By Wendy Winn PT, OCS
Marathon season is accompanied by one constant question: “Is this normal?”
Pain: no. Discomfort: yes. Taper crazies: yes. Losing your period: no.
But what happens when “normal” gets confused for “common”? Red flags get dismissed, potentially dangerous behavior gets repeated (sometimes encouraged), and small problems get blown out of proportion. While the injuries listed below are common, that does not mean they should be brushed off. If you recognize the warning signs, talk to a PT as soon as possible.
Based on Custom Performance’s 10-year history, here are the three most common injuries we see during Marathon Season:
Stress Fractures
Definition: Tiny cracks in the bone that can lead to anything from bone swelling to a full break
Typical Causes: The truth is all bones are under stress when running, so we can think of boney stress as somewhat normal, until excessive stress is applied to it (overtraining.) Bones break down while running and without enough rest in between stresses, are not able to recover.
Go Deeper: Not enough energy intake and too much energy output forces the body to redirect any available resources to vital organs and muscles. As such, the skeletal, cardiovascular, reproductive, gastrointestinal and endocrine systems can suffer. This leads to a host of symptoms commonly associated with RED-S (Relative energy deficiency in sport). Read more about what causes stress fractures, here.
Warning Signs: Persistent pain; Worsening pain at night; Inability to hop on the affected limb; Previous history of a stress fracture.
See A Doctor If: You have a nagging pain in your hip, lower leg, foot, or quadricep after 1-2 runs. If rest is not helping this pain subside, it’s time to make an appointment to see a doctor.
Stress fractures are extremely serious and need to be treated immediately to avoid bone fractures.
Posterior Tibial Tendonitis
Definition: An overuse injury of the posterior tibialis muscle and tendon, which runs inside and under your calf. This will cause pain along the shin, ankle, or foot.
Typical Causes: Weakness in other muscles such as the glutes and calf muscles. Because it crosses the ankle to the foot, it is particularly susceptible to overuse with being on your feet and the impact of running. Beyond muscle weaknesses, this injury is frequently caused by worn out shoes.
Warning Signs: Persistent pain along the inside of your calf
See A Doctor If: After 1-2 runs and stretching your calves, you still have pain along the inside of your shin and/or ankle. Your training plan will need to be modified to help this pain subside.
Iliotibial Band Syndrome
Definition: Tightness and pain at the outside of your knee, with potential for tightness along the hip and thigh.
Typical Causes: Too much running too soon, not enough strength work for glutes and core, sitting prolonged after a run without stretching or foam rolling, jumping right back into a training program after taking “time off.”
Go Deeper: The Iliotibial band runs from your hip to your knee and is a soft tissue structure that tightens with overuse. It “overworks” to provide stability to your legs when your core and glutes do not provide enough muscular strength or endurance for long periods of running
Warning Signs: Sharp pain and the side of the knee
See A Doctor If: You have a sharp pain on the side of your knee that a) flares up every time you go down the stairs and/or b) will not subside with normal rest.
This list is not an exhaustive list of all possible injuries during marathon training, but a snapshot of what we see the most. If you’re experiencing lingering pain, it is likely that you still need Physical Therapy. Our general rule is: make an appointment if your pain persists past stretching and foam rolling.
If you have questions about your specific situation, schedule a no-cost appointment to chat with our PTs.