Tips to Prevent Marathon Injuries

Hospital for Special Surgery Offers Runners Tips to Prevent Injury

NEW YORK, N.Y.—October 26, 2007

More than 90,000 people will descend on the Big Apple on November 4, 2007 to take part in one of the world’s premier marathons, the ING New York City Marathon.  Most of these runners have trained diligently and extensively for this grueling 26.2 miles. Injury prevention is a vital part to marathon preparation, both physically and mentally, for this big day.

“Whether lacing up for a marathon or embarking on a loop around the park, running takes proper training and a dedicated training regimen,” said Rebecca A. Demorest, M.D., a pediatric and young adult sports medicine specialist from Hospital for Special Surgery. “Everyone from amateur runners to elite athletes needs to take precautions to prevent serious injury,” said Dr. Demorest.

According to Dr. Demorest, “Overuse injuries such as shin splints, IT band syndrome and patellofemoral stress syndrome can plague runners, especially during long distance runs, so proper training and cross training is essential. Acute injuries such as ankle sprains, falls and dehydration can unfortunately not always be avoided; however, sensible planning and careful attention to the weather, conditions of the surroundings and smart running can help to lessen some of these injuries.”

Crossing the finish line takes more than dedicated training; it takes an educated athlete who pays careful attention to their health and safety.  Here are training and race day tips from Dr. Demorest to help you run a safe, and hopefully injury-free, marathon.

Training and Race Day Tips

  1. Give yourself plenty of time to train for a marathon. Although training varies depending of your level of fitness, on average, 16-24 weeks of training 4-6 days per week is needed to get your body in shape and ready for the big day.

  2. Develop a running program that takes into account your work and life schedule. Follow a training regimen that will mimic the race course including easy runs, short distance, tempo, hill, speed and long distance training. Focus on one long run per week with shorter training runs during the week.

  3. Try to run with a partner or friend who is running at your same level. Do not train with friends who are at different fitness levels, have been running for a longer time or have a longer stride or much faster pace.

  4. Do not increase mileage or intensity too quickly; no more than a 10-20% increase per week. Long runs should gradually increase over the training course.

  5. Run in proper running shoes designed for your foot and body type. Replace your running shoes every 300-500 miles. Knee and shin pain can sometimes be the first sign that your shoes are wearing down, even if they look like new.

  6. Run on proper surfaces and vary your routes. Try to run on more giving surfaces as opposed to hard concrete. Repetitively running the same route may increase your risk for injury.

  7. Do not run with headphones, especially on race day. You may put yourself at risk for injury by not being able to properly pay attention to your surroundings.

  8. Cross-train with other aerobic activities such as swimming or biking – this can replace up to 20% of mileage and reduce wear and tear on the body.

  9. Include strength training and stretching in your training program - strength training can protect joints from injury, but runners should avoid heavy lifting and reduce strength training as the marathon approaches.

  10. Create a strong core. A strong core (abdominal, back, hip and buttock muscles) is essential for injury prevention and better running. Many runners have poor hip strength that can translate into knee and shin problems.

  11. Make sure to rest at least one day each week. Get plenty of sleep.

  12. Don’t overtrain. Signs of overtraining include recurrent injuries, the inability to heal after injury, muscle aches, fatigue, lack of energy, insomnia and mood changes.

  13. Eat properly. A diet rich in complex carbohydrates and low in fat will give you the energy to run. Your diet should also contain adequate protein and iron. Make sure you have the “energy to go” before you start your run. Carry some energy boosters rich in carbohydrates for during your run.

  14. Stay hydrated. Do not wait until right before or during your run to hydrate.  Some recommend hydrating with a sports drink if you will be running for more than 45 minutes. Concentrated urine may be the first sign of being dehydrated.

  15. Don’t over-hydrate. Those taking longer to complete a marathon and those that drink too frequently may be at increased risk for overhydration. Signs include extremity swelling, bloating, weight gain after a run and mental status changes.

  16. Check weather conditions. High humidity and hot temperatures can be a forecast for disaster, so plan your runs accordingly.

  17. Heed warning signs of an injury and do not continue to train with pain – if you have swelling, cannot bear weight, the pain worsens or happens earlier in workouts, or the pain persists at rest or at night see a doctor. Prevention is much easier than treatment.

  18. Be flexible. Injuries and change of plans happen, so be prepared for blips along the way. Staying relaxed can make all the difference.

About Hospital for Special Surgery
Hospital for Special Surgery (HSS) is the world’s leading academic medical center focused on musculoskeletal health. HSS is nationally ranked No. 1 in orthopedics and No. 2 in rheumatology by U.S. News & World Report (2016-2017), and is the first hospital in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. HSS has one of the lowest infection rates in the country. HSS is an affiliate of Weill Cornell Medical College and as such all Hospital for Special Surgery medical staff are faculty of Weill Cornell. The hospital's research division is internationally recognized as a leader in the investigation of musculoskeletal and autoimmune diseases. Hospital for Special Surgery is located in New York City and online at


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