Injury Prevention: Stretching, Warm-up, and Avoiding Common Problems
Jonathan Drezner, MD
Associate Professor, Department of Family Medicine
Associate Director, Sports Medicine Fellowship
Team Physician, Seattle Seahawks & University of Washington Huskies
“Don’t eat and then go swimming.” “Wear a jacket and warm-up if it’s cold outside.” “Stretch before you play.” We have all heard these and other common words of advice from parents, friends, and coaches on how to avoid injuries during athletics. So what do you need to know before running a marathon that will keep you healthy, prevent injuries, and allow you to accomplish your goals?
This simplistic statement may summarize the best strategy: “Prevention is the best treatment.” While easier said then done, appropriate training and race-day planning are the keys to preventing injuries during a marathon. Many runners decide to pursue a marathon but allow only a short timeline to prepare. In fact, the vast majority of overuse running injuries are directly related to training errors, or running too much too soon.
Training for any athletic endeavor should be gradual. Muscles, tendons, bones, and the cardiovascular system all need time to adapt to the stresses of conditioning. Runners should begin by calculating their total weekly mileage. Training often consists of lower mileage and speed runs during the week, and a single longer run on the weekend. Runners should be careful not to increase their total weekly mileage by more than 10% per week. If you are new to running, successful training for a marathon may take 6 to 12 months, or even longer. Abrupt increases in running distance, intensity, or frequency may cause common overuse injuries such as shin pain, patellar tendonitis, iliotibial band syndrome, plantar fasciitis, or even stress fractures. Most of these injuries can be avoided by proper training and allowing the body to gradually adjust to the demands of higher levels of conditioning.
Stretching and a proper warm-up are also important. Similar to a slow progression in running distance, the body needs adequate time to warm-up before heavy training or competition. A light short distance jog and gentle stretching will assist the body and muscles to properly prepare for more intense exercise. The exact warm-up routine will vary from person to person, but each runner should be comfortable with their routine – including stretching, warm-up, meals, shoes and clothing – prior to the marathon.
Unfortunately, not all injuries can be avoided. From blisters to leg cramps, you must be prepared to modify your running if unforeseen problems arise. Runners should not “push through” significantly painful symptoms. If you develop unexpected limitations, slow your pace, walk, rest, or stretch before attempting to continue. If you develop major symptoms such as chest pain, difficulty breathing, lightheadedness, or confusion, stop immediately and ask for help.
Remember, train appropriately, plan well, listen to your body, and, most of all, think safety first!