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Expert Comment: 35 years of the London Marathon and preparing for the big race

marathon 150x150 Tuesday 29 March 2016

As the London Marathon celebrates its 35th birthday, Dr Peter Angell, Lecturer in Sport and Exercise Sciences, discusses the toll that marathon running can take on the body and how some runners prepare. 

Since the London Marathon’s inaugural event in 1981, the number of people taking part in the 26.2mile event has increased from just over 7,500 to around 40,000. It has been suggested that the event has been responsible for a dramatic increase in those undertaking running as a recreational past-time as well as for improving cardio-respiratory health. Whilst this is to be applauded and any increase in physical activity by the general population should be seen as a positive, the running of a marathon is an extremely physically demanding task and carries with it its own inherent risks.

Some of the most common ailments afflicting individuals during training and the event itself are ‘Joggers nipples’, chafing (blisters), ‘Joggers toe’ and ‘athlete’s foot’. Whilst all can cause significant discomfort they can all be remedied with relative ease. ‘Joggers nipples’ can be avoided by placing Vaseline or plasters over nipples to form an extra barrier between clothing and skin. The risk of ‘Joggers toe’ can be reduced significantly by having properly fitted trainers with sufficient room in the toe box whilst also keeping toe nails short. Correctly fitting footwear is also imperative to help minimise the risk of blisters. However, due to the distances involved and the volume of training necessary, sometimes these things are somewhat unavoidable. Another regular ailment for runners is ‘athlete’s foot’ which is a fungal infection brought about by the warm and sweaty conditions present in the runners' shoes. Fortunately this can also be avoided by washing thoroughly sweaty socks and also applying specially designed powders to absorb the excess moisture.

Whilst many of the ailments previously mentioned can be easily remedied, there are a number of other injuries/conditions that can arise from the training required to complete a marathon. Knee injuries are the most common with patellofemoral pain but other injuries include Achilles tendonitis, plantar fasciitis, illiotibial syndrome and tibial stress (Fredericson & Misra, 2007).  Hamstring and calf injuries were also seen but more in men than women, whilst women suffer more from hip injuries.

Many of these more common injuries are tendon-related and this is partly due to the increase shock absorption required of them during running where impacts of 2-3 times body weight are placed on joints (Munro et al, 1987).  For many of these issues, prevention is the best form of attack in order to limit the amount of training missed. Firstly, individuals should listen to their body and avoid aggravating injuries. If training cannot be stopped then trying to reduce impact by running on softer ground, using water running or even performing other modes of exercise, preferably non-weight-bearing. Many of the tendon and ligament injuries arise from an accumulation of workloads and muscular imbalances.

In order to limit the effect of cumulative stress, post-exercise considerations should be explored. The use of massage or self-massage techniques such as foam-rolling can loosen muscles and therefore help to relieve strain on the tendons/ligaments. A particular area of focus for the runner should be the illiotibial band which has its origin at the hip and inserts at the knee. This is a known trouble spot for runners and should be regularly targeted for myofascial release using a foam-roller. Another regular problem is plantar fasciitis which is tightness and discomfort on the tendons in the sole of the foot. This can be relieved somewhat by placing a hard ball under the arch of the foot and rolling it underneath the foot with as much pressure as can be tolerated.

For many individuals taking part in marathon running, they (quite understandably) spend considerable time focusing on the running side of their training but often neglect other ancillary work which will not only aid their performance but will also reduce their risk of injury. An often overlooked component of training is muscular strength and balance. Muscular imbalances can often exasperate the risk of injury and so measures should be used to identify and correct these imbalances. Some particular areas of focus should be quadriceps to hamstring strength ratio which should be between 1:0.8 to 1:0.5. Another particular area of focus should be gluteal activation with a particular focus on the gluteus medius which helps to stabilise the hip during single-leg stance.

Running a marathon is an extremely demanding task that places significant physiological stress on the body as well as a strong psychological demand. Whilst determination is key to overcoming the challenges posed by the training and event itself, sufficient planning and the use of ancillary training and recovery methods can help to avoid the regular ailments that afflict the recreational runner.

Note: Before embarking on any exercise such as marathons please consult your doctor.

Profile - Dr Peter Angell

Health Sciences at Liverpool Hope

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