Running a marathon is an attractive challenge for most runners. Whether it is to cover the distance or achieve a particular time goal, the physical demands of a marathon must not be underestimated. Many athletes get injured or pick up small niggles in the final 12 weeks before a marathon race when the training volume and intensity is at its most severe. Athletes are simply trying to do that high volume training with poor running mechanics.

Running is a skill in itself and one that is seldom learned or practised. It is when we place greater demands on our bodies that our unlearned running styles begin to cause problems.

Your body is an important piece of equipment. When you take your bike out of the shed and decide to go for a long ride you would first check the tyres, the chain and the frame. If the tyres are flat, you pump them up. If there are loose nuts and bolts you tighten them up, otherwise, your bike in its poor mechanical condition will likely break down somewhere along the journey. Should we not be equally as prepared when we take our bodies out for long runs?
Strengthening your hip muscles, ankle and knee joints are similar to pumping up the tires and tightening the nuts and bolts on the bike frame. These areas take a lot of stress when your foot strikes the ground. The load must be evenly distributed across the chain and the gluteal muscles have a big job to do.

Many novice runners have a running style where they carry their feet very low as the leg swings through before landing. As a result, they over-stride and with stretched muscles, which are not prepared to absorb the load and generate force. Injury can occur and the energy wasted can be worth several minutes over 26.2 miles. Too much flexion around ankle, knee and hips during the mid-stance phase can be the source of many injuries, as the body attempts to absorb the load with a ‘spongy’ compliant joint. We need a ‘stiffer’ joint as we make an impact to absorb the load more effectively to avoid injury and energy leakage.

Common biomechanical overload injuries (see diagrams below) include Anterior Biomechanical Overload Syndrome (shin splints, knee pain), Posterior Biomechanical Overload Syndrome (calf or Achilles pain, compartment syndrome) and Iliotibial Band Syndrome (including lateral knee pain). High volume and/or high intensity running with the biomechanical features associated with these injuries pose a high risk to develop such injuries. Gait retraining, through coaching cues and drills, coupled with properly devised strength and conditioning exercises will help reduce the injury symptoms or prevent them from occurring in the first place.

Anterior Biomechanical Overload Syndrome

Posterior Biomechanical Overload Syndrome

---

Many athletes fail to even get to the start line of a marathon. Before an athlete begins their critical final 2-3 month build-up for a marathon, a period of strength and conditioning work, as well as running-specific drills is recommended. This will ensure that the body is strong enough to tolerate the high loads it will be exposed to from training for the marathon alone, not to mention racing the marathon itself. There is also the performance benefit of improved running economy associated with strength training for endurance athletes. Over 80 muscle groups and 46 bones in the body are involved during running. We must train multi-joint complex muscle groups. We must also train ourselves to be able to move well under fatigue and pressure.

---

A typical strength and conditioning session should include:

• Warm-up – consisting of mobility and ‘glute activation’ exercises.
• Double leg ‘whole body’ strength exercise such as an Olympic lift (or regression of), squat or deadlift.
• Single leg strength exercise. This can include single leg squats, split squats, lunges, step-ups or single leg Romanian deadlifts.
• Ancillary strength exercises. This is very much individualized to cater for the athletes needs. It may be ankle strength, shoulder strength, trunk muscle strength or any other joint or movement pattern that the athlete needs to address.

Two to three strength and conditioning sessions per week for a 6-week period if done correctly, is time well spent. Including running drills to work on different phases of the running gait cycle to ensure that the right muscles are trained to work at the right time will ensure optimal transfer from strength exercises.  These can include ankle drills, drills that challenge single leg stability and foot contact.  We can progress these drills to making more complex and challenging to ensure continued motor skill learning to make running more robust.

A good foundation of strength and technical work prior to increasing training volume will help make the athlete more efficient and robust under the physical demands of a marathon training programme. Once we start to increase the running volume it will still be important to maintain strength training and technique drills to some degree, so that we don’t lose what we have gained. Taking the right measures to prevent injuries can also help improve performance.  There is a double benefit to improving strength and running technique!

In the next blog, we will look at the physiological preparation for a marathon and how to train at the right intensities for long runs and key workouts.

Click here or phone +353 1 5262030 for further information on our Running Clinics at UPMC Sports Surgery Clinic.