Training for a Marathon: How to Avoid Injury

June 15, 2021

If you are a runner, let’s face it, getting injured stinks. It doesn’t matter if you are training for a marathon or preparing for your first community race, being knocked off course with pain can be very hard to handle mentally and physically.

Be forewarned: injuries are very common among runners. Recent research estimates that 82% of runners will become injured at some point in their running career and yearly injury data shows that up to 90% of runners experience an injury while training for a marathon. Some of the most common of these running injuries include a stress fracture, plantar fasciitis, hamstring tendonitis, ankle sprain, runners’ knee (patellofemoral syndrome), and Achilles’ tendonitis.

Injury prevention is critical if you want to continue running and improving long-term. Here are some tips from Dr. Joshua Blomgren, sports medicine physician at Midwest Orthopaedics at Rush and a 15-time Chicago Marathon team physician.

Don’t overtrain

It's important to go easy when adding mileage or intensity to your training. As a rule, don’t increase your weekly mileage OR running intensity by more than 10 percent each week. Build up slowly and let common sense and a good training schedule determine how much you run.

Invest in good shoes

Never run in worn-out shoes. Go to a specialty running shop to be properly fitted for running shoes and/or orthotics and replace them every 350-500 miles. Incorrect shoes can create changes to your gait, leading to varied stresses and injuries in your feet, legs, knees, or hips. Wearing shoes with worn-out cushioning also contributes to changes in foot biomechanics and contribute to injury.

Choose the best running surface

Look for running surfaces that absorb shock, rather than passing it along to your legs. Avoid concrete as much as possible which is much harder than asphalt. Try to find grass or dirt trails, especially for higher mileage runs. Consistency is also important. Changes to a new running surface can cause injuries. Avoid tight turns like on short running tracks. Instead, find straight running paths or those that include slower curves.


Many runners don't stretch, but they should. Training can cause your muscles to become very tight which can cause strain and changes in your gait which can lead to injury.

Take the time to follow a regular stretching program and commit to it after your runs. Just 5 to 10 minutes after each workout can make a big difference. Massage or using a foam roller can help eliminate muscle tightness common in runners.

Strengthen muscles

Don’t forget about the other muscles that support your ‘running’ muscles. Runners usually have tight hip flexors because their quads are overtrained from running. By strengthening the hamstrings and glutes, you can create balance in the lower body, reducing the possibility of injury.

Perform cross-training strengthening exercises two to three times a week focusing on your glutes, abductors, and adductors — and your core — to create balance and stability.

Watch out for heel striking

It’s called heel striking when your feet land in front of your hips during each step and your heel hits the ground before the rest of your foot. This less efficient way to run is common among new runners but can lead to injuries such as shin splints, stress fractures, and joint pain. One recent study found that runners who first strike the ground with their midfoot or forefoot experience fewer knee injuries than runners who heel strike.

Focus on landing mid-sole with your foot directly underneath your body for each step. Try to step lightly and quickly as if you are running barefoot on hot pavement.

Prioritize posture

Good form means staying upright and keeping your shoulders back and relaxed. If your shoulders are hunched, it could cause aching in the lower back during or after a run. Make sure to work core exercises into your training. Mid-run, do posture checks every so often, then raise and lower your shoulders to a relaxed position. Keep your head in the proper position to help prevent back and neck pain. Hold it right above your shoulders and hips. Try to keep a balanced posture with the ear, shoulder, hip, knee, and ankle in line as you lean forward while running.

If you would like to talk with Dr. Joshua Blomgren about your running injury, please visit or call 877-MD-BONES.