Three Overuse Injuries Common in Marathon Training, According to Jill Lamontagne

Jill Lamontagne—Mentor, Marathoner, Mission‑Driven Leader—pairs first-hand racing experience with a career dedicated to holistic health education. As Assistant Supervisor of Adult Case Management at Waypoint, she translates complex regulations into compassionate care plans and trains new case managers in evidence‑based wellness strategies. Off the clock, Jill clocks coastal miles, volunteers with Rotary Club service drives, and coaches young athletes, giving her deep insight into both the mechanics of endurance running and the prevention of overuse injuries. Her mantra—“Keep moving, stay grateful”—guides the practical advice that follows.

For the nearly three-quarters of Americans who do not meet the Centers for Disease Control and Prevention recommended guidelines for physical activity, the idea of running a marathon likely feels very remote, if not impossible. However, any person who commits between 16 and 20 weeks to training should be able to complete a race.

Throughout training, runners must listen to medical professionals, more experienced athletes, and their own bodies in order to minimize the chances of common running injuries. Runner’s knee ranks among the most common injuries during marathon training. Officially known as patellofemoral syndrome, runner’s knee is signaled by a persistent dull pain localized at the front of the knee, radiating out from where the joint connects the tibia to the femur. Runner’s knee may be sensitive to the touch and feels worse while in motion; the condition is often described as two pieces rubbing or grinding against one another.

The prevalence of runner’s knee underscores the importance of proper technique for runners, as many instances of the condition can be attributed to imbalanced posture and other poor biomechanics. Inferior footwear can also contribute to runner’s knee, as can weak thigh muscles and tightness. Training too much without resting can cause or exacerbate the symptoms of runner’s knee.

As with many injuries incurred during marathon training, the most effective form of treatment is rest. Runners should also ice the knee, apply compression, and keep the knee elevated, a process collectively known as RICE. Individuals can further benefit from working with physiotherapists who can demonstrate targeted stretches, strengthening exercises, and hands-on manipulations to further alleviate symptoms. Some patients may benefit from a form of treatment called extracorporeal shockwave therapy, a minimally invasive procedure that uses small impulses of energy to stimulate soft tissue structures that have been impacted by injury. Most importantly, physiotherapists can assess a runner’s gait and help them develop a more efficient and biomechanically sound running style.

Achilles tendonitis is another condition typical among the distance running community. The injury occurs when the Achilles tendon, which is located on the back of the heel and connects two calf muscles, becomes inflamed. The severity of the inflammation can vary considerably, from mild discomfort to severe pain. The ankle may appear normal or visibly swollen.

One of the major contributing factors to Achilles tendonitis is overuse. The likelihood of overuse injuries increases dramatically during marathon training, especially if runners are not careful about increasing the frequency, intensity, and duration of their runs. In addition to running, Achilles tendonitis pain may increase when a person is walking, using stairs, or standing on tiptoes.

RICE treatment methods can help alleviate the pain and discomfort associated with Achilles tendonitis. Care providers may also recommend pain relief medication and physiotherapy, along with targeted exercises and stretches. Like athletes with runner’s knee, individuals suffering from Achilles tendonitis may benefit from better running shoes and improved running technique.

Finally, medial tibial stress syndrome is a common injury that can completely derail marathon training. Better known as shin splints, the condition is defined by inflammation throughout the muscles, tendons, and bones surrounding the tibia. For some people, shin splints feel like a dull ache throughout the shin, but for others, the pain is sharp and intense.

Excessive training, improper footwear, and muscle tightness or imbalance all contribute to shin splints. Runners with flat feet are at an elevated risk for the condition. RICE and pain relief medication are the most common treatment for shin splints. Runners must abstain from all training until the symptoms have dissipated.