Common Marathon Injuries and how to prevent them

27 September, 2019

We are well aware that marathon season is in full swing. You have been training for months (or not) and are getting ready to take on this gargantuan challenge that lays before you. 26.22 miles of pure mental and physical endurance, with family and friend’s adulation waiting for you at the finishing line. Do not let marathon injuries hamper your efforts or the hours of training you have put in.

To help marathon runners stay healthy before the event, and also during the event, we have put together a series of articles each day this week, listing 26 of the most common marathon injuries (one for each mile) and how best to deal with them.


Blisters are one of the most common injuries for runners. Blisters are a collection of fluid, usually under the upper layers of skin, which forms after the area has been damaged. When you run blisters can form from too much friction between your feet and shoes. They can be extremely painful and could set your training regime back a few days or hamper you on marathon day.

Therefore it is important to wear-in your trainers before the big day, to ensure they have moulded more to your feet and the fit is more appropriate. If you suffer from blisters regularly and have specific problem areas then you should put plasters over these to give added protection, or use a lubricant barrier like petroleum jelly. If you unfortunately do get a blister, they will heal in 3 to 7 days and should not be popped if it can be helped. If they do pop, let the fluid drain away and cover it with a sterile dressing to stop infection.

Shin Splints

Shin splints can be extremely painful and usually occurs during/ after exercise. The pain occurs in the lower legs and develops through repeatedly putting weight on your legs (such as running or basketball). As you will be training hard (or not) you may suffer from this condition from time to time. It is important that if you do develop shin splints, the only way to get rid of them is rest. You can also ice your shins to reduce inflammation, and take pain relief.

You can still exercise when having shin splints, but it should be low-impact such as swimming or cycling. Before the marathon should have at least a few days off from training so your body is fully repaired and will be at a lesser risk of injuries such as shin splints.


Sprains occur when one or more ligaments are stretched further than their means. They can be extremely painful and can leave you unable to put any weight on it. The joints most affected by sprains are knees, ankles and wrists and could hamper your ability to finish a marathon. To best guard against sprains, you should always wear the correct footwear for running, warm up and cool down when doing exercise and to do regular strengthening exercises of joints to improve durability.

If you suffer a sprain you should use the RICE technique to treat it. You should Rest it, Ice it, Compress it (bandage) and then elevate it. Hopefully, you don’t suffer one in the actual marathon itself as it can mean your exit from the race. 


Fractures occur when a bone in the human body partially or totally breaks as a result of an injury. While running, you are in danger of breaking a bone if you fall over or run into something. While running you should always be aware of what’s around you as there could be a lot of congestion during the marathon and could lead to you tripping and injuring yourself. If you do suffer a fracture, then that will almost certainly be your marathon over, and no one wants that.

If you do suffer a fracture, you should always go to the hospital to see the extent of the damage and then they will advise you on the best course of action to heal the bone properly. This could range from just resting it and having it in a removable boot, to having to have surgery on it to repair the break.

Sore nipples

Sore nipples are a common injury for marathon runners. This can occur when there is friction from the t-shirt and the nipple. Although it doesn’t sound bad, if you are running for a couple of hours and your t-shirt is constantly rubbing against your nipple, it can become extremely painful at the end. This will not end your race but can ruin the rest of the day/week after your run.

To prevent nipple chafing it is common practice to apply Vaseline to lubricate the nipples or where protective plasters over the nipples. There are special Nipple Guards out there to help counteract this injury. If you end up getting sore nipples, then you should apply ointment to help the healing process.

Chafing thighs

Chafing thighs occur when your inner thighs rub together or rub against clothing which can cause increasing pain and discomfort while running. It can cause blisters or tiny tears in the skin because of the friction, however, there are ways to help prevent this while running.

Firstly, you shouldn’t wear cotton shorts as they can soak up water, causing a lot of friction. Synthetic materials are much better for running in. Compression shorts can help as well, providing a tight fit so your skin can’t rub on anything. Finally, that trusty lubricant can help your legs glide when you run and help abate any friction between your thighs.

If you do end up getting thighs that are red raw, you should take a lukewarm shower as soon as possible after your run. Then you should pat the area dry and apply ointment to the affected area.

Joint pain

Joint pain can become a problem, especially when you are running a lot more than you may usually do. The knees are the most common joint to get pain in as they have to take the majority of your body weight. When pain occurs it usually is because the joint has become inflamed and can make it difficult to run.

To avoid getting joint pain you should always be careful not to over exert yourself and give yourself an adequate amount of rest time. However, the risk of joint pain will always be there, when you are running regularly. If the joint does become painful you do have a few options on how to treat it.

If the joint seems inflamed you can use a cold compress to soothe the pain. Heat therapy can also be used, as this can widen the blood vessels and improve circulation to the joint, which can ease pain. Also, medication such as paracetamol or ibuprofen can help keep pain to a minimum. Rest will also help.

Achilles injury

The most common form of Achilles injury is Achilles Tendonitis. This is caused by the Achilles (the tendon connecting the two calf muscles to the heel) being overworked due to a tight calf muscle. This can happen for multiple reasons. Common causes include not stretching the calf muscle out enough before exercise, running too far too soon, overworking the calf and wearing inappropriate shoes that force the Achilles to twist.

To prevent Achilles Tendonitis, it is good practice to constantly stretch and strengthen your leg muscles to give them more flexibility which will reduce your chance of getting injured. However, if you do end up injuring your Achilles, you should stop running immediately as this could exacerbate the problem. You should take pain killers, if required, for the pain and ice the area every day for around 20 minutes until the inflammation goes away. You shouldn’t start running on it until you can do toe raises without any pain.


While exercising your body uses a lot more water in the form of perspiration to cool your body down. This can increase your chances of becoming dehydrated if your water intake is not adjusted appropriately. Symptoms of dehydration you should look out for include thirstiness, feeling lightheaded, dry mouth, feeling tired and infrequent, dark, strong smelling urine.

This is even more important for a runner as severe dehydration can drastically affect your performance during the marathon and also will have adverse effects to your health. Runners must always ensure they are sufficiently hydrated and if you feel any of the symptoms mentioned above, you should take on more fluids. If you are fully hydrated, you will maximise your performance and ensure you stay healthy throughout out your marathon training and the big day.

Nutritional imbalance

As well as keeping well hydrated, it is extremely important for runners to be eating the right foods, to ensure they have the fuel to carry out their arduous training regime and perform on the day. Ensuring your body is at its strongest not only improves your performance but also reduces your risk of damaging your body.

Ensuring you have enough vitamins & minerals can help strengthen multiple areas of your body including skin, bones, muscles and the immune system. Putting the right food in your body will get the right results during training and the marathon. Ensure you look up what foods might best help you strengthen areas of your body that need it.

Cuts & grazes

Cuts & grazes are always going to be a problem for a runner. Falling over is part of repeatedly running until you can’t feel your legs. They are usually not serious but can be extremely painful during and after a run.

To help protect against them you want to ensure you are wearing appropriate trainers to help best keep your balance while running and also you do not want to over exert yourself, especially while training. Over exertion will increase your chances falling over and getting cuts and grazes as you may not be in full control of your body at times. If you do fall over and get a cut or a graze, you should stop the bleeding first, then clean it thoroughly and apply a dressing to protect it against infection. Minor cuts and grazes should only last for a few days.

Muscle injuries

Muscle injuries can come in many different forms, but the most common in runners are muscle strains and tears. Muscle strains are less serious than tears, as muscles tears can stop your marathon dream dead in its tracks. However, muscle strains can also hamper your training or marathon race and can be extremely painful.

Strains and tears occur when the muscle fibres are stretched beyond their limits or contract too quickly. This sort of injury is most common in the hamstrings and lower back and symptoms include swelling, bruising, pain, muscle spasms and weakness in that area.

To help guard against strains and tears, don’t over work your body and if you feel a slight pain or strain, rest it before it becomes worse. Rest, Ice, Compression and Elevation should be applied to any strain you may have to help the healing process.


Leg cramps can cause intense pain as your muscle tightens excessively and stays tight for a period of time. Cramps can be common when you exercise excessively, and the most common muscle to cramp is the calf. It will stop you from running and can be tender for several hours afterwards, so be careful if you mean to carry on exercising that day.

To best avoid getting cramp you should always rest after a long run and ensure you have enough salt, an essential electrolyte, as sodium deficiency can be a cause of muscle cramps. If you do get cramp, try to stretch out your muscles as often as possible to help ensure you get them less frequently.


A side stitch usually occurs after intensive exercises and is characterised as a muscle spasm of the diaphragm. They are extremely common in runners and come in the form of sharp pain, affecting your ability to run. To help keep stitches away, strengthening your core is always a good place to start, such as doing planks for 10 minutes a day.

When you fuel your body, it can affect if you get a stitch while running or not. You want to ensure you don’t run after eating, as not enough blood fill be flowing to your muscles and increase your risk of getting a stitch. Warming up your body will get your ready for running and reduce your risk of getting a stitch, also breathing deeper can help.

Black Toenail

You can get bruises anywhere on your body, but a common problem for athletes is bruising of the toe. The most common cause of a black toenail is constant rubbing and knocking on the toe by the top of the shoe.

This can be painful as the bruise is caused by damage to the toe and blood collecting under the toenail. However the pain doesn’t last for long, but the black toenail will take a while to go away. To help reduce your chances of getting a black toenail, make sure your nails are clipped short, and wear shoes with a lot of room for the big toe so it doesn’t get knocked.

Don’t forget to come back tomorrow for part 4 of your common marathon injuries and how to treat them.


A Bunion is a deformity of the bone, located around the joint of the big toe. The main signs that you may have a bunion include a swollen bony lump on the outside of your foot, pain at the big toe joint made worse by wearing shoes, tender skin over the bunion and shape changes in your feet.

Bunions are thought to be genetic, but wearing poorly fitted shoes can exacerbate them. Finding comfortable shoes that fit properly and give the toes space to move will help reduce the risk of you getting bunions. If you do have one and are still running and doing a marathon, you can get symptom control products such as pain killers and bunion pads to help make them less painful.


Corns are small circles of callused skin that commonly occur on the toes or sole of the foot. They occur when you wear poorly fitting shoes which allows your feet to move too much and rub. Also, people who have more bony feet are more susceptible to getting corns as there is less flesh to cushion the foot against the shoe.

To prevent corns from occurring ensure feet are dried properly and apply foot cream. A pumice stone can help to gently remove tough dry skin and most importantly get comfortable footwear that fits your feet well.

Corns will not get better unless the source of the friction/ pressure is removed. Continuing running with the same ill-fitting shoes can cause the skin to get thicker and more painful. You should seek advice from a podiatrist on how to best treat the corn.


When training for a marathon, or running the actual thing, fatigue or exhaustion can occur through training hard or even overtraining. Some people will give it all in training and the marathon and push their body to the limits and this can lead you feeling sore and lacking energy.

Exhaustion can be prevented by not trying to do too much too soon. Build yourself up to running longer distances and ensure you are eating the right foods to replenish your energy stores so you are less likely to be running on empty. If you still suffer from extreme fatigue or exhaustion after trying to do this, you should consult a medical professional to ensure there isn’t an underlying condition.

Breathlessness and wheezing

When you’re running, your body pumps blood round the body at a higher rate, trying to get more oxygen to your muscles. Breathlessness is a common condition for runners as breathing rates increase with exercise intensity to get more oxygen into the body to meet its demands and to get rid of the carbon dioxide building up in the body.

Fatigue of the respiratory muscles can often cause breathlessness. Much like your skeletal muscles respiratory muscles such as the diaphragm needs training to be able to cope with the demand of extensive runs. If you go too hard too early you are more likely to get out of breath easily.


Runner’s trots or Diarrhoea can be a common condition in most athletes, especially runners. While you’re running, blood is being taken from the intestine and other areas of the body and used for your muscles. On top of this, the motion of running and hormonal changes in the intestine while running can increase the speed in which waste goes through the body and affects the absorption of liquid. All this increases the chances of runners suffering from urgent pit stops.

Common triggers for more urgent bowel movements can include Sorbitol (found in things such as sugar-free gum), Hot drinks (tea & coffee), the over consumption of fibre, fatty foods, spicy foods alcohol and too much vitamin C. If you try and limit your intake of these it should help, however there is no guarantee you won’t need to urgently use the toilet during the race.

Pop by tomorrow for the fifth and final entry in our common marathon injuries series.

The Wall

Often thought to occur at around mile 18 of a marathon, The Wall is a mental condition that will affect most runners over their running careers. It can come at any time of the race and is where your body begins to become weak and negative thoughts flood your mind, making you want to give up. It can be disastrous to your marathon run and some people struggle to get past “The Wall”.

To best prepare for the wall and overcome it, you should ensure you have eaten right and taken on enough fluids before and during a run. Having liquid and high energy foods on you during a run can help you get past fatigue and carry on your run.

Also to help with your mental state, it is recommended that you try and take your mind off the race for a while, instead try and concentrate on something. Maybe what you want for dinner that night or count things such as lampposts that might be in the immediate vicinity. And if the organisers permit headphones, listening to music can help.


A hernia is where something inside your body pokes through a hole in the muscle/ tissue wall. They can occur anywhere between the chest and hip and are usually the result of overworking the abdomen and become more prevalent with age.

To help prevent you getting hernias it is good practice to gradually strengthen your core muscles and not to over strain yourself. Your body needs to get used to running long distances gradually to build up the strength to go further. If you respect your body, you will have a much smaller chance of getting an injury, including hernias.


Runners vomiting during or after a race is a common sight at races. There are a few reasons as to why this might happen, and how you can combat against this. As blood is redirected to the essential muscles that are being exercised, the digestive system will find it harder to digest nutrients as easily. This increases the likelihood of you being sick because of running. If you over eat during or shortly after the race, this will increase the chances even more of you vomiting as the body can’t handle it.

Also stopping too quickly can bring on a vomiting episode. The digestive system is just getting used to the exertion your body is going through and can’t handle the sudden stop in exercises and evacuates your stomach. This is similar to someone being sick after a rollercoaster ride. Make sure you carry on jogging after and gradually bring your body back to normal.


Dizziness in runners after a race is quite a common condition and is often attributed to low blood pressure. When you stop exercising after you cross the finish line, your blood pressure will drop as without the movement of your muscles blood struggles to return to the heart at the same rate the heart is pumping to the muscles. This on top of the sweating means there is a lower volume of blood than usual, being pumped round the body which can cause dizziness.

It is recommended that you carry on moving after crossing the finish line to help keep your blood pressure up and return your body to normal functions.

Heat stroke and Sunburn

A big factor that people sometimes forget to consider is the Sun. Whether the sun is out for all to see or hiding behind some clouds it is important to prepare for it. The Sun’s rays can still penetrate clouds and when you are out running for a long time, you can get burnt or even get heat stroke.

You should always be wearing sun cream to protect against the UV rays as they can make your body a lot sorer the next day. Also, it is important to take on adequate fluids during the race as on a hotter day you are going to sweat more and this needs to be replaced. If it’s not, your body may find it difficult to regulate your temperature and cause heat stroke.

Heart attack

When you exercise you will undoubtedly put stress on your heart. Exercising helps heart health, but at the same time during exercise, it does increase your chance of a heart attack because of the added pressure.

The best thing you can do is ensure you are eating healthy and keeping your heart happy. Do not over exert yourself, and if you have chest pains while running you should stop and seek help. Runners World looked at a few surveys of marathons and found that there have been 8 deaths among 712,000 runners. This equates to 1 death in 89,000. So it is an unlikely occurrence but it is best to keep your heart as healthy as possible if you are planning on doing a marathon.

If you are doing any sort of running event in the near future, everyone here at Ashtons would like to wish you the very best of luck, and hopefully, you won’t suffer too much from any of these injuries and conditions.