Physical Therapy

Spring Marathon Injury Prevention

Casey Egan

As winter fades and spring marathon season approaches, runners everywhere begin ramping up their training. Mileage increases, workouts intensify, and long runs return to the weekend calendar. While this is an exciting time, it’s also when many runners unknowingly set themselves up for injury.

One of the most effective—and often overlooked—ways to stay healthy during marathon training is preventative physical therapy before training officially begins. Addressing small issues early can mean the difference between reaching the start line strong or watching race day from the sidelines.

Why Injuries Spike During Marathon Training

Marathon training places repetitive, high loads on the body over an extended period of time. Even minor movement inefficiencies or muscle imbalances can become problematic when repeated thousands of times per run.

Common reasons injuries occur during spring marathon training include:

Sudden increases in mileage or intensity
Lingering weaknesses from previous injuries
Poor running mechanics or strength imbalances
Limited mobility from winter inactivity
Inadequate recovery between sessions

Many runners wait until pain appears before seeking help—but by then, tissue irritation or breakdown may already be present.

What Is Preventative Physical Therapy?

Preventative physical therapy focuses on identifying and correcting issues before they cause pain or injury. Instead of treating symptoms, a physical therapist evaluates how your body moves and how well it’s prepared for the demands of marathon training.

Key Benefits of Preventative PT for Runners

1. Identifying Weaknesses and Imbalances Early

Many running injuries stem from strength asymmetries, poor hip or core control, or underactive stabilizing muscles. A preventative PT assessment can uncover:

Hip or glute weakness
Core instability
Left-right strength imbalances
Poor ankle or foot control

Correcting these early reduces excess stress on joints and tissues during high-mileage weeks.

2. Improving Mobility Where It Matters

Winter often brings reduced activity, stiffness, and limited mobility—especially in the hips, ankles, and thoracic spine. Limited range of motion can alter running mechanics and increase injury risk.

Physical therapy can help:

Restore joint mobility
Improve soft tissue flexibility
Ensure your body moves efficiently during longer runs

3. Optimizing Running Mechanics

Subtle form issues may not cause pain at low mileage but can become problematic as training volume increases. Preventative PT may include:

Running gait analysis
Assessment of stride, cadence, and alignment
Drills to improve efficiency and reduce impact forces

Even small mechanical improvements can significantly reduce cumulative stress over a marathon training cycle.

4. Building a Strong Foundation for Training Load

Marathon training is about consistency. Preventative physical therapy helps prepare your body to tolerate higher training loads by:

Gradually strengthening tendons and muscles
Improving neuromuscular control
Enhancing shock absorption through proper strength and form

This foundation allows you to train harder—and smarter—without breaking down.

5. Reducing the Risk of Common Running Injuries

Preventative PT is especially effective at reducing the risk of:

Shin splints
Achilles tendinopathy
IT band syndrome
Plantar fasciitis
Knee and hip pain

By addressing root causes early, runners often avoid these issues altogether.

What a Preventative PT Program Typically Includes

A preventative physical therapy program for runners is highly individualized, but often includes:

A comprehensive movement and strength assessment
Running-specific strength training
Mobility and flexibility exercises
Balance and stability work
Education on training load, recovery, and footwear

Many runners are surprised to learn that just 1–2 focused sessions per week can make a meaningful difference throughout their training cycle.

When Should Runners Start Preventative PT?

Ideally, runners should begin preventative physical therapy 4–8 weeks before marathon training officially starts. This allows time to address deficits and build strength before mileage increases.

However, it’s never “too early” or “too late” to benefit. Even runners already training can use preventative PT to stay ahead of minor aches before they escalate.

A Smarter Way to Train for Spring Marathons

Marathon success isn’t just about logging miles—it’s about keeping your body healthy enough to complete the training. Preventative physical therapy gives runners the tools to train consistently, recover better, and reduce injury risk long before pain appears.

As you prepare for spring marathon season, consider making preventative PT part of your training plan. Investing in your body early can help ensure that when race day arrives, you’re healthy, confident, and ready to perform your best.