Let me start this article by saying….RUNNING INJURIES ARE CONFUSING! ESPECIALLY if you have an injury during marathon training because you have so much hope, hard work, and emotions rolled up into it.
From an outsider’s perspective (especially a non-runners perspective), it can seem so straightforward. You got injured. Running hurts. You stop, heal, and pick another race.
But when you invest so much and CARE ABOUT YOUR GOALS, getting an injury during marathon training (well, getting injured before a race—but especially a big one that requires lots of time to train like a marathon) is anything but SIMPLE.
Related: How I Stopped Being a Injury-Prone Runner
My Injury During Marathon Training Story
I know the life of dealing with an injury during marathon training oh so well.
If you’re familiar with me and my story—please feel free to skip ahead. But here’s the summary:
After my first marathon after having kids, my coach and I decided I try to qualify for the Olympic Trials Marathon. This is in the late spring of 2019. I go all in, run triple-digit weeks, start The Mother Runners in July…and trip in August and strain my hamstring. In September, I tear it in a half marathon.
I take a week off and do all the things to try to heal it. Having an injury during marathon training isn’t ideal but I was not going to miss my shot of an OTQ. I run my marathon in November. I miss qualifying by 11 minutes. (A lot.) I had to drag my leg behind me.
I try to come back and shut things down in February. Take about a year off. Come back next winter. Have a bad reaction to the second COVID shot. Get pleurisy. Off running for about 6 weeks. Come back for 4 weeks and tear my plantar fascia. Take 6 months off. Come back the following winter (this is 2022 now), get COVID and long COVID symptoms. Shut down again.
Related: Does PRP Help Plantar Fascia Tears?
My return to running after injury
And then FINALLY I return to training without an injury during marathon training cycles—well two marathon training cycles, and now onto the third. (Running a 2:58 and 2:54).
What I leave out in this recap of my marathon injury saga is all the CONFUSION I had with my injuries, all the misdiagnoses, unsolicited opinions, shaming (from non-runners) and SELF-BLAME (from listening to them).
I want to make things easier on you than it was on me. I learned a lot. And, as a runner I am grateful for the time off because now I view every run as a gift. And, as a running coach, I feel like the understanding and advice I can offer has helped many of my runners sidestep injury during marathon training (or in general).
Related: Lessons Learned from My Running Injury
In this article, I am going to walk you through:
- What to do if you have an injury during marathon training (a step-by-step guide)
- Training options if you have an injury during marathon training
- What to do if you have an injury during marathon training depending on your timeline
- What injuries you can run a marathon with and what injuries you can’t
- How to maintain running fitness while injured
What should you do if you are injured during marathon training?
If you become injured before your marathon, it’s smart to be proactive but not panic. Dealing with injuries is a part of being a runner chasing goals. It happens and it’s not your fault. Repeat after me. IT IS NOT YOUR FAULT.
Related: How to Self-Diagnose Your Running Injury
7 Steps for What to Do If You Are Injured During Marathon Training
Here is a step-by-step guide in what to do if you have an injury during marathon training.
1. Treat it at home.
In most cases, ice and heat as much as you can throughout the day. Stay off of it. Pay attention to when it hurts, how much, and how long it lasts. Rest it for 1-7 days. Do cross-training if that doesn’t aggravate it but make sure you don’t overdo it.
2. If pain doesn’t improve, see a pro.
After 3-7 days of rest, try an easy 30-minute jog or half of your typical daily distance. If the pain is still present above a 3/10, make an appointment to see a sports physician or trusted physical therapist that works with runners. Personally, if I treat an injury at home and it doesn’t improve or sticks around for more than a week, I seek help.
3. Get it imaged.
Unless you are certain of the running injury you are dealing with, it’s never a bad idea to get a diagnostic ultrasound (cheaper and quicker to get than an MRI), MRI or X-ray. I wasted a lot of time, money, and actually made my injuries worse by having them misdiagnosed. Know what you are dealing with.
4. Come up with a plan.
Unless you have a tear, stress fracture, or bone break, you may be able to continue to train for your marathon with an injury. Now is the time to look at your options (more on that below). In many cases, you can find cross-training options or use of an anti-gravity treadmill to maintain fitness while you heal.
5. Be honest with how you are feeling.
If the doctor says you need two weeks off but it doesn’t feel like it’s improving, or needling doesn’t seem to be helping, etc., be honest with yourself and be open to changing the plan. You may need a different treatment. You may need more time. Don’t delude yourself that you are feeling better if you aren’t.
6. Seek a trusted advisor.
We don’t see clearly when dealing with an injury during marathon training. So, ask a trusted friend, partner, or family member what they think you should do if you’re still in pain and the marathon race date is approaching. Be honest and open, and don’t forget that there are other marathons.
7. Return gradually.
If you do start to heal your injury and marathon training is able to resume, be sure to build back gradually. (I have more information on returning to running after injury here). You will need to begin with reduced mileage, easy running, and potentially walk breaks.
Remember that it’s okay to feel some pain as you run (no more than a 3/10). And progress is not linear. There may be some days pain creeps up but then you just learn you pushed too hard and need to be a bit more conservative. You got this!
Related: How to Return to Running After injury
What type of injuries can you run through?
If your injury during marathon training is a mild strain or inflammation such as tendonitis, you can still continue to run as long as the pain isn’t above a 3 out of 10, doesn’t worsen as you run, or cause you to change your gait.
If you have a mild strain or tendonitis at any point during your marathon training, it is likely you can continue to train with alterations to your training plus treatment.
What injuries should you not run with?
You should not run with a stress fracture, bone break, or grade II or III muscle strain.
What type of injury do I need to cancel my marathon for?
When you get an injury during marathon training and the severity of your injury will determine if you need to cancel your marathon:
- If you suffer a serious running injury like a bone fracture or break, or a muscle tear, within two months of your marathon, you will likely need to cancel your marathon.
- If you suffer a serious running injury in the beginning of your training cycle with four months ahead of your marathon, you may still be able to run your marathon.
- If you suffer a mild injury such as tendonitis or a mild muscle strain, you very likely do not need to cancel your marathon—even if it is within weeks of your marathon. You may need to alter your training, and potentially alter your marathon goal—and determine if you are okay with that.
Related: How to Cope with Fear of Running Reinjury
You should cancel your marathon if you have the following injuries within the following timeframe:
- Bone fracture or stress fracture within 4 months of your marathon (because it will take 6-8 weeks off running plus a gradual return to running)
- Grade II or III muscle strain or tear within 3 months of your marathon (because it will take several months off of running plus a gradual return to running)
- Severe tendonitis or inflammation within 6 weeks of your marathon if it is severe and chronic as it may take 4 months off running to heal
How do you train for a marathon while injured?
How do you continue to train for a marathon with an injury? There are many ways to maintain running fitness while injured.
Here are some options for training for a marathon with an injury.
- You can scale back training volume and cease intensity while getting treatment until pain resolves.
- You can cross-train until pain begins to resolve.
- You can off-load weight and continue to run by using an anti-gravity treadmill such as the Alter-G or the “Lever” which attaches to any at-home treadmill.
- Alter your marathon goal so that you aren’t trying to hit a specific time but just finish.
- Choose another marathon that gives you more time to train—if you need it, depending on how long it takes your marathon injury to heal. I am always a big fan of contingency plans!
Related: The Best Cross-training Exercises for Runners
Consideration for Running a Marathon with an Injury
When trying to decide if you should cancel your marathon due to an injury, it’s important to remember that running a marathon with an injury puts you at risk for being injured longer or developing a compensatory injury (which I did!). You may decide that the risk is one you are willing to take. But don’t forget, there are always other marathons.
I don’t regret running a marathon with a hamstring tear. It was my one and only shot to try to qualify for the 2020 Olympic Trials Marathon. I decide to shoot my shot. I ended up with a 5-minute marathon PR—but also a very long layoff due to running through pain and ignoring my body longer than I should have.
In many cases, the sooner you can address your running injury, the quicker it will heal! I have seen this time and again with the athletes I coach. Listen to your body’s whispers before they become screams!
If you want guidance with your running goals, including returning from injury or marathon training, check out my run coaching services. Also, be sure to check out my free training plans:
- Postpartum Training Plan
- After a Break Training Plan
- 5k Training Plans
- 10k Training Plans
- Half Marathon Training Plans
- Marathon Training Plans
- Strength Training Plan