City Run Enthusiasts Must Know! How to Care for Yourself Before Running a Marathon to Prevent Knee Damage and Plantar Fasciitis

The 'marathon' and 'City Run' trends are gaining strong momentum. However, long-distance running carries many hidden risks. Information from Khoddee Meesuk Hospital reveals how to prepare and the injuries runners should be aware of before competing.

Currently, worldwide including in Thailand, the "marathon" fever is sweeping across. This is not just a fitness trend but a fusion of sport, social life, fashion, and tourism, leading to new running cultures like "Run Club" and "City Run," which have become 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. From a niche group of runners, participation has expanded rapidly to working adults and teenagers, with national and community runs happening nearly every week. Yet beneath the triumph at the finish line, marathon running involves repetitive impacts about 3-4 times body weight transmitted through the ankles, knees, and hips. Without proper understanding and preparation, this can easily turn fitness into injury.

Khoddee Meesuk Orthopedic Hospital (kdms) has introduced guidelines to transform beginners running in parks into sustainable "marathon runners" through scientifically grounded preparation and deep understanding of injuries.

Three fundamental pillars of “how to care for yourself before running a marathon” based on scientific principles.

To safely step into the marathon field, Khoddee Meesuk Orthopedic Hospital highlights three essential elements the body must adapt to:

1. Accumulating mileage

• 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 total weekly mileage by no more than 10% to prevent 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 necessary to improve tolerance to lactic acid buildup.
• Most importantly, strength training is vital to strengthen core and leg muscles to withstand impact.

3. Nutrition and rest

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

Check the top 5 common injuries marathon runners often face.

Statistics show that most marathon runners have experienced at least one injury during training. The most common are:

1. Runner’s knee pain

• Symptoms: A dull ache around or beneath the kneecap, worsening with weight-bearing or knee bending activities such as running downhill, descending stairs, or prolonged squatting.
• Cause: The kneecap moves out of alignment, rubbing against the thighbone and causing inflammation. This often results from weak quadriceps and hip muscles, sudden increases in distance or speed, and flat feet causing inward knee rotation.

2. Iliotibial band syndrome (inflammation of the tendon on the outside of the knee)

• Symptoms: Sharp or burning pain on the outer knee, typically appearing after running a certain distance (e.g., 5 or 10 kilometers), forcing the runner to stop.
• Cause: The iliotibial band running from the hip to the outer knee becomes overly tight and repeatedly rubs against the outer knee bone. This often occurs in runners who increase mileage too quickly, run on sloped surfaces, or repeatedly run laps in the same direction on a track.

4. Achilles tendonitis

• Symptoms: Tightness, pain, or swelling above the heel at the back of the ankle, often worst in the morning upon waking or during the first steps.
• Cause: The Achilles tendon is overloaded from springing motions, commonly due to tight calf muscles lacking stretching or training that emphasizes toe running, such as hill running or speed work without sufficiently strong calf muscles.

5. Plantar fasciitis (heel pain)

• Symptoms: Sharp stabbing pain like a needle in the heel or sole when taking the first step in the morning or after prolonged sitting.
• Cause: Tight calf muscles pulling on the plantar fascia, combined with running heavily on hard surfaces and foot structure factors like flat or high arches.

Internal risks not to be overlooked

Besides muscles and bones, Thailand’s rising temperatures increase risks of dehydration and heatstroke because the body cannot dissipate heat quickly enough. Also, low blood sodium can occur from drinking excessive water, diluting electrolytes in the bloodstream.

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

Khoddee Meesuk Orthopedic Hospital advises that if runners develop injuries, the first step is to "accept the pain and immediately stop running." Modern medical advances can help runners return to the field faster through "sports medicine."

Sports medicine is a specialized field combining knowledge of bones and joints, physical therapy, and nutrition. A team of specialist doctors, rehabilitation physicians, and physical therapists collaborate to prevent, diagnose, treat, and rehabilitate injuries to restore patients’ health and enable them to resume sports quickly, often with equal or improved physical performance.

Crossing the finish line with a smile and no injuries is the true success. Respecting distances, preparing mindfully, and understanding your body are the best defenses for sustainable enjoyment of marathon and City Run events.