Keep the Gain – Not the Pain – in Your Running: Tips for Maximizing Your Race Performance

An interview with physical therapist Michael Levinson

"The better prepared a runner is, the better his or her performance will be," says Michael Levinson, PT, Clinical Supervisor of the Sports Rehabilitation and Performance Center at HSS. "However, without the proper training, a runner may be risking one or more serious injuries."

According to Levinson, “The route for any competitive race is paved with many painful possibilities, from shin splints and runner's knee to Achilles tendonitis and the agonizing symptoms of the plantar fascia inflammation that affects the bottom of the foot.”

"The first requirement for a marathon runner is experience," says Levinson. "People should limit their competitive running to shorter distances unless they have been training for at least a year and run an average of 25 miles a week."

“Warming up is also a prerequisite for safe and successful running, whatever the distance. Cycling and jumping rope are two good ways. Walking and jogging before a race are two others.”

And, Levinson notes, "Pacing your practice runs is important. Someone who can talk with a running buddy and breathe without huffing and puffing is probably training at the proper speed, and as weeks go by, that speed may be increased gradually."

“Keeping your system well hydrated is also vital,” he says. “A runner should be drinking water at least once every half-hour. It’s in a runner’s best interest to drink before he/she feels thirsty. It’s also a good idea to augment their water intake with sports drinks such as PowerAde and Gatorade. The liquids are a good way of minimizing the chance of leg cramps, heat exhaustion, and nausea.”

As Clinical Supervisor of Sports Medicine Rehab Services, Levinson considers proper running shoes equally as vital to getting good performance and avoiding injuries. The choice depends on a person's stride, the structure of his or her arches, and the type of surface they train on.

A runner's responsibilities are not over after that person crosses the finish line. "It is important to cool down muscles with an easy jog and to stretch them gradually without inducing pain," he adds.

The final instruction is to take a well-deserved rest. Levinson prescribes a week of light exercise after a 10K run and a month of light exercise after completing a marathon.

"Running any distance can be exhilarating and fun,” he says. "But without the proper precautions, it can be hazardous to your health."

Here are some Dos and Don’ts from the Sports Medicine Center at Hospital for Special Surgery:


  1. Start training with long easy runs.
  2. Engage in speed training, but not more than once a week, and not until you’ve developed endurance and strength.
  3. Pace yourself when you train by limiting your long-distance runs to one every 2-3 weeks. Start with 8-mile runs and work up to running 22 miles, or 3 hours, a month before the marathon.
  4. Stretch to keep your muscles flexible, but not to the point where you feel pain. Include strengthening exercises for your postural muscles & legs.
  5. Maintain a high-carbohydrate diet before a race -- fruits and vegetables, as well as bread and pasta -- increasing the percentage to 70% of your food intake the week before the marathon.
  6. Be sure to drink plenty of fluids; remember to drink before you feel thirsty.
  7. Replace your running shoes every 250-500 miles, whether or not they appear worn out.
  8. Apply sunscreen before the race.
  9. Survey the marathon route before the race, and station friends at various spots along the way so they can hand you sports drinks or fruit slices to replenish your energy.


  1. Increase your mileage too quickly when you’re training.
  2. Continue to run if you feel pain.
  3. Run 7 days a week. Be sure to take a day off every week.
  4. Forget to stretch.
  5. Ignore cross-training aerobic exercises such as cycling, swimming, and stair climbing to build fitness.
  6. Wear new shoes or clothing at the race. It could cause chafing or blisters.


Mickey Levinson, PT, CSCS
Rehabilitation Department
Hospital for Special Surgery

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