Injury Prevention Tips While Running a Marathon

By Jenny Lee, Physical Therapist

Long-distance running, such as running marathons, is a huge physical and an indication of peak physical, and often mental, performance. Unfortunately, an activity such as long-distance running, that involves a repetitive strain on your body, often comes with its share of injuries. In fact, the majority of runners will experience an injury that is severe enough for them to temporarily take a break from running during their running career. The most common injuries often involve the lower limb.

Shin Splints

3 Most Common Running Injuries:

Runner’s knee (patellofemoral syndrome) 

Runner’s knee is characterized as a dull pain under or around the kneecap. Individuals can experience this pain either immediately as they begin to run, or delayed, only feeling it 2-3 hours after their run or even the next day. Aside from running, pain can occur when bending down, going up and downstairs, or sitting for too long. It can also be accompanied by clicking or popping the knee cap. It is caused by an imbalance or improper control of the muscles that attach around and to the kneecap. The best way to treat this condition is to “correct the imbalance” of the muscles around the knee. The most common muscles that cause imbalance are the tight quadriceps, a tight IT band, and weak gluteal muscles. 

IT band syndrome 

IT band syndrome is a repetitive strain injury, caused by a tight IT band. The IT band is a band that runs down the side of your leg, from your hip to your knee. If tight, the IT band does not move properly and causes friction between the band and the bone underneath it. Pain can be characterized as either a dull ache or a sharp shooting pain. It can be felt all of the way down the band, or locally at the attachment of the band on the outside of your leg, just below your knee cap. 

Achilles Tendonitis

Achilles tendonitis is an inflammatory condition of the Achilles’ tendon, which is a tendon that connects the calf muscles to the heel bone. It is an overuse injury and occurs when repetitive stress or straining is placed on the Achilles’ tendon. Symptoms include dull pain on the lower part of the back of your leg, and visible swelling on the Achilles’ tendon (the back of one ankle looks “fatter” than the other). The condition can be acute, which means the injury is new and the swelling that is present will fluctuate from day to day, or chronic, which is characterized by actual structural changes in the Achilles’ tendon.

Treatment includes modifying the running technique, reducing the running load (for example; running 4 x 5 miles intervals with more rest instead of 2x 10-mile intervals), stretching the Achilles’ tendon, and strengthening the calf and tendon. 

Stretches to Perform Regularly

Quad stretch:

Bring your heel to your bottom in a standing position. Hold for 20 seconds, repeat 3x.


IT band stretch:

Stand with one leg in front of the other. Lean your upper body in the direction of your front leg, sticking your hips out in the opposite direction. Hold for 20 seconds, repeat 3x.


Medial Glute strengthening:

Tie an exercise band around your knee and adapt a squatting position. Take 10 steps in each direction, pushing out against the band, not letting it pull your knees in. Alternatively, you can simply complete squats while adding the band around your knees. Push out against the band while squatting in order to engage your medial gluts. 


General tip:

Do not forget about good running shoes. Running does not take much equipment, so your running shoes are one of the only ways to protect yourself. Studies show you should get new running shoes after every 300-500 miles of running, which happens quickly for long-distance runners. I also suggest speaking professional opinions when finding running shoes. There are stores specifically for buying running shoes that have trained professionals that can help you pick the right pair. 

Some general first aid tips are:

  • Apply ice to the injured area for 15-20 minutes, several times day-Elevate the injured area for at least 15 minutes
  • Compress the area with a wrap to decrease swelling-protect the area: explore different braces, wraps, and options with athletic tape to offer your support when you run

About the author:

Jenny Lee is a Physical Therapist and expert in orthopedics and women’s health. She is the CEO of In-home Therapeutics, a physical therapy company that specializes in mobile and home-based physical rehabilitation solutions. She is the founder of “The Pelvic Floor Master Class”, an online initiative that aims to provide expert-level treatment, education, and resources to women who experience pelvic floor dysfunction. Her goal is to spread awareness of key issues in women’s health, often overlooked in the media. She has worked with several high-level publications as an expert contributor in women’s health and the pelvic floor.


Instagram: @jennybrycelee


The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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