Ask the Experts: Marathon Injury Prevention Q+A with Sarah Connors



  • Hi Nick,

     yes your right a scan would prob still be positive.

    It's best to build up steadily the 10% rule is always a good one and don't increase training by more than this each week.

    Have you found the cause of your stress fracture? Is it your mechanics were you wearing old shoes, did you build up to quickly. If you've eliminated the cause you'll feel more confident building up again.


  • Hi Running bez,

    I know you are having US but has anyone looked at your foot and ankle? There is normally stiffness in the subtalar joint and around the ankle causing abnormal mechanics and pain. Have you had your gait checked so you know the kayano is def the right shoe? I'm not sure if they have changed the heel cup I've got the new ones and love them but everyone is different. you def need to rule out and stifness in the foot. are you seeing a physio for the U?S ? make sure they are used to seeing running injuries and get that checked out.


  • Sarah,

    thanks for response.

    Stuck to 10% rule....but have stopped increasing.

    Cause - not shoes. Minor biomechanical issue of dropped 1st ray in foot of problem leg - have always used 'superfeet' orthotics. Brief experiment with other orthotics gave me 6 weeks of grief before ditching them.

    Suspect cause was not enough rest after too many high mile weeks, and off-road 100k was simply too much. 

  • Hi Hornchurch Hammer,

    lots of these tightening of the muscles that you descibe come from the lower back it would make a huge difference to your quad if you had this mobilised the the hip stretched out. everything just gets tighter and tighter when training for a marathon, in fact I sponsor my friends with physio for that reason.

    Try and do some bridhing to to try and activate the gluts further to take some load off the quads. the best way to trstch is called the Thomas stretch where you hang the hip over the edge of a bed with other leg pulled towrads you and get someone to try and gently stretch the quad. This is shown in the video of stretching in the steeple chase water jump pit.


  • Thanks Sarah
    The pain feels more like a bruise like sensation to the muscle on the outside of the main shin bone
    The bone does not hurt at all and no pain when resting
    Can feel pain when I stretch it by keeping heel on floor and lift the front of foot up. Can also feel pain when pushing my thumb into the muscle about half way between knee and ankle

  • Thanks Sarah for your reply.

    Couple of quick questiosn

    Where can I find the video? Is it on this site?

    I'll do the stretches and try and get as much in between now and Sundays run (and of course after that) With a tight quad what is the worst than can happen in my half (this Sunday) if I try and race through any tightness??

  • Hi Liam,

    have the chiros been helping you stretch the hip and back area out as this will relieve masses of the tension, it's important to get as free as possible before the race then you can keep going longer without pain, get them to focus on freeing you up more than laser. If you've done your 20 mile you should be fine training wise, try not to run with pain as this creates more inflammation.

    hope that helps.


  • Hi Victoria,

    you won't have damaged your ACL as this is one of the stsbilising ligaments inside your knee normally injured in footabll or skiing.

    you have prob got inflammtion of the ITB which is the long fibrous band that runs down the outside of the thigh, if this is tight it can pull the patella( kneecap )out of line and cause knee pain.

    Yes def keep stretching the hip and foam roller the TFl soft fleshy bit at front of hip and alos try and get your lower back loosened off as well. Do this and try some easy running you need to know you are ok before you atsrt the race.


  • Hi Sarah

     the pain is in both knees, just behind the knnecaps and both inside and outside(!)

  • Thanks Sarah - I think my back is ok though they pointed out that my hips are tense (is that the correct phrase?!).  Anyway, I've got exercises for the hips but only one of the IT Bands - could you point me in the direction of any more?



  • Hi Jackie,

    it's really hard to treat your achilles yourself other than stretching and strengthening it good to do eccentric work once initial acute phase has passed dropping heels down on a step then lifting up initially with 2 feet.

    You need someone to asses your gait look at your trainers and your foot to see what has caused the problem as this is the key to eliminating achilles problmes. Are your trainers old do they give when you try to twist them Is there stifness around you heel altering the mechanics of your foot. these are all hard to do yourself.

     I would seek some advice try the local running shop first and get them to look at your shoes and gait and go from there.

    Good luck


  • Hi Rob,

    if the groin is sore you need to stretch all the muscles around the hip to free it off inc the adductors on the inside of the thigh and the hamstrings. Is your pelvis level if not then you will be putting unequal strains through the hips, Try standing and see where bothe hips bones are and if the feel level.

    worth stretching the hip and working the gluts to off load the area. these should all help. Keep cross training and try some easier runs to see how feels prior to race.


  • Thanks Sarah,

     Will pass on your thoughts tomorrow when I have my next session. Yes he specialises in Sports injuries. Also had my gait checked last october and confirmed I was in the right shoe. It was toss up between the Brooks or the K16s, stuck with what  I knew, Went through the 16's then got 17's.

     Now as I say giving the Brooks GTS a go. Only other change was some extensive running in trail shoes over xmas in the snow. Whether these have triggered something?

  • Hi Ian,

    ITB pain is more a sign of glut weakness as the TFL then has to overwork to compensate so try some glut exercies to take the pressure of. make sure you increase mileage slowly.


  • My right foot has a dull ache that is present in the centre of the foot / arch towards the inside edge.  The area that aches is approximately 40mm diameter.  This ache is not present at the start of the day but becomes noticeable after a short 15min walk from the train station to work (I have a short cycle ride to the train station from my house and this does not seem to agitate this).  I walk to work in my Brooks running shoes (which are of a design to give arch support.  I have been buying this design for 5years, and the current pair are less than 6months old / less than 300miles) and change these shoes at work to an ordinary pair of shoes.  My work involves sitting at a PC (ah! Modern life!) and after a while, the ache disappears and I no longer notice it.  It will be present again on the return commute home (in running shoes).


    The real issue is when I try run.  After 5mins running the pain will be enough for me to have to stop. Which is quite inconvenient for the marathon training I need to do L  I have been running for quite a few years now and never had this sort of injury before.  I think the pain may have started after a long practice run in old trainers and been exaggerated by a recent half marathon run in wet muddy slippy conditions with my new trainers. 


    Any advice to get me back on track please?

  • Thanks Sarah,

    I had my gait analysed last July and have trainers to correct overpronation. Have kept to the same type and been running in my current pair since mid January so can't see them being the problem.

    I'll book a physio appt for this week and will pop back to running shop to see if anything has changed!

     Thank you,


  • Hi guys,

    The clock has struck 2.30pm so I'm afraid we can't take any more questions. Thank you Sarah for all your help and advice!

    Scroll to the bottom of the ASICS Super Six page to check out videos of some the stretches Sarah has mentioned in the webchat. The link is here:

    Dominique RW

  • Hi Mick,

    yes you would def get more support from a different shoe, try the 2160 or the Kyano.

    Go to a local shoe shop that's experineced in fitting shoes and get them to look at you on the treadmill. 


  • Hi Running penguin,

    sounds like it could be your ITB, we've had lots of questions on this. I find the best ways to treat this are by looking at any lower back tightness stretching the hips and making sure the biomechanics are right. I also go through a glut strengthening programme. Try discussing this with your physio.


  • Hi Liam,

    it's really hard to do anything for Itb it's best to address the hips.sarah

  • Hi Running bez,

    trail shoes are def alot stiffer and the hips work alot harder in the snow so could be the cause.


  • Hi Karen,

     it sounds like you overpronate which is causing you to increase the load on the big toes, mkae sure you have the right shoes. You may even need insoles. You are probably falling as your knees are turning in. Your groin will be overloaded due to the overpronation and this can be helped by strngtheing the core and the gluts.

    Hope that helps.


  • Hi Ian,

    you need to have a good feel of the bone and make sure that not tender and a tress reaction to running on the harder surfaces.


  • Hi Alexis,

    if not get better with all that rest then time to seek advice get an assessment with a running experienced sports physio to find out what is going on


  • Kevin stretch this by trying to sit on your heels and stretch the front of foot. Get your thumbs into it and massage it to try and release.


  • Sarah

    It doesnt matter whether running on or off road, on road it comes on quicker but generally after a few miles or so.


  • Hi Hornchurch don't push through pain the worst is you will tear the muscle and be out for 6 weeks. Not sure where on the site can't look at the mo!


  • Hi neil then loads of quad and hip flexor stretching this is key for anterior knee pain.


  • Hi Clare sounds like you may have the start of plantar fascitis really tricky to treat so I would seek advice asap.

    Try stretcing the bottom of foot on a step with toes up the step.


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