muscle contraction. Stretching may leave you with a greater range but it may also be a weaker range with less protection. Dynamic stretches have also been known to cause acute muscle injury by the sudden stretch in an unprepared muscle. On the other hand, active warm-up exercises can effectively prime the vital muscles for action and therefore can be more useful in your pre-run preparation.

4. Finally, get your injuries sorted out properly

You should address all injuries, even minor ones before you carry on running. Having an injury is the biggest risk factor for developing another injury. It’s difficult to tease out the precise mechanisms which make a history of injury such an important risk factor, but whether it’s that the athlete continued running through an injury, that the injury was not adequately treated before the athlete returned to running, or that scar tissue is inherently weaker than normal muscle or ligament, the fact remains it is the most reliable predictor of future injury. It simply does not pay to run through an injury. Fortunately, most minor injuries will settle with a few days rest, but persistent or increasing pain, pain at night, or pain associated with swelling requires a formal assessment and occasionally a scan. With an accurate diagnosis, a thorough treatment and rehab program can be arranged to allow you to return to running pain-free.

In summary
The keys to reducing your chances of future running injuries are: sticking to a gradually progressive and suitably varied training program; running in shoes which you find comfortable; and addressing injuries by obtaining an accurate diagnosis and then working through a thorough, exercise-based, active rehab program before a gradual return to training.

Professor Courtney Kipps has long experience in endurance and team sports medicine through his current role as the Assistant Medical Director of the London Marathon and previous roles as the Medical Director of the London and Blenheim Triathlons and Club Doctor for Harlequins Rugby Club.

He is co-leader of the Master’s program for Sport and Medicine at UCL, training the next generation of sport and exercise medicine clinicians.

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