Coping with marathon niggles - Women's Running

Coping with marathon niggles

Read Time:   |  March 9, 2016

Marathon niggles

My clinic tends to work in seasons. It’s about this time of year that I start to say goodbye to the knee-braced skiers, and begin to welcome a limping conga of injured and worried marathon runners. Why this time of year? It’s generally because most spring marathon training programmes call for a ratcheting up of mileage, forcing your body to absorb more load.

So this article is about offering some advice on how not to join the back of the conga and end up in my waiting room. This guide is about what you can do if you begin to up your mileage and notice that ominous niggle appear that you just can’t shake.

  • Dont panic but don’t run through it. This is not the time to panic, my friends, you will see below that there are plenty of things we can do to navigate this issue. But please do not place your training programme above what your body is telling you. Don’t say, “Today’s my 18-mile run, I’m hurting, but my programme says I have to do it so I’m going to.” That’s a sure-fire way to make things worse. And, while we are on the subject, don’t worry if you haven’t done a 20-mile long run before race day. It’s not necessary. Last year I had a client who only managed a 13-mile long run but still managed a sub-4hr marathon. I’d much rather you be on that start line fresh and injury-free, rather than have gone to war to get your 20-22-miler in and line up beaten up, fatigued and niggle ridden!
  • Rest. The obvious one. Perhaps all this niggle needs to settle down is one or two rest days to allow the area to adapt, strengthen and desensitise. Remember, rest is where all the adaptation is taking place.
  • Get plenty of good quality sleep and keep stress low. This goes hand in hand with the rest advice. Getting good amounts of quality sleep and keeping yourself free of stress (I know, easier said than done), puts the body in recovery mode, meaning that your internal environment is set up for recovery and healing. Helpful to overcoming any niggles.


  • Alternate your footwear. I’m a big fan of shoe rotation for injury prevention. Personally, I have racing flats, very minimalist shoes and shoes towards the more maximalist end of the footwear spectrum. This is because we know that different types of shoe load your body differently. Generally speaking, minimalist shoes place more load on the foot and ankle, whereas more maximalist shoes tend to load the shins and knees. So if you have an achilles or calf niggle, by simply changing to a more maximalist shoe it may de-load the area sufficiently enough to allow you to continue running pain free.
  • Change your workout. Let’s say you’re on a long run and you start to feel the niggle and it’s not going away. In fact it’s getting worse. There’s nothing wrong with being flexible with your training week. The problem with the long run is that we all tend to run it at the same pace, which means the same loading pattern on your body with every step. So another option is to turn the session into a speed session instead. The different speed, distance, rest intervals and range of motion experienced in a speed session, again, could be enough to offload the injured area and still means you log a beneficial workout.
  • Cross-train or pool running. You may have noticed that all of these tips are around offloading the injured area enough to allow any healing/desensitisation to occur. This is another. Cross-training (traditionally people think cross-trainer or cycling) is another way to continue building fitness, while de-loading the injured area. Personally, I like pool running in deep water with a specialised belt float. Although definitely one of the more boring workouts, it does mean you keep in-graining the correct movement patterns associated with running and, as long as you are still training with the correct intensity, you will still get the benefits, just without the load. It’s like a cheap anti-gravity treadmill.

Young People Spinning in the gym

  • Change your running style. Depending on where the niggle is, there are technique changes that can be made to shift the load from that body part. For example, increasing cadence is a common cue used to change loading patterns. You can check out my site for some more info on this or alternatively go see a physio or coach that specialises in running re-education. They can give you the cues needed to change your running technique and this may be enough to continue running pain free.
  • Stay positive. Last but by no means least, stay positive. Running injuries are just another category of pain and it is well established that depression, anxiety, fear, catastrophisation (fearing the worst) can change your experience of pain – and not for the better.

Terry Smith

Physiotherapist, barefoot running coach, resident physio for Women’s Running online. Terry Smith began his physiotherapy career in 2007 with the NHS. Since leaving the NHS in 2010, he has worked in national fitness centres/gyms, a professional sports team and spent two years in Canary Wharf, working for one of the biggest investment banks in the world as its Advanced Lead Practitioner. Terry is a certified barefoot running coach and UK Athletics leader in running fitness. WWW.LONDONRUNNINGPT.COM

Meet the team

We use cookies to give you a better experience on By continuing to use our site, you are agreeing to the use of cookies as set in our Cookie Policy.

OK, got it