Marathon training can be a challenging experience for runners as it can be gruelling and comes with its set of risks, especially to bone and soft tissue structures of the lower limbs. Bone or tissue injuries tend to be due to repetitive trauma as a result of overtraining or inadequate periods of rest but with New Year 2024 around the corner and several marathons slated ahead, we got you sorted with some heads up on common injuries to look out for during marathon training, tips to handle these injuries, when to seek medical attention and preventive measures to avoid them.

Common Running Injuries:

In an interview with HT Lifestyle, Dr Sanesh Tuteja, Consultant-Arthroscopy and Sports Medicine at Fortis Hospital in Mulund, revealed the common running injuries to be -

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• PATELLOFEMORAL PAIN SYNDROME A.K.A RUNNER'S KNEE: This is the most commonly encountered injury among marathon runners and is characterised by knee pain that arises from irritation of the cartilage under the kneecap. It is triggered by repetitive bending and straightening of the knee during running. Symptoms include pain, clicking, and catching sensation in the knee.
• TIBIAL STRESS SYNDROME “SHIN SPLINTS”: This is caused by the inflammation of the outermost layer of the bone (Periostitis) of the Tibia (shin bone). It presents as a dull ache over the shin, that worsens with ankle movements and weight bearing.
• ACHILLES TENDINITIS: Occurs due to the inflammation of the Achilles tendon causing pain at the back of the heel.
• STRESS FRACTURES: Tiny cracks appear in the bone due to repetitive stress. These cracks propagate to a fracture if the body does not get adequate time to heal and this is particularly common among runners. They are more common in the lower extremities, particularly in the shin bones, Metatarsals (foot), and Pelvis. Symptoms include pain, swelling and difficulty in weight bearing on the affected area.
• PLANTAR FASCIITIS: This condition occurs due to inflammation of the plantar fascia, a thick band of soft tissue that supports the foot's arch. Inflammation occurs due to overuse. Risk factors include high BMI, tight calf muscles and endurance activities like running. It presents as pain in the heel or arch of the foot which is typically noticed on taking the first step in the morning.
• ILIOTIBIAL (IT) BAND SYNDROME: IT band syndrome is caused by inflammation of the Iliotibial band, a thick band of tissue that runs from the hip to the shin. It is characterised by pain on the outside of the knee

How to Handle the Injury

Dr Sanesh Tuteja advised -

1. Rest: Allow sufficient time for the body to heal.
2. Ice: Apply ice to reduce inflammation and ease pain. This can be done for up to 20-30 mins, every 2-3 hours.
3. Compression: Use compression bandages to reduce swelling and support the injured area.
4. Elevation: Elevate the affected limb above the level of the heart, it will reduce swelling.

When to See a Doctor?

Dr Sanesh Tuteja recommended that while minor injuries can often be self-treated, it is essential to consult a doctor if you experience the following -

• Pain is severe or persistent: Especially during or after rest
• Swelling or bruising: Indicates potential serious injury
• Inability to bear weight or move the injured area: Could indicate a serious injury to the bone or ligament
• Swelling, redness, or warmth around the injury: This could be a sign of infection in the joint that can sometimes occur secondary to a collection of blood or fluid in the joint
• Changes in gait or joint instability: May signify a more significant issue
• Pain interferes with daily activities: Hindering your ability to walk or perform routine tasks

Ways to Avoid Injury/Precautionary Measures:

Dr Sanesh Tuteja suggested -

1. Gradual Progression: Increase the intensity and duration of the training over time to allow the body to adapt and heal from the activities.
2. Proper Footwear: Invest in shoes that provide proper adequate support and cushioning. If you have a foot condition, check with your doctor to decide on the appropriate type of trainers for you.
3. Include Cross-Training: Low-impact activities like swimming help build endurance.
4. Strength Training: To Build target muscles and help you run longer.
5. Focus on nutrition and rehydration: Replacing fluid loss during training as well as an adequate amount of proteins to maximise gains.
6. Rest and Recovery: Allow adequate time for the body to recover between intense workouts and training sessions. Using cryotherapy/ ice baths to enhance recovery can be useful.

Dr Sanesh Tuteja concluded, “Marathon training is demanding on the body, and injuries are a common occurrence. It is important to possess the foresight to minimise the risk of injuries and enjoy success in the marathon. Remember, always listen to your body and prioritise your health and well-being throughout your training journey.”