Injury Prevention in Long Distance Runners

By Erica Bonnicci-Mallia, Senior Physiotherapist

Marathon season is upon us again. Marathons attract experienced as well as amateur runners. For some participants this may be a yearly undertaking but for many this may very well be the first endurance race they have ever signed up for.

Running a marathon is no easy undertaking and it requires a lot of physical as well as mental preparation.  Preparation for the event usually involves following a set program which sets weekly targets to gradually build up milage and train muscular endurance. It is not uncommon to experience injury along the training journey which often causes frustration and disappointment. Injuries cause delays in achieving weekly goals and may also prevent individuals from running the race entirely.

Ensuring a training program is effective and individual specific can help reduce the risk of injuries. Below are a few points which may help reduce the risk or the extent of injury and therefore improve recovery and a quicker return to training.

  1. Warm-up

It is very tempting to just ‘go for a run’! The purpose of a warm-up is to increase your heart rate and respiratory rate which in turn allows muscles to take up more oxygen, subsequently promoting efficient contraction and relaxation. An exercise specific warm-up helps activate the connections between your muscles and nervous system to improve the efficiency of movement as well encouraging mobility in the body.

A good warm-up should consist of a variety of dynamic exercises including a range of slow and fast exercises which target all the muscle groups needed for the run. Most injured runners we see as Physiotherapists seem to warm-up with a slower-paced run for a few minutes before gradually building up to their desired pace. Despite its effectiveness in increasing blood oxygen levels, this type of warm-up does not target the full function of the muscle groups to be used in the run and can in turn increase the risk of injury.

2. Endurance Training

Endurance is the ability of the body to withstand exercise over a prolonged period of time. Marathon running is a direct test to this and the training program should target this specifically. A gradual increase in running mileage over a number of weeks should allow your body to gradually adapt to running longer distances with appropriate rest to allow time for muscle recovery. This gradual increase should be person-specific and it would depend on your previous running experiences and how much time you can devote to preparing for the marathon.

3. Strength and conditioning

Resistance based training can help improve muscular strength allowing muscles to work more efficiently. Strength work has been found to improve running economy and performance without increasing body mass. Strength training can be done at home or within a gym setting and should be performed twice weekly. Exercises can include weighted or body weighted exercises and should aim for muscle fatigue.

There are conflicting thoughts around the benefits of strength training in reducing running injuries. It was previously thought to be an important contribution to preventing injuries, however recent evidence is suggesting that a lack of strength may not necessarily be the direct cause of injury. In saying that this does not mean there are no benefits of strength training in injury prevention and in rehabilitation. If you have sustained an injury or have a longstanding injury and on assessment a strength deficit is picked up by a physiotherapist, then there may be a secondary benefit to incorporating strength training within the training program.

4. Rest and Recovery

Muscle fatigue is normal in long distance running and result in a change in muscle function and running technique. Incorporating rest sessions throughout your training program is essential for muscle recovery. Muscle fatigue has been shown to cause changes in strength, alter movement patterns and increase tissue loading, all of which can result in an injury. Overtraining syndrome is a common risk when it comes to training for marathons. A strong focus on achieving weekly goals within a set time frame is usually to blame for this. Rest days should be given the same importance as reaching the desired mileage.

Long distance running is a challenging but rewarding experience. I wish you all the best in your preparation and with the right regimen, you will seize the day. We at the Thornbury Clinic would be delighted to help you optimise the build up to the event and ensure appropriate guidance on how to manage injuries should you sustain them. why not book now or visit us at our Thornbury, Thornbury Active or Yate clinics.