How Physiotherapy Can Help Get You Through Your Marathon Training

Completing all 26.2 miles (42km) of a full marathon is one of the toughest endurance tests around – the intensity of marathon training is well known, and many runners don’t make it to the finish line. The key to success usually lies in the training and body conditioning program.

Even if the marathon you intend to run is months away, it is a good idea to start training and preparing your body as well as possible in advance. The training itself is a stressful event for the whole body and whilst nobody can deny it is an incredible accomplishment and has a lot of positive health benefits, it also frequently causes injury.

Serious injuries are less common and fatalities even less so, however anybody with a pre-existing condition such as heart disease or diabetes should seek medical advice before considering running a marathon. Fortunately, more serious complications are less common – however there are a number of other troublesome injuries which can prevent a successful completion of a marathon.

Marathon physio

Common Complaints Associated with Long Distance Running

Runner’s Knee

Patellofemoral syndrome, or runner’s knee as it is more colloquially known, is usually an overuse injury; however individual running style and poor control of foot pronation can also contribute. Runner’s knee provokes anterior knee pain located beneath or behind the kneecap (patella). It is caused by contact between the posterior surface of the patella with the femur. This painful disorder can be overcome with rest, specific stretches and exercises provided by your physiotherapist, as well as ensuring the appropriate footwear is used.

Shin Splints

Shin splints is a blanket, all encapsulating term used to describe pain felt in the shins – it is frequently caused by overuse. It may be a result of medial tibial stress syndrome, which occurs when the muscles of the lower leg, persistently pull on the periosteum causing painful symptoms. Shin pain is usually the result of overuse or overloading, it may also be caused by poor muscle flexibility or excessive foot pronation. Rest, conditioning and sufficient stretching before and after training, physiotherapy and sports massage can help recover.

Stress Fractures

Long distance running exerts heavy demands on the skeleton and can in some cases, lead to stress fractures. These are small cracks which can occur in the weight bearing bones of the body such as the tibia, fibula, femur, metatarsals or navicular bones. Stress fractures can be extremely painful – pain is usually felt at the site of the fracture but may also affect nearby soft tissue, causing swelling and inflammation.

Achilles Tendinitis

An overuse injury of the Achilles tendon – a band of tendon tissue which connects the calf muscles at the back of the lower leg to the heel bone. It is a common complaint amongst athletes whose training involves running or jumping and is especially common during marathon training. Achilles tendonitis is usually caused by overuse, tight calf muscles and inadequate footwear may also contribute to the problems. This disorder can be treated initially with rest and ice or heat packs, physiotherapy is highly beneficial to this disorder, as calf strength and flexibility is essential.

Plantar Fasciitis

Inflammation of the plantar fascia – a band of tissue which connects the heel bone to the toes and supports the arch of the foot, it is usually a result of overuse, and is one of the most common causes of heel pain. It is often associated with high arched or flat feet and can be exacerbated by unsuitable footwear. Specific strengthening and stretching exercises provided by a physiotherapist can be very helpful.

Muscle Injuries

Strains are tears in the muscles and are commonly cited injuries, occurring when the muscle fibres are overloaded and stretched or worked beyond their limits. Muscular strains and injuries commonly occur in the hamstrings, lower leg muscles and lower back causing great discomfort. A physiotherapy program can help to condition affected muscles.

Ankle Sprains

The impact of running on pavements for long distances can have a negative effect on the weight bearing joints – the ankles, knees and hips. Ankle pain can be a result of a number of things including, muscle overload, unsupportive footwear, Achilles Tendinitis or an inversion sprain. Sprains and other issues can be avoided by practising correct running form as well as regular strengthening and stretching exercises. Sprains in particular are extremely painful and are likely to improve much quicker with the help of a professional.

Blisters, Corns and Bunions

Although blisters, corns and bunions are generally considered to be only minor problems, they can cause acute discomfort during a long-distance run, seriously hindering performance on the actual day.


Runners suffering from extreme fatigue are more prone to injury as their muscles are not able to stabilise as well, putting additional pressure on the joints.

How Physiotherapy Can Help

Professional athletes have a whole team of people, dedicated to helping them succeed including not only their coach, but also physiotherapists, massage therapists, nutritionists, doctors and sports psychologists. While the average marathon participant won’t be in a position to hire such an entourage, a well-qualified physiotherapist can be invaluable to their overall performance, helping them get through the tough training program, providing an individualised program of specific stretches and strengthening exercises. This will improve the tissue’s ability to handle excessive loads and improve performance while reducing any potential problems.

A thorough physical analysis of your body and running gait will help identify potential problems such as poor foot pronation, poor running style, weak muscles, joint related problems, areas of poor flexibility and overall posture. A specific program targeting any weak points will help improve strength, endurance and flexibility, leading to improved performance and a reduction in potential injuries.

A tailored bespoke program should not only analyse your training regime, but also take into consideration your day to day routine, diet and lifestyle – some of those training for the marathon may be physically fit but suffering from postural issues resulting from their daily routine – sitting at a desk all day for example. This can in turn lead to issues during long distance running such as a stiff neck or shoulders.

The Benefits of a Sports Massage

A necessity rather than a luxury, during marathon training, regular sports massage should be an integrated part of the training program.

Sports massage therapy has numerous physical as well as psychological benefits:

How We Can Help

ProPhysiotherapy offers experienced sports clinicians, specialising in physiotherapy, massage therapy, podiatry, nutrition, personal training and more. Allow a team of professionals help you get into optimum form for your upcoming marathon.

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