Expert Tips from a Foot Doctor and Pain Doctor for Marathon Training

Training for a marathon is a rewarding but demanding process that requires careful preparation to avoid injuries, especially for the feet, knees, and back. At Garden State Pain & Orthopedics, we know the importance of building a training plan that prioritizes injury prevention and pain management. Below, our pain management specialists and foot doctors share essential tips to help you prepare for marathon day while minimizing the risk of injury.

1. Start with a Gradual Training Plan

One of the biggest mistakes beginner and even experienced marathoners make is jumping into high mileage too quickly. Overloading the body can cause overuse injuries, stress fractures, and tendinitis.

• Follow the 10% Rule: Increase your mileage gradually, aiming to up your distance by no more than 10% each week.
• Include Recovery Weeks: Every three to four weeks, decrease your mileage slightly to allow your muscles, joints, and tendons time to recover and adapt.

Advice from the Pain Doctor: Pacing yourself and including rest days is crucial to preventing muscle fatigue and overuse injuries. Listen to your body; if you feel unusually sore or notice swelling, give yourself time to heal before pushing further.

2. Invest in Proper Footwear

The right shoes are essential for absorbing impact, supporting the arch, and preventing injuries to the feet, ankles, and knees. Running shoes wear out over time, and marathon training accelerates this process.

• Get Fitted by a Professional: Visit a specialty running store to ensure you’re wearing shoes suited to your foot type and gait.
• Replace Shoes Regularly: Foot doctors recommend replacing running shoes every 300-500 miles, depending on the shoe’s construction and your running style.
• Consider Orthotics: If you have flat feet, high arches, or a history of foot pain, custom orthotics can provide extra support and prevent conditions like plantar fasciitis.

Advice from the Foot Doctor: Wearing old or improper shoes can lead to conditions like shin splints, stress fractures, and Achilles tendinitis. Orthotics can be especially helpful for runners with biomechanical imbalances, as they help distribute pressure evenly across the foot.

3. Prioritize Strength Training

While running is a key part of marathon training, strength training is equally important. Strengthening the core, hips, and lower body improves stability, alignment, and running efficiency.

• Focus on Core Stability: A strong core provides a solid foundation for running. Planks, bridges, and Russian twists are all excellent for core strength.
• Build Hip and Glute Strength: Exercises like lunges, squats, and clamshells help stabilize the knees and prevent excessive impact on the hips and lower back.
• Don’t Forget Ankle Strength: Calf raises and resistance band exercises can strengthen the ankles, reducing the risk of sprains and Achilles injuries.

Advice from the Pain Doctor: Strengthening the muscles surrounding your joints reduces the load and impact on the bones and tendons. This is especially important for runners prone to back pain, as a strong core helps maintain proper posture during long runs.

4. Be Mindful of Your Running Surface

The type of surface you train on can affect your injury risk and training progress. Mixing up your terrain can improve stability and reduce repetitive strain on the joints.

• Grass and Dirt Trails: Softer surfaces reduce the impact on joints but may require more balance and stability.
• Asphalt: Common in most city races, asphalt provides a consistent surface but can be hard on the knees and back.
• Treadmill: Good for controlled environments and reducing impact, but it doesn’t fully simulate the outdoor running experience.

Advice from the Foot Doctor: Running on harder surfaces can exacerbate foot conditions like plantar fasciitis or heel spurs. Mixing up your terrain and wearing proper shoes can help reduce the risk of these injuries.

5. Implement Dynamic Warm-Ups and Post-Run Stretches

Warming up and cooling down properly can make a significant difference in preventing injuries and easing muscle soreness.

• Dynamic Warm-Ups: Before each run, perform exercises like leg swings, high knees, and walking lunges. Dynamic stretches increase blood flow and prepare your muscles for the activity.
• Post-Run Stretches: Focus on stretching the calves, hamstrings, quads, and hip flexors after every run. Static stretching helps increase flexibility and reduce muscle tension.

Advice from the Pain Doctor: Dynamic stretching primes the muscles for running by improving range of motion and reducing stiffness. After running, static stretching helps lengthen muscles and prevent post-run tightness, which is a common cause of back pain.

6. Practice Good Form

Running with proper form not only makes your stride more efficient but also helps protect against injuries.

• Maintain a Slight Forward Lean: Leaning slightly forward helps engage your core and reduces strain on your lower back.
• Keep Your Arms Relaxed: Avoid clenching your fists, as tension in your arms can radiate to your shoulders and neck.
• Run Quietly: If your feet hit the ground heavily, it could mean you’re overstriding. Aim for shorter, quicker strides to reduce impact.

Advice from the Foot Doctor: Many runners experience pain due to poor biomechanics. Working on form with a coach or using video feedback can help you identify and correct habits that may lead to injury.

7. Manage Pain and Soreness Proactively

Running can cause aches and pains, but knowing how to manage these early can prevent them from becoming serious injuries.

• Use Ice for Inflammation: Applying ice to sore muscles or joints can help reduce swelling and pain after a long run.
• Apply Heat for Muscle Stiffness: If you experience muscle tightness, heat therapy can increase blood flow and relax the area.
• Consider Massage or Foam Rolling: Both can help reduce muscle knots, increase circulation, and improve recovery.

Advice from the Pain Doctor: Treating mild pain immediately with ice, rest, or anti-inflammatory medication can help prevent it from progressing into a more severe injury. If pain persists or worsens, see a specialist.

8. Schedule Rest and Recovery

Rest days are as vital as training days in your marathon prep. They give your body the time it needs to recover, build strength, and adapt to the increased mileage.

• Take at Least One Day Off Per Week: Use this day for light stretching, walking, or other low-impact activities.
• Incorporate Active Recovery: Gentle activities like cycling, swimming, or yoga can help loosen muscles and improve flexibility.
• Prioritize Sleep: Quality sleep is essential for muscle recovery and overall endurance.

Advice from the Pain Doctor: Pushing through fatigue increases the risk of injury and burnout. Listen to your body, and don’t be afraid to take extra rest days if you feel unusually sore or tired.

9. Consult a Specialist if Pain Persists

It’s normal to experience occasional soreness or discomfort during marathon training, but persistent pain could indicate a more serious issue. Conditions like stress fractures, tendinitis, and plantar fasciitis can worsen if left untreated.

• Visit a Foot Doctor: If you experience chronic foot pain, see a specialist to assess any structural or biomechanical issues.
• Consult a Pain Management Specialist: If back, hip, or knee pain is interfering with your training, a pain specialist can offer treatments like physical therapy or guided injections to relieve pain and support your goals.

Advice from Both Doctors: Early intervention can prevent small issues from turning into chronic pain. Our specialists at Garden State Pain & Orthopedics are here to help you address any pain and keep your training on track.

Final Thoughts

Training for a marathon is an incredible journey that requires dedication, patience, and a thoughtful approach to avoid injuries. By following these tips from our foot and pain doctors, you can enjoy a successful and healthy marathon training experience. Remember that prevention and proactive care are key to crossing the finish line pain-free.

Meet Lauren Gasparini, DNP

Lauren Gasparini DNP is a Nurse Practitioner at Garden State Pain & Orthopedics, specializing in pain and rehabilitation. Lauren received her Bachelor of Nursing degree at William Paterson University, and acquired her Doctor of Nursing Practice, Adult Nurse Practitioner from Rutgers University. Prior to completing her Doctor of Nursing program, Lauren was an orthopedic nurse for five years at Saint Barnabas Medical Center in Livingston, NJ. Upon graduation, she immediately began her career as a pain management nurse practitioner.

Lauren was chosen to speak about Pain Management/Opioid Crisis at the Saint Barnabas Medical Center Nursing Excellence Conference in 2018. When asked what brought Lauren to the medical field, she responded " I had brain surgery as a child, and knew that I wanted to take care of others the way I was cared for during my recovery. I originally went to school/began a career in Business Marketing but knew something was always missing; causing me to pursue my dream of becoming a nurse."

Lauren was born and raised in Northern Jersey. Outside of the office, you can find Lauren enjoying the fresh air (especially near or on water)! She loves spending time boating, swimming, going to the Jersey Shore, and visiting her family's lake house in the Adirondacks. Lauren loves spending time with her beautiful family, husband and daughter.

Fun Fact: Lauren was an avid swimmer and athlete growing up. Although this may come at no surprise with the spirit and joy she portrays, Lauren was her college mascot (The Bobcat) for one year at Quinnipiac!

If you have any neck pain or back pain you can schedule an appointment with Lauren at one of Garden State Pain & Orthopedics’ offices in Clifton, Jersey City, and Edison, New Jersey.