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Tips to Avoid Injury While Training for a Marathon

April 26, 2021

As the warm weather hits here in Duluth, runners throughout the area have one thing on their minds. The approaching Grandma’s Marathon. Whether competing against others or against yourself, the importance of safely training for race day is something everyone should be taking into consideration.

We talked to a few of our physical therapists about their training tips to avoid injury before and after running a marathon. Not making your way to the start line? Don’t worry. Following these tips can be beneficial for even casual runners.


Our physical therapist team recommends dynamic stretching both before and after a run. These stretches are controlled movements that prepare and warm-up your body for performance. This helps with mobility, which is important for good running form. Static stretching, where you hold a single position for a period of time, can be beneficial after a run to increase flexibility and range of motion.

Strengthening exercises like core and hip movements can also be highly beneficial to complete after a run. Specific muscle strengthening is important in order to maintain good running form and to prevent injuries.

Different Types of Workouts while Training

Following a training program that incorporates a variety of intensities and distances is critical to improve cardiovascular fitness. Typically, a week should include at least one threshold workout, an intensity workout, and a long run at a lower heart rate.

Cross training and other endurance activities including biking, swimming, or skiing, between runs can help to prevent injuries.

While it is important to put in the miles while training for a marathon, strength training is also essential to avoid injury and improve performance. Plan to include core, hip, and single leg strengthening exercises, as well as working in different planes. For instance, use movements within the lateral and transverse planes instead of only the sagittal plane. 

Doing bended and straight knee calf raises can also prevent calf strain, which effects almost every runner.

Universal Practices to Stay out of the PT’s Office

Most of the running injuries our therapists see are due to training error. Doing too much too soon can lead to injury, so progressions needs to be gradual. We recommend duration increases of 10% per week. Intensity can be safely increased at a rate of 3% per week.

When transitioning to different surfaces, for example from a treadmill to the road, it is important to keep your duration and intensity light for the first few runs since different muscles may be used depending on the terrain.

Make sure to keep hydration and fuel in mind. Eat about 40-60g of carbohydrates per hour during training and replenishing with at least 25g of protein and carbs after. Sleep can also be equally as important.

When to know you should see a Physical Therapist

If you feel any pain, monitor it over 24 hours. If the pain rates a 3 or 4 out of 10 during a run but goes back to a 0/10 within 24 hours, it is safe to continue running. If the pain gets worse during a run or over the next day, take a break from running for a few days. If the pain is from a tendon or muscle issue, try not to take more than a few days off. Otherwise you go into a pain – rest – weakness spiral. Tendons and muscles recover better with appropriate movement.

If you are having difficulty increasing weekly mileage due to pain, or symptoms persist after taking a few days off, then it is time to see a running specialist.

Good Tips for Marathon Day

Remember to be well hydrated and fueled by simple, easily digestible carbs before the race even starts (about 3 hours beforehand). Eat/refuel earlier in the marathon than you might think. If you allow yourself to go too far before consuming glucose, it may be difficult or impossible to catch back up to the fuel intake your body needs.

Also, remember to pace yourself! Don’t start out of the gate too fast or hard. Adrenaline will kick in when the race starts, but this jittery start will not be sustainable miles down the course.

Orthopaedic Associates Resources

Orthopaedic Associates of Duluth offers complete comprehensive running evaluations, which include a formal physical therapy evaluation and a running form assessment.

While training for any race - let alone a marathon - can be overwhelming, these tips should ease your mind and provide value to your running training program. Happy running!