It is said that the marathon was originally introduced as a tribute to the distance travelled by the Greek soldier Pheidippides, to notify Athens of victory against the Persians in 490BC.
A marathon is a race of 42.195 kilometres (26.219 miles) in distance. It rose to prominence as an olympic sport in 1896 and has continued to grow in popularity. There are currently more than 800 marathons that are held throughout the world each year and usually involve running on hard flat concrete surfaces.
Many of the injuries caused by marathon-training are related to the distance, the surface we run on and aiming for the fastest time possible. These factors can lead to a build-up of tissue stress.
The common injuries experienced by marathon runners that we see in our practice include:
- Iliotibial band syndrome
- Patellofemoral knee syndrome
- Calf and Achilles pain
- Heel pain
- Medial tibial stress syndrome (commonly known as shin splints)
- Plantar plate tears
- Plantar fasciitis
- Stress fracture of the metatarsals
All of the above injuries can be treated or prevented to some extent with sensible measures.
Time: Make time for sufficient warming up and stretching exercises. We strongly advise first time marathon runners to prepare and gradually increase the training distance leading up to the event – Do not do too much too soon. This allows runners to address small things such as the importance of using good socks to prevent blister points, and building lower limb muscle strength. If symptoms arise during training, specialist intervention can be sought.
Footwear: Another important consideration prior to running a marathon is the use of well made and comfortable running trainers. Trainers are more or less designed to support the foot and aid in shock absorption. In general, a running shoe has approximately 250-500 miles of life span before they lose their shock absorbency. We would strongly advise runners to visit a shoe shop where experienced technicians can help select the right trainer.
One should not ignore symptoms if they arise and it is recommended that the runner seeks professional help. As a clinic we perform a thorough assessment of the musculoskeletal system and analyse gait, where we aim to identify abnormalities that may give rise to symptoms or problems. We may order medical imaging to help diagnose or exclude potential pathologies.
A video gait analysis is used to assess the health and effectiveness of the musculoskeletal system.
Treatment will often involve some or all of the following:
- Using Orthotics to reduce stress loads and treat symptoms
- Extensive physiotherapy such as stretching and strengthening
- Footwear advice
- Injection therapy
The most important advice to bare in mind is: Don’t run through pain, as it can cause long-term damage.
By Mr Amir Saipoor & Mr Steven Thomas