10 Tips for Marathon Training and Injury Prevention

By Christopher C Bell MD

If running a marathon is on your bucket list, check out these tips to help you get ready and prevent injuries.​​

10 Tips Marathon Training

1 - Gradual Progression

There is a general guideline when it comes to the progression of training as you increase the distance of long runs and overall weekly mileage. The 10% Rule: This means increase long runs and overall weekly mileage by no more than 10 percent each week. While this has not been scientifically proven to reduce injuries, it is a well-established, tried-and-true element of most training plans. Following this helps to rein in those of us who are more ambitious and tend to push ourselves a lot harder than we should. Also, if you are completely new to running, it is wise to start with more realistic goals like finishing a 5k, then a 10k, and then a half marathon before considering tackling the full 26.2 miles. While it is possible to go from the couch to a marathon, a very small percentage makes it; most are derailed by burn-out, fatigue, and/or injury.

2 - Training Plan

If you are new to marathon running, it is especially wise to follow a training plan. Training plans can be found online at many sources (runningtimes.com, runnersworld.com, running.competitor.com, to name a few). You can even find plans tailored to the type of runner you are, whether you are beginner or more advanced. Keep in mind that most plans are 20-24 weeks in length with scheduled runs or cross training workouts most days of the week. It would be wise to run a certain weekly mileage (at least 15-20 miles) in the months prior to beginning it. In addition, you may want to alter it a little bit and give yourself more time than the allotted number of weeks. Build in extra days or weeks for yourself that you may need to miss due to family, work, travel, illness, or injuries. This way you won’t feel stressed if you have to miss a few days here and there. Remember that everyone is different; what works for your running buddy won’t necessarily work for you.

3 - Nutrition

Just because you are training for a marathon doesn’t mean you can gorge on burgers, fries, and sweets! Sure you’re burning a lot of calories, but it's important to fuel “the machine” properly in order to stay healthy and maximize your training. Healthy whole foods are the answer. You can still indulge of course, but all things in moderation. It’s important to take in calories while exerting yourself for over 60-90 minutes, and especially if you’ll be out there for well over three hours. This improves performance and prevents the dreaded “bonk.”

You can practice how you will take in calories during the race while on your long training runs. It’s a huge mistake to enter race day and eat or drink new products your stomach and intestines are not used to: most of those marathons end badly and not necessarily at the finish line. Find out what they will have at the feed stations so you can start using those products in your training in order to get used to them before the race. If they don’t have what you like or are already accustomed to, you should take your own nutrition with you.

4 - Drink to Thirst

While staying as hydrated as possible during a marathon is important, preventing over hydration is more important. Up until recently the standard advice on hydration in marathons was to drink X amount of fluids every Y minutes. The new standard is to drink to thirst. Everyone should be a little dehydrated at the end of the race, and this is not such a terrible thing. Those who win marathons are two to four percent dehydrated at the finish; so that means us mere mortals can handle a little fluid depletion as well.

If you already have your system down and it works well for you, then by all means continue on. But for those of you just getting into the marathon game, don’t fall into the trap of over hydration. The potential result is called Exercise-Associated hyponatremia (EAH). Hyponatremia is the medical term for low sodium concentration in your body fluids. When athletes over-hydrate they dilute their electrolytes - especially sodium - resulting in hyponatremia. This can lead to nausea, fatigue, dizziness, and ultimately, if severe enough, death. Granted, it takes a lot of fluids to get to that point, but unfortunately it has happened many times over. But remember, no matter what anyone tells you or what your read, sports drinks (those that contain electrolytes and carbs), DO NOT prevent hyponatremia—even though they do have electrolytes, they do not have nearly enough to replace what you lose.

Drink as you go, but let your thirst guide you. Remember, a good time to practice this is on your long runs. If you’re worried about getting overheated (hyperthermia), dump some water over your head instead of drinking it—this is much more effective for cooling you down.

5 - Race Plan

It is important have a race plan coming into race day, but it is more important to be realistic. Have a goal pace in mind based on your training but adjust as needed according to how you feel. Just because you might feel a little sluggish early on does not mean the whole race is shot. One mile you can feel poorly, but then the next you may perk up. Stay positive, and keep taking one step at a time. On the flip-side, if you feel great early on, try to rein yourself in a little bit; overexertion in the first few miles will inevitably catch up with you later on. Practice your pacing during your tempo and long runs.

You should also have a plan for your nutrition and hydration, and stick with it as best you can. When you’re in the last few miles and your quads and calves are so sore and tired you don’t think you can take another step, the last thing you’re going to feel like doing is eating something. Bonking is a terrible experience and can be avoided by sticking to your nutrition plan. Another way to reduce the stress of race day is to have all of your gear ready to go the night before, and plan to get to the start line in plenty of time. Arrange your morning meal as well, and get up early enough to take in some calories two to three hours before the race start. Most important: do the best you can to get lots of sleep the week before the race.

6 - Recovery

Recovery is an extremely important element in training. It seems paradoxical because when we think of training, we don't exactly picture ourselves sitting on the couch. We all want to prepare as much as possible, and resting does not seem to fit into that scenario. However if you don’t allow for recovery, you run the risk of not only injury but also Overtraining Syndrome, which can leave you feeling drained, unmotivated, getting sick all the time, and depressed. If you feel this coming on, you need to take a rest for week or two to recover. To prevent overtraining syndrom, schedule at least one rest day each week and build a “rest week” periodically into your training plans (if they’re not already built in) where you run less mileage and have fewer intense sessions. Also, follow a taper plan leading up to the race.

There is little you can do in the last two to three weeks leading up to a race that will have a positive influence on your marathon performance. However, there is plenty that can be detrimental. Have confidence in the training you’ve put in; it will pay off.

Nutrition is also very important for recovery. Ingesting carbs and protein after each tough session helps you to recover faster and prepares you for subsequent runs. It’s been shown that the sooner you can take in carbs and protein after a workout, the better you replenish your glycogen (which is the storage form of glucose in our muscles and liver) and the better you recover. It’s recommended to eat after a run within two hours, but ideally within 30-45 minutes.

7 - Shoes

Find a comfortable pair of shoes. It may require trying on a few pair, but this is perhaps the most important thing you can do for a successful marathon completion. Use the various foot type-shoe pairings to give you a rough guide, but comfort is the most important element. Most running store personnel are very good at figuring out which type of shoe is best for your foot. Running stores typically have treadmills for you to use for testing out shoes as well; take advantage of this. Walking around is helpful but does not replicate your running stride.

It is often recommended that your running shoes be about one size bigger than you normally wear. This allows for the swelling that occurs with long-distance running and prevents the bruising that can affect the tips of your toes, especially if you are running downhill. It might also allow you to keep all of your toenails. But by all means, don’t buy a new pair of shoes to wear right before the race itself. Buy them at least a few weeks before the race to break them in and make sure they fit well and are comfortable. At the same time, it is best not to have an old, worn-down pair of shoes, this can lead to injury. Ideally, you should replace your running shoes every 300-500 miles.

8 - Core Strength

There is plenty of research data on the importance of core strength and balance for injury prevention in running. This particularly applies to the hip and pelvic muscles; problems here can translate into injuries down the kinetic chain (hip, knee, ankle, foot). In addition, strength and balance at the ankle and foot can help prevent injuries in those areas as well.

It is fairly common for runners to have injuries to the tendons around the ankle. To help prevent this, include balance exercises in your weekly strength training. Balance on each foot for 30-60 seconds a few times each week and this will help not only strengthen the muscles in the foot and lower leg but also improve balance. Good core and balance programs can be found at the popular running websites such as those mentioned above under “Training Plan”.

9 - Listen to your Body

Know when to rest and when you can push through. Small aches that pass after a few seconds, or last no longer than one to two days can usually be written-off as insignificant. Pain that forces you to stop in the middle of a run, or persists despite a few days of rest, ought to be evaluated by a physician skilled in musculoskeletal diagnosis, such as in Sports Medicine or Orthopedic Surgery. It is best to catch injuries early. A little rest and rehab early on gives you the best chance for a quick recovery so you can get back out on the road pain free. Ignoring it and pushing through increases the odds that you’ll worsen the injury and have a long, drawn-out bout with it. The longer injuries persist, the longer it generally takes for them to heal.

10 - Enjoy the Process!

There are far too many variables when training for a marathon for everything to go absolutely perfect. Despite flawless preparation, things may not all fall into place. The more important aspect is the running lifestyle and the lessons you learn about yourself and what you are capable of—which is often so much more than what you thought possible. Enjoy the training, enjoy the outdoors, and enjoy the friendships and camaraderie. Above all, have a deep appreciation for the physical ability that makes it possible for you to even consider running a marathon.