What to do when injury beats you to the starting line
Anne Stein, M.S.
Sports & Fitness Journalist/Author
“If you address your injury promptly rather than letting it go, there’s a good chance that a week or two of rest, ice, gentle stretching and/or myofascial work will diminish your pain significantly. And in the end, says Lynch, that pre-race rest may be a blessing in disguise, especially for an overtrained runner.”
You’ve been preparing for months, building up mileage gradually. You’ve been strength training and stretching, and have figured out fueling strategies for race day. Your longest training run is done, and your taper has begun. It’s one to two weeks before marathon Sunday — then injury strikes.
It might be a lingering pain at the base of one knee, a persistent knot in your glutes, or a tight, achy Achilles tendon. Whatever the cause, the pain is beyond the minor tweaks you’ve tolerated throughout your marathon prep.
First: Don’t panic. Second, don’t ignore it. Third, don’t run through it. Fourth, there’s some good news: If you’ve been sticking to a good training plan, it’ll take two-and-a-half to three weeks to start losing your marathon fitness, and there’s a good chance you can recover and run your race.
Jimmy Lynch is a New York City coach and physical therapist based at Wharton Performance who trains a number of elite marathoners preparing for this year’s ING New York City Marathon. The key to dealing with injuries, he says, is to know your body well in order to nip the injury in the bud. “Don’t run through it and damage it more,” he warns.
The most common marathon training injuries Lynch sees close to race time are Iliotibial (IT) band syndrome, Achilles tendonitis, hamstring pain, and hip flexor pain.
“Most of the injuries come about because runners haven’t done enough strength work, they don’t have enough mileage under their belt before they increase their mileage, and/or they’ve done speed work when the body’s not yet prepared yet to do it.”
Lynch suggests seeing a doctor or medical expert right away to diagnose the injury, which is often overuse, tendonitis, and/or inflammation. If caught early, many injuries can be treated by stopping run training for at least a few days (until the pain subsides), along with ice massage and light stretching. Then start hot and cold contrast on the injured area – ice massage for a few minutes followed by a few minutes of a heating pad or hot towel on the same area, to stimulate fresh blood and oxygen flow to the injured spot.
Below is general advice from Lynch on common pre-marathon injuries and treatment. Visit your own healthcare professional to adequately address your injury.
- ITB syndrome/knee issues: Stop running for a few days and run in the pool to take stress off your joints and maintain fitness. Do gentle flexibility work and active, isolated stretching (stretch for one to two seconds, then release and repeat.) Lynch also likes myofascial release and ice massage to decrease inflammation.
- Achilles injuries: These are usually the result of increasing mileage too quickly, muscle overuse, and/or not stretching after long runs, which puts excessive tension on the Achilles via tight calf muscles. Lynch’s advice: Don’t run through it because you risk tearing the Achilles. Back off running, ice and stretch gently. Myofascial release can also be helpful.
- Hamstring issues: These are usually caused by tight glutes. Lots of people do speedwork, says Lynch, when they don’t have the base fitness to do it, causing hamstring inflammation. Avoid this problem ahead of time by having a proper strength training program, which includes the hamstrings. “Hamstring inflammation can last for months,” says Lynch. “You can ice it and take time off, but you really need to take three to four weeks off, strengthen the hamstring and ice and massage.”
- Hip flexor: Pain in this area is often a result of hip flexors that weren’t strong enough to handle long runs. Use ice massage to decrease inflammation in the hip flexor and stretch gently.
If you address your injury promptly rather than letting it go, there’s a good chance that a week or two of rest, ice, gentle stretching and/or myofascial work will diminish your pain significantly. And in the end, says Lynch, that pre-race rest may be a blessing in disguise, especially for an overtrained runner. It’ll provide a much-needed break from running and give you fresher legs for the race.
If you can’t recover in time to run, there’s no need to let training go to waste. Look for other marathons to enter at any of these great sites: