Running A Marathon? Here’s How To Prevent Injuries This Season

Marathon season is officially upon us, and many Canadian runners are preparing for events such as the Niagara Ultra happening on June 15. While marathon training can bring bountiful physical and mental benefits, it’s important to understand that this pursuit can also lead to aches, pains and more serious injuries if not undertaken sensibly. All runners dread injury, especially close to a race date, as many train throughout the year to ensure their bodies are prepared for the endurance required. We chatted with Dr. Tenforde, sports medicine physician at the Spaulding National Running Center, one of the only centers in the United States exclusively dedicated to the diagnosis and treatment of running-related injuries, to learn more. —Noa Nichol

As a former professional runner and now a sports medicine physician, can you explain how marathon running specifically affects the body, both positively and negatively?

Running has many health benefits, including improved cardiovascular function, improvements in mood, sleep, and metabolism. Those with heart disease or concerns for underlying medical issues may consult a healthcare provider before initiating a new exercise routine. For most, the primary health concern in training for a race include development of musculoskeletal injuries.

With the Niagara Ultra and other marathon events approaching, what are the most important steps runners should take to prepare and train safely to minimize the risk of injury?

Many health behaviors can promote appropriate recovery and response to training, including eating a balanced diet, adequate sleep, and wearing proper footwear. It can be helpful to have a training plan or consult a coach when preparing for a marathon distance to ensure there is a gradual increase in training volume, frequency and intensity along with appropriate recovery built for training adaptations.

What are some of the key warning signs runners should watch out for before, during, and after a marathon that might indicate they are at risk for a serious injury?

A key principle I have found helpful is to “listen to your body”. If you have a new pain, it’s important to monitor that does not reflect injury. While pain and soreness may occur in acute response to exercise, this should improve with training response. Pain that builds during a run, persists after discontinuing a run, or causes a limp should be evaluated by a medical provider to ensure proper diagnosis and rehabilitation plan.

From your experience at the Spaulding National Running Center, what are the top five most common marathon training injuries you see, and how can runners best prevent and manage these injuries?

Common injuries in those training for endurance events including Achilles tendinopathy, plantar fasciitis, leg pain, knee tendinopathy, joint pain and bone stress injuries. Most injuries are attributed to training errors that can benefit from developing a good training program. Often a general strengthening program 2-3 times/week can be incorporated to improve lumbopelvic strength along with leg strength. This includes abdominal exercises (such as planks and bridges), squats, and calf raises. Bone stress injuries are from overload to bone and can have multiple causes. Optimizing diet (including energy availability, calcium, vitamin D and iron), appropriate sleep, generalized lower body strengthening, and ensuring appropriate hormone function (in women – normal menstruation and in men – ensuring no symptoms of low testosterone) are good strategies to promote musculoskeletal health.

Given your unique perspective as both a doctor and a former professional runner, what advice would you give to runners who are preparing for a marathon but are worried about the potential for injury as race day approaches?

Developing a plan around training, nutrition and recovery can often result in good training preparation for the marathon. A taper (reduction in training volume) with good focus on maintaining nutrition and sleep can prepare for race day. It’s not uncommon to have temporary pain that disrupts planned training – listen to your body and make adjustments knowing that overall training effort can often prepare you to complete the event when getting to the starting line as healthy as possible!