Advice on How to Avoid Injury and Aid Recovery for Marathon Runners
Preparation: Biomechanics assessment pre-run
It’s not unusual for people to decide they want to run a marathon. From 0 to 100, they jump straight in. Usually, we’ll give some thought to good footwear and get going. Less usual is for people to give some thought to what’s going on inside that brand new trainer, the leg as a whole or even the rest of the body for that matter. Running, especially long distances, asks a lot of the body. Its repetitive nature means that physical habits, strength deficits, poor running technique, pre-existing aches and pains and anything else you have going on in the body are magnified. Especially, during a marathon; A race which, lets face it, began because someone died after running it with no preparation. Needless to say then, your training programme is vital. And that will be most effective if you know where you’re starting.
The old trope “Prevention is better than cure” certainly holds true for marathon running. A Physiotherapist or Osteopath who specialises in sports and performance will be able to carry out a thorough biomechanics assessment and address anything they find. This could be anything from helping you find your core, activating sleepy muscles or helping to strengthen and stabilise weak ankles. You may also like to work with a PT to structure the optimal training plan, who can then work with your manual therapist to fully support your training.
Training: It’s not all about running
Your secret weapon when it comes to endurance running is strength training. Just running slightly longer distances each week will only take you so far; your progress will plateau and the risk of injury will increase. A typical training programme each week should include; a short run, HIIT or cardio training - such as swimming, cycling or rowing, strength training, a long run, and last but not least some TLC for your body; this could be a dynamic vinyasa practise, active stretching, a good rolling session and Rest!!
Ground reaction force (GRF), is the force exerted by the ground on a body of mass in contact with it. When we run this goes up to between 1.5 – 6 x our body mass, on each leg; Running is a single leg activity after all. This starts to give you some indication of why you might be experiencing new aches and pains if you’re new to running and why running alone doesn’t prepare the body sufficiently. To turn this into some practical advice, a good level of baseline strength support the body when running a marathon is as follows;
8 - 10 Single Leg, Leg Press at 1.5 x your body weight, each side, for 3 Sets.
1 set of 25 single leg heel raises are also a recommended baseline level of strength for your calves – which also act as shock absorbers when running.
Other good tips are;
Work on your explosive power - Box jumps, either single or double legged, would be great. they help train the body to absorb shock and provide some extra spring in your step.
Mix up the kind of exercise that you do. This will help keep you mentally engaged and your body ready to adapt. Increased movement variability has been shown to be key in reducing injury.
Rest. Good sleep hygiene is another often overlooked component of a pro training programme. It’s when our body recovers most.
Last but not least - Good nutrition, this will mean your body has the resources it needs for optimal performance and recovery both through training and on race day. Training is one half of your preparation for a marathon. A well balanced food intake is the other.
Also, be sure that your training programme includes the following components.
Stretches for the Hamstrings, Calves, Glutes and Hip Flexors. Downward dog or hanging your heel off the back or a step is great for Hamstrings and calves respectively, half pigeon is good for the glutes or even your classic figure of 4 stretch, and for the hip flexors - a runner’s lunge, drawing the back foot up to the glutes whilst keeping the glutes pushed forward to get into both ends of the hip flexors at the same time.
Using a roller and/ or a massage ball will also help. You can use the roller to release your Quads, Hamstrings, Calves and IT band. A shorter, more dynamic go on the roller can also be a great way to wake your muscles up pre-exercise. Massage balls can get into the harder to reach areas such as the piriformis muscles, and if you put two together or get your hands on a double massage ball, use them to get into the muscles of the lower back.
Posterior Chain Activation. The posterior chain is made up of the muscles at the back of the body, working in concert with each other. We’re particularly interested in the activation of the calves, hamstrings and glutes - the primary drivers of hip extension and power when it comes to running. This is important because a lot of time spent sitting can cause the glutes to become under active. A problem when you want them to propel you along for 26.2 miles.
The good news is, switching it on is relatively easy, if a bit dry. Hamstring Bridges, Single leg glute bridges, calve raises and standing toe taps are all great ways to switch it on. Your manual therapist will be able to help you with all the pointers above.
Whilst this all gives you a strong foundation to build from. It’s still common to get niggles and aches along the way. This is to be expected. However we should be aware of any niggles that aren’t resolved within a couple of days, or they are a new pain you haven’t felt before - especially if it’s a sharp shooting pain or it’s stopping you from training or even weight bearing. Altered movement patterns to avoid pain can compromise your training further. Try not to let them snowball - those training runs are only going to get longer!!
The Run
Race day. You’ve finally made it. The excitement and nerves have your body in high alert, even before we add in the electric energy of the other participants. The very nature of the beast means that runners push themselves that bit harder during the race. Use the race day energy to keep you focused rather than let it carry you away. Stick to your plan. You’re likely to be running in a new course and environment. Injuries can happen.
Sometimes, it’s clear that something isn't right during the race. However, the temptation to grind out the last few miles of a marathon, despite having to drag one leg behind you can often be overwhelming, and in that instant feels like the more appealing option rather than stopping after all the training to get you across the finish line. But try to listen to your body. Now it might not be that bad, but continuing to run on a leg or lower back that just doesn't feel right, and / or is giving you sharp shooting pain, will most likely lead to a considerably increased recovery time. If this is you, then it will be worth seeing an Osteopath or Physiotherapist as soon as possible to get things checked out further.
Recovery: Post-run care
Let's assume that you have made it to the finish line in one piece. Your body will be under a lot of physical and metabolic stress and its resources will be running low. Immediately after - eat a carb-rich snack / drink. Within a couple of hours - eat a nutritious / balanced meal or carbs, veg and protein. Stay well hydrated.
Now, whilst it might be the last thing that you want to do after a marathon, and instead of those long static stretches, keep the body moving for about 10-15 mins, or until your heart rate has returned to normal. By the time you have stopped moving your body will already be starting to recover - healing the microtrauma to the bones, muscles and other connective tissues. Any steps you can take to enhance this natural process will be beneficial; some suggest taking a nap shortly after the race to promote healing, or avoiding alcohol which inhibits protein synthesis - slows muscle repair.
As the body cools down, aches, pains and any minor injuries that occurred during the marathon will start to come to the surface. So, in the immediate aftermath of the marathon avoid static stretches or deep tissue massages which could exacerbate anything going that you’re not aware of yet. Achy bits and delayed onset muscle soreness is to be expected at this point and will resolve after the next few days. From 3 days to a week after the marathon your body will be rested enough to return to gentle exercise and to finally get that massage or take time on your foam roller getting into all the tight bits.
By 2 weeks post race any new pains that are still hanging around and are new would be worth getting checked out by an Osteopath or Physiotherapist. Without proper rehabilitation sporting injuries can often get worse over time and reduce future performance.
