Marathon Training Part 3: Preventing Injuries

By: Chuck Finder

This is the third in a three-part series about training for the Pittsburgh Marathon.

Injury treatment and prevention go hand-in-hand – or, in this instance, muscle-on-muscle and bone-on-bone – with proper training, fitness, exercise, warm-up and, if necessary, examination.

So once Vonda Wright, M.D., and Ron DeAngelo, ATC, showed a crowd of 100 runners Saturday the ways to get ready to run, Aaron Mares, M.D., went to the front of the LHAS Auditorium at UPMC Montefiore and illustrated for the attending athletes where and how they could develop, treat and further prevent injuries. In their nearly four-month preparation for the Dick’sSporting Goods Pittsburgh Marathon, Dr. Mares told the runners, they should listen to their bodies and use a common-sense approach.

“Your body’s trying to tell you something when you can’t walk,” he said.

His tips for injury prevention sounded simple: Don’t do too much, too hard or for too long; abide by your body’s suggestions (if it increasingly or continuously hurts you, stop doing it – though Dr. Wright offered the idea of running, biking and swimming as cross-training preventatives); and wear appropriate gear.

Aaron Marest, M.D.

Dr. Mares also proffered that there is no need to run more miles in a day than your race lasts – a 10- to 12-mile run should suffice as a preparation highpoint for a half-marathon participant, a 20- to 22-mile, one-time maximum for a marathoner. 

RICE was his acronym for the best injury treatments in general: rest, ice, compression, and elevation.

“Sometimes, you have to back off,” Dr. Mares said. “I’d avoid heat with an acute injury, too. Heat brings blood, blood brings swelling – we’re trying to avoid swelling initially.” And he pointed out that to avoid swelling, raise the appendage to a point above the heart.

His three-step program to getting a runner back on his or her feet: rehabilitation, decreasing inflammation and bracing/immobilization. He also advised against a runner taking NSAIDs before a run because the resulting low-salt levels can create issues. “You end up seeing me in the finish-line medical tent, and I don’t want to see you there,” Dr. Mares said.

Dr. Mares showed slides of the most common injuries for long-distance runners, and they are many: overuse injuries such as stress fractures from the hip and pelvis down to the foot; patellar tendinitis above, below or in the middle of the knee; patellar-femoral pain also known as runner’s knee, which can result from the kneecap groove tracking or cartilage softening; IT band-friction syndrome, where the fluid-filled sac outside the knee can stretch and inflame that IT band; shin splints; calf strain; ankle sprain or tendinitis; plantar fasciitis; and more.