City Runners Must Know! How to Take Care of Yourself Before a Marathon to Prevent Knee Damage and Plantar Fasciitis

'Marathon running' and 'City Run' are gaining huge popularity, but long-distance running carries many hidden risks. Information from Khod Dee Mee Suk Hospital reveals how to prepare and the injuries runners must know before hitting the track.

Currently, worldwide and in Thailand, there is a 'marathon running' fever. This is more than just a fitness trend; it combines sports, socializing, fashion, and tourism, creating new running cultures such as 'Run Club' and 'City Run' that serve as social status symbols reflecting discipline, health awareness, and a mental sanctuary for the younger generation.

Looking back over recent years, marathon events in Thailand have surged in popularity. Once limited to niche groups, they now rapidly include working adults and youths. National and community runs occur almost weekly. However, beneath the success at the finish line, marathon running subjects the body to repetitive impact forces about 3-4 times body weight transmitted through ankles, knees, and hips. Without proper understanding and preparation, fitness can quickly turn into injury.

Khod Dee Mee Suk Orthopedic Hospital offers guidance on transforming from a casual park runner into a sustainable 'marathon runner' through scientifically grounded preparation and a deep understanding of injuries.

Three core principles for 'taking care of yourself before a marathon' based on science.

To safely reach marathon readiness, Khod Dee Mee Suk Orthopedic Hospital identifies three essential body adaptations:

1. Mileage buildup

• The human body requires gradual adaptation over time.
• The cardiovascular system, lungs, tendons, and muscles need at least 4-6 months to develop.
• Runners should increase their weekly total running distance by no more than 10% to avoid overloading the body.

2. Balanced training schedule

• Marathon training isn't just about long runs.
• It must include easy runs to build endurance.
• Tempo runs are needed to improve tolerance to lactic acid buildup.
• Most importantly, strength training is essential to build core and leg muscles strong enough to absorb impact.

3. Nutrition and rest

• Carbohydrates are the primary fuel; runners must properly load nutrients before, during, and after training.
• Sleeping soundly for 7-8 hours daily is crucial for the body to repair and strengthen itself.

Check the five most common injuries marathon runners face.

Statistics show that most marathon runners experience at least one injury during their training careers. The most frequent injuries are:

1. Runner’s knee pain

• Symptoms: Dull pain around or below the kneecap, worsening when bearing weight or bending the knee, such as running downhill, descending stairs, or squatting for long periods.
• Causes: The kneecap moves out of its groove, rubbing against the thigh bone and causing inflammation. Often due to weak thigh and hip muscles, excessive mileage or speed increases, or flat feet causing the knee to rotate inward.

2. Iliotibial band syndrome (ITBS)

• Symptoms: Sharp or burning pain on the outside of the knee, usually starting after running a certain distance (e.g., 5 or 10 kilometers), forcing the runner to stop.
• Causes: The iliotibial band, running from the hip to the outer knee, becomes overly tight and repeatedly rubs against the outer knee bone. Common in runners who increase mileage too quickly, run on slanted surfaces, or run repeatedly around a track in the same direction.

4. Achilles tendinitis

• Symptoms: Tightness, pain, or swelling above the heel on the back of the ankle, worse in the morning upon waking or with the first steps.
• Causes: The Achilles tendon is overloaded by repeated springing motions. Often caused by tight calf muscles due to inadequate stretching or training that emphasizes forefoot running like hill sprints or speedwork before calf muscles are strong enough.

5. Plantar fasciitis (heel pain)

• Symptoms: Sharp stabbing pain in the heel or sole when taking the first steps after waking or standing after prolonged sitting.
• Causes: Tight calf muscles pulling on the plantar fascia, running heavily on hard surfaces, combined with foot structures such as flat or high arches.

Internal risks that must not be overlooked.

Besides muscles and bones, Thailand's rising temperatures increase risks of dehydration and heat stroke because the body cannot dissipate heat quickly enough. Also at risk is hyponatremia, caused by drinking excessive water, diluting blood electrolyte concentrations.

Injured but want to keep going? Recover with sports medicine.

Khod Dee Mee Suk Orthopedic Hospital advises that if a runner develops an injury, the first step is to "accept the pain and immediately stop running." Modern medical science now helps runners return to the track faster through sports medicine.

Sports medicine is a specialized field combining knowledge of bones and joints, physical therapy, and nutrition. A team of orthopedic specialists, rehabilitation physicians, and physical therapists collaborates to prevent, diagnose, treat, and rehabilitate injuries, helping patients recover quickly and return to sport with equal or improved physical capacity.

Crossing the finish line with a smile and without injury is the true achievement. Respecting your mileage, preparing mindfully, and understanding your body's signals provide a strong shield to keep you thriving on the path.Marathon enthusiastsand City Run participants can enjoy sustainable running careers.