Marathon Injury

Congratulations you have completed the London Marathon 2019, your training paid off and your donations are submitted. The hard work is done and your sore legs, black toenails, and blisters (if you’re lucky) are a physical reminder of those 26.2 very long miles.

Some were not so lucky…

What constitutes most casualties during the marathon, are made up of dehydration, nausea and breathing, many competitors fail to report musculoskeletal complaints until stepping over the finish line. This is thought to be due to swelling, heat, determination and adrenaline spurring us on without realising we are injured.

In fact in 2014 a runner completed the London Marathon despite running 18 miles with a broken bone in his foot! More recently Angus Cameron, 45, broke his leg just metres from the finish line. Describing the feeling as a “pop” and assuming he had pulled something.

The vast majority of lower body injuries are due to poor foot function which occurs during training… But, it’s now too late to worry about what you may have done wrong, instead we have to address the injury, how we can recover, repair and rebuild for the next big challenge!

Marathon injury – most common

Knee injuries

AKP (Anterior knee pain) is a name to describe a range of injuries/conditions which affect the front of the knee. These injuries are commonly diagnosed as “overuse” injuries.

Patellar Tendinopathy (Aka ‘Tendinitis’)

Patellar tendinopathy is an injury to the tendon which connects your knee cap to your shin bone.
It is described as a sharp pain under the kneecap. The pain will become more intense during or after activity and eventually affect day to day life.

If left untreated it can become more painful and difficult to resolve.
It is important to get help from your physio as well as caring for your injury at home.

Home help advice – Ice packs and rest for at least twenty minutes, preferably two or three times per day for the first 2-3 days. Avoid activities which cause more pain, working through pain of this kind only makes the condition worsen. Gentle, steady quad stretching can help reduce muscle spasm, but avoid bouncing when performing your stretch. As soon as you feel able, return to gentle strengthening exercises for the quadriceps as making the leg stronger will help to resolve the tendon pain.

Hip bursitis – Inflammation of the bursa

Bursae are fluid-filled sacs that act as a cushion between bones and tendons.
Sometimes inflammation of the bursa can either be a knock on effect of glut medius tendinopathy or be mistaken for it.

Home help advice –
As with glut medius Tendinopathy, ice packs should be applied for at least twenty minutes, preferably two or three times per day along with elevated rest and then return to graded strengthening as soon as pain allows. Avoid activities which cause more pain, working through pain of this kind only makes the condition worsen.

For those who continually suffer from inflammation of the bursa, steroids can be injected into the area to block prostaglandin (the body’s natural activation of the inflammatory response).

Iliotibial Band dysfunction (also known as: IT band syndrome, ITB syndrome, or ITBS)

The Iliotibial Band runs from the outside of your hip to the outside of the knee and injury occurs when the IT band is tight or inflamed. This causes pain on the outside of the knee which many describe as a clicking sensation at the start of any run.
If ITB is ignored it can become chronic, and the band thickens making it harder to combat.

Home help advice – Stretching the ITB by bringing your heel up to your bum. This can be held for longer if you are lying down. You need to do this as often as you can throughout the day, avoiding bouncing or overstretching.

Marathon injury - A female wearing black gym shorts and top with trainers on, holding her right leg up behind her with her right hand. Stood against a white background.

Avoid running, however when you feel it’s the right time to start back, try bending your knee more and adjust your gait.

A physiotherapist may also help evaluate the problem and look at muscle strength and balance and/or flexibility.

A sports massage is also highly recommended, this will help loosen the ITB.

Steroid injections can provide pain relief, and can help your recovery time.

Shin splints and stress fractures

Pain in the lower leg can be associated with mid tibial stress syndrome (Aka shin splints) this can potentially become stress fractures.

Often mistaken for one another, shin splints are thought to be an irritation of the lining of the bone where the muscles attach whereas a stress fracture is a tiny fracture which if ignored when running can turn to a full fracture. Just like our friend Angus Cameron, it can be mistaken for shin splints and lead to serious consequences.
Stress fractures occur after prolonged and repetitive stress on the bone, whereas shin splints come on as soon as you start your exercise!

Home help advice – Unfortunately stress fractures can take some time to heel. Rest is recommended 6 – 8 weeks after diagnosis. This means feet up, ice and compression!
Shin splints can also take some time to heel although most patients report a quick recovery (2-3 weeks).

Both shin splints and fractures can be avoided by visiting your physio. They will be able to help you with your running style and strengthen any weak muscles which support your lower leg.

If you have an injury from running this year’s marathon OR you want to improve your running style for next year’s marathon then get in touch with our experienced team.

Our highly specialised ultrasound guided injection clinic provides fast and easy access to pain relieving injections for a range of musculoskeletal pain disorders such as shoulder pain, frozen shoulder, Plantar Fasciitis, De Quervain’s tenosynovitis and Carpal Tunnel Syndrome.

Our diagnostic sonography can confirm diagnosis and provide highly specialised patient care.

We work alongside Complete Physio who are vastly experienced to treat a very broad range of conditions and provide a running clinic which aims to help you achieve your ‘running potential’ by working with you to become a stronger, faster and more resilient runner.