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Going the distance

Nurturing

How to lower the risk of injury while training for a marathon

Health
Andrew O'Brien

While he was never as charismatic or quotable as other heavyweight champions, Mike Tyson had a point when he said ‘everyone has a plan until they get punched in the mouth’. It’s that time of year when countless runners are getting the proverbial punch in the mouth. The Dublin Marathon is now less than a fortnight away, and for the last month physiotherapists around the country have been dealing with a steady influx of marathon hopefuls who are starting to fall apart.
It’s an interesting time, a period that feeds the age old myth that ‘running must be hard on the joints’. Why, if so many people have done so much training and are getting ever fitter and healthier, do so many struggle to get to the start line of a marathon. The answer is both simple and complicated, because while beginners often struggle, so can the more experienced and even elite runners.
Before we even consider how big of a challenge it is to run a marathon, it’s worth looking at the difference in injury rates between beginners and more experienced runners.
One study found that there are approximately twice as many injuries per 1,000 hours of running amongst those who have been running for less than 12 months when compared to their more experienced counterparts. Interestingly though, some researchers would consider anyone with less than three years of running under their belt as a novice, with injury rates in that period progressive reducing each year, before levelling off thereafter. However you look at it, when there’s a lot of training to be done, the relative newbies are more likely to struggle.
So, beginners are more likely to get injured. In simple terms that may be because their bodies just haven’t gotten used to the loads required to run longer distances. It’s also worth adding here that the early improvements tend to be the biggest, so a lot of novice runners find it relatively easy to progress from 5km to 10km and even beyond to half marathon distances in a relatively short period of time. Perhaps that first flush of enjoyable improvement makes novices jump to the big one quicker than might be advisable.
Marathons are a whole different kettle of fish to shorter events. Most of the truly elite take their time to progress to the full distance, and only really do so after they finish their track career, Mo Farah being a case in point. Farah ran his first marathon in 2014, but only fully turned his attention to the event this year, winning the Chicago Marathon earlier this month.
What has all of this got to do with ‘Iron Mike’ punching folks in the mouth? Probably not that much! But everyone training for the marathon has a plan, a training programme that they downloaded from the internet, were given by a coach, formulated from their own experience or just scribbled down on a beer mat. And at some time in the last few weeks, that plan has decreed that the longest training runs needed to be done, usually 30km or more.
For the beginners that is invariably further than they have ever run, right when they are at their most fatigued due to the training demands. Unsurprisingly it’s when the physiotherapists get busy.
Mary gets a sore knee after a training session and struggles to walk downstairs afterwards, but the plan is to run again tomorrow. Bang – there’s your punch in the mouth. What to do? I find myself telling people to go home and tear up the training plan, otherwise it will whisper in their ear and convince them to run when they are in too much pain to do so and risk making themselves worse.
For the first-timers in particular, it’s here that psychology is important; what could be more damaging to morale than thinking ‘If it hurts after 5km, how the hell will I be able to run 42?’.
It’s these people who need to be creative, keeping their fitness going by cross-training and keeping their legs moving by running small amounts comfortably. In a lot of ways, injured runners need to taper in reverse, dropping the mileage right down for a while then sneaking it back up. To paraphrase Dr Seuss, we need to be doing just so much, but no more, or something might happen, you never know what.
On top of it all, you need some luck. So here’s some from me: best of luck to all of you toeing the line. Well done for getting this far, now try to enjoy it!

Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at www.wannarun.ie.

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