Marathon Injuries and Exercise Induced Leg Pain.

With the upcoming London Marathon, most runners are excited and nearly ready for the race. Unfortunately for others, it´s a completely different story. In this blog, we discuss the common issues and injuries Marathon Runners have to dodge on the lead up to Race Day.


A close friend of mine has sadly withdrawn from the upcoming 2018 London Marathon because of ongoing knee pain. The pain significantly impacted the amount he could train, and unfortunately he no longer meets the training milestones to finish his first marathon. He is one of many first-time participants whom fall into a heap during their training, and here‚Äôs the likely reasons why…

       1. Training Spikes

       2. Poor Biomechanics

       3. Low Baseline Strength

       4. Vitamin-D Deficiency


1.Training Spikes 

Eager participants often have a cracking start to their training regime, although by the time it hits the festive season of Nov-Dec, the poor weather and the abundance of Christmas and New Years parties mean their training and fitness skids to a halt.

In January, these runners regain the running-bug and try to pick up where they left off, resulting in a sudden spike of running volume. This sudden influx on a deconditioned body is a sure fire way to sustain an injury.


2. Biomechanics

The average ‘marathon cycle’, a term combining the Sept-April training routine and the event itself, has some surprisingly strenuous numbers associated with it:

  • The Average runner has around 2k steps/mile
  • The usual training program suggests 40miles/week
  • Individuals usually train over a 6 months period from September to April
  • These figures extrapolate to a whopping 2 million strides per ‚Äúmarathon cycle‚Äù.


With 2 million steps, even the slightest biomechanical abnormality or weakness is likely to cause an overuse injury somewhere in the lower limb.

Abnormal biomechanics tension the soft tissues of the limb differently, causing them to excessively stretch or flick over bony prominences. Continuous tension or prolonged flicking of these tissues causes them to get irritated, painful, swollen and generally quite angry.



3. Baseline Strength

You have to be strong to run for the duration required for a marathon. Really strong.

Your muscles need to be able to propel your body along undulating terrain for 4-5 hours. Those who are fresh faced to marathon training are unlikely to have the baseline strength or endurance for this feat, and most will seldom consider any resistance training alongside their running routines.

When the cumulative demands on a tendon or muscle exceed its capacity, this is when muscle tears and tendinopathies occur,

Most good training programs strongly recommend cross-training to mix up the demands placed on the body for this exact reason. Strength is key to making sure you aren’t going to crumble during the race.


4. Vitamins and Nutrition

In England, we aren’t blessed with the greatest weather in the world. From September to April, we only have an average of 10 hours sunlight per day. As well as making us feel more chipper, Sunlight also provides us with a healthy dose of Vitamin D, which contributes to maintaining bone health and density.

Most individuals during Daylight Saving hours will have lower Vitamin D levels and have no problems, but this deficiency in someone who’s training for a marathon can result in a lot of trouble.

Lack of Vitamin D can predispose individuals to have a ‘stress response’ or bone-bruising style symptoms due to reduced Bone Turnover. These stressed areas can rapidly progress to a stress fracture if impact forces and bone health are not addressed, likely ruining your marathon hopes for the year.



If you have sustained an injury during your marathon running, we at PhysioMotion are here to help. We can provide in-depth running analysis, treatments for the issues you’re facing, and advice for strength training.

For the next few weeks we are offering 50% off all initial physiotherapy assessments if you are running the 2018 London marathon on behalf of a charity. Organise an appointment with our team today to salvage your marathon hopes for the year.