Reducing injury risk before, during, and after your marathon

March 26, 2019 Catherine Conelly

If there’s a marathon in your future or past, you’ve probably had someone at some point ask you, “Why on earth would you ever run 26 miles?”

And the truth is, while some people consider running even just a few miles to be an act of insanity, for others (maybe you) it becomes a form of self-care — an essential part of who they are.

That being said, let’s be honest. You may fall in love with the feeling that comes after completing a marathon (or even just a training run), but it can break you down just as fast as it builds you up. Without proper training and recovery techniques, advanced and beginner marathoners alike can find themselves in a world of pain.

A study published in Sports Medicine found that the injury rate among recreational runners ranges from 37 to 56 percent. The good news: There’s a lot you can do to decrease your risk of breaking down. Here are some strategies to keep in mind, whether it’s your first marathon or your 100th.

1. Skip the post-race couch-potato session.

You may think you’ve earned a Netflix binge after crossing the finish line, but your body will thank you later if you walk around and stay mobile. “Motion is lotion for our tissues and joints,” explains Justin Newman, a physical therapy manager at EXOS.

Consider the time you put into your run: A three- to four-hour race takes a lot of effort, but 20 hours of poor recovery puts all that effort in jeopardy. “A sedentary environment starts to decrease blood flow and forces you to sit in positions that shorten key muscles in your hips and back,” says Eric Dannenberg, a performance manager and coach at EXOS. So, do your body a solid and just keep moving.

Listen to your body when it tells you to slow down. Pushing yourself too hard on a training run can result in injury before you even get to race day.

2. Do more than stretch after a run.

We know stretching is important. “Static stretching tends to force people to relax, breathe, and let go of tension,” says Dannenberg. And reducing tension is key for minimizing injury risk. But don’t stop there. There are several other recovery techniques that can help.

Ask around at local physical therapy clinics to see if they offer cold-water immersion therapy. It’s been shown to reduce soreness in the 24 hours following exercise and to improve muscle function as part of the recovery process. Some sports medicine clinics also offer compression therapy services that are linked with reduced soreness and quicker recovery.

And don’t forget the basics. For example, hydrating, eating a balanced meal that includes both carbs and protein, and getting a good night’s sleep — according to Newman, this is all important after a run even if it seems rudimentary.

Runners expect to be sore, but it’s important to recognize when pain is your body’s way of telling you something is wrong.

3. Stay in touch with your stride.

“The most common mistake I see in runners from a mechanics standpoint is that they tend to overstride,” says Newman. “They land with a large heel contact, their knee straight, and their foot too far in front of their center of mass.”

This increases forces in all the wrong places throughout the lower body and leads to a lot of back, foot, knee, and hip pain. “Your foot should be landing right underneath your hips,” says Dannenberg. He adds that you should land with a full foot, keeping most of the pressure on the ball of your foot.

Helpful trick: Every time you see a mile marker or water station, check in with your posture. As the miles go on, you get tired and it’s easy to lose form.

4. Check in with your body at every mile marker.

When the running gets tough, even the most experienced marathoners can get lazy with their form. Make it a habit to check your alignment at every mile marker or water station. Your shoulders, torso, hips, and where your foot strikes the ground should all be in alignment. Keep the crown of your head reaching toward the sky and think of your body like a spring. “Even if one small loop of the spring is out of position, meaning your head is tilted or your butt is poking out behind you, it’s not going to work as efficiently,” says Dannenberg.

5. Address pain early.

Runners expect to be sore, but it’s important to recognize when pain is your body’s way of telling you something is wrong. Newman recommends visiting a physical therapist or doctor if it’s progressively getting worse after 24 hours. And don’t be afraid of the answers. Sure, no one wants to be told they have an injury, but if you address the problem early, there’s a better chance you can correct it through physical therapy and avoid surgery. If it’s limiting your normal activity and training abilities, start asking questions.

6. Overhaul your warmups.

You may have heard that dynamic exercises are better than static stretching before a run. So does it really make a difference? Yes. One study published in The Journal of Strength and Conditioning Research found that static stretching before a run could actually decrease endurance, while dynamic stretches have been found to improve muscle performance.

A smart, dynamic warmup eases your body into the same ranges of motion it will have to endure for a long 26.2 miles. “If you don’t do that, you’re just not going to be as efficient as you could be,” says Dannenberg. He recommends adding pillar marching and pillar skipping into your warmup routine. Newman also recommends a series of bounding, carioca, and lateral shuffles.

Without proper training and recovery techniques, advanced and beginner marathoners alike can find themselves in a world of pain.

7. Make sure your cross-training includes strength training.

“It’s essential for runners to incorporate strength training at least two to three times per week,” says Newman. Think about it. While running, you perform one movement pattern repeatedly. This can result in muscle imbalances like quad dominance, and being too reliant on one muscle can lead to injury.

“Cross-training exposes the athlete to different movement patterns,” says Newman. By adding strength exercises into your routine, you can prevent imbalances while also developing more total-body strength to become a more efficient runner.

So, where to start? “Pushups are great because they’re total body and very focused on posture and core position,” says Dannenberg. He adds that rows can help train the body to keep an upright position instead of a rounding forward. Deadlifts, squats, and step-ups are some other options. But most importantly, don’t mistake strength training for powerlifting. “It might have facets of that in there, but it’s important to focus on mobility and stability before you get into strength and power,” says Dannenberg.

Overstriding leads to more pain and possible injury. When your foot strikes the ground, it should be in line with your hips.

8. Add mobility and stability work to your warmup.

Stretching doesn’t equate to warming up. “One of the biggest missing pieces for most runners is mobility and stability exercises,” explains Newman. Yet, preventing common running injuries like plantar fasciitis, IT band syndrome, and runner’s knee depend on this type of movement.

Try mobility exercises like knee hugs or a heel-to-glute stretch with an arm reach. Handwalks, reverse lunges with an overhead reach, and the “World’s Greatest Stretch” are other options. For stability work, try these movements: DNS star pattern, glute bridge with a mini band around your thighs, quadruped hip abduction, squats using a mini band, and a lateral bent leg walk using a mini band.

It’s not just about the miles you log. Strength training plays a big role in becoming a less injury-prone runner.

9. Don’t forget to rest.

You may get so caught up in your training and think your body doesn’t need that rest day, but it does. “The danger is that you’re not allowing tissue to heal,” says Newman. Your nervous and immune systems can suffer more fatigue, and it can negatively affect sleep, all of which can decrease your performance and make you more injury-prone on your journey to finish 26.2. Those rest days are in your training plan for a reason. Use them.

Additionally, it’s OK to shorten a training run or back off your normal speed if that’s what your body needs. “It will have a very small and insignificant effect on your training schedule, and those decisions may be the reason you stay healthy and injury free,” says Newman.

In other words, think big picture. While you don’t want to be undertrained, you also don’t want to be overtrained. If you listen to your body instead of forcing it, you’ll be more likely to avoid injuries before race day.

About the Author

Catherine Conelly

Catherine Conelly is a California-based health, fitness, and lifestyle writer.

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