Why Marathon Training Puts Your Body at Risk
Whether you’re preparing for your first Flying Pig Marathon or chasing a personal best, long distance running places repeated stress on your body. Every mile adds up—on your bones, joints, and tendons.
That’s not a bad thing. It’s how your body gets stronger.
But when training ramps up too quickly, that same stress can lead to injury.
“One of the most important things when we’re talking about marathons is preparation,” says David Bernholt, MD, orthopaedic surgeon at UC Health. “You’re putting real stress on your body, and you have to give it time to adjust.”
With UC Health serving as the official healthcare partner of the Cincinnati Flying Pig Marathon, our sports medicine team works closely with runners across the region—helping them train smarter, recover faster, and stay on track for race day.
The key? Understanding where injuries come from—and how to prevent them before they start.
The Most Common Running Injuries
When runners get injured, it’s usually not from one sudden event—it’s from repeated stress over time.
“Assuming there’s no traumatic incident, the big things we worry about are stress fractures and tendonitis,” says Dr. Bernholt.
Stress Fractures (The Most Serious)
Small cracks in the bone caused by repeated impact. These can sideline runners for weeks—or longer.
Tendonitis (The Most Common)
Tendon irritation from overuse, including:
- Iliotibial band (IT band) syndrome
- Patellar tendonitis
- Achilles tendonitis
These often start small—but worsen if ignored.
Why These Injuries Happen
Most injuries come down to one issue: too much, too soon.
Without proper progression:
- Bones don’t rebuild fast enough
- Tendons stay inflamed
- Minor pain becomes major injury
How to Train Safety for Race Day
Building Your Marathon Plan
Training for a marathon can feel overwhelming—especially with so many plans out there. But the most important place to start is simple: your plan should fit you.
“There are cookie-cutter plans out there, but you still need to individualize it,” says Dr. Bernholt.
Every runner is different. Some are preparing for their first Flying Pig Marathon. Others are chasing a personal best. Your plan should reflect:
- Your fitness level
- Your experience
- Your goals
- How your body responds to training
In marathon training, consistency—not intensity—is what gets you to race day.
The #1 Rule: Gradual Progression
If there’s one rule that prevents injury, it’s this: build slowly.
“We recommend increasing the amount of miles you run by about 10% at most per week,” says Dr. Bernholt.
This gives your body time to adapt safely.
What Gradual Progression Really Means
Each run places stress on your bones, muscles, and tendons. With the right progression, your body rebuilds stronger after each effort.
But when mileage jumps too quickly:
- Bones don’t have time to adapt
- Tendons become overloaded
- Small aches can turn into bigger injuries
Build In Recovery Weeks
Progress isn’t just about adding miles—it’s about knowing when to pull back.
Smart training follows a cycle:
- Gradually increase mileage
- Step back for recovery
- Then build again
These recovery weeks allow your body to reset, repair, and come back stronger for the next phase of training.
Marathon Training Tips to Stay Injury-Free
1. Warm Up the Right Way
Jumping straight into your run can put unnecessary strain on your muscles and joints. A proper warm-up helps your body transition from rest to movement—reducing injury risk and improving performance.
Start simple:
- Begin with a brisk walk or light jog to gently raise your heart rate
- Then move into dynamic mobility exercises to activate key muscle groups
Mobility exercises:
- Leg swings (forward and side-to-side)
- High knees
- Butt kickers
- Skipping drills
These exercises don’t just stretch your muscles—they “turn them on,” helping your body move more efficiently once you start running. Think of your warm-up as a system check: getting your heart rate up, your muscles engaged, and your body ready for the miles ahead.
Skipping this step might save a few minutes—but it can cost you later in your training.
“A good warmup activates your muscles before you start running,” says Dr. Bernholt.
2. Stretch After You Run (Not Before)
Not all stretching is created equal—and when you stretch matters just as much as how.
Before your run, your muscles need movement—not long holds. That’s why dynamic mobility (like leg swings and drills) is the better choice to prepare your body. After your run, when your muscles are warm and more flexible, static stretching becomes valuable for recovery and reducing the likelihood of tendon-related issues.
How to stretch:
Hold each stretch for about 15–30 seconds, without bouncing, and focus on steady breathing. Target the areas that take on the most stress during long distance running:
- Hamstrings
- Calves
- Quadriceps
- Hip flexors
Think of this as your body’s cool-down and reset—helping you recover today so you’re ready to run again tomorrow.
3. Prioritize Sleep and Nutrition
Training for a marathon doesn’t just challenge your muscles—it challenges your entire body. Every run creates small amounts of stress and strain. How well you recover from that stress determines how strong you come back.
“You’re putting your body under a lot of stress—nutrition and sleep are imperative for recovery,” says Dr. Bernholt.
Why It Matters for Runners
When sleep or nutrition falls short, your body has a harder time keeping up with training demands. Over time, that can lead to:
- Increased fatigue
- Slower recovery between runs
- Higher risk of injury
Keep It Simple
You don’t need a perfect routine—you need a consistent one.
- Eat regularly to support your training
- Stay hydrated throughout the day
- Aim for consistent sleep each night
These small habits give your body the building blocks it needs to recover and adapt.
4. Choose the Right Running Shoes
The right pair of running shoes does more than feel comfortable—it helps reduce the repeated stress your body absorbs with every step. Over the course of marathon training, those small impacts add up. Having the right support can make a meaningful difference in how your body handles that load.
“It’s good to have proper footwear, especially with the increased stress running places on your body,” Dr. Bernholt notes.
Start with Your Gait
Not all runners move the same way. That’s why getting your gait—or how your foot strikes the ground—assessed can be helpful. This can identify whether you:
- Overpronate (foot rolls inward)
- Underpronate (foot rolls outward)
- Have a more neutral stride
Understanding this helps guide you toward shoes that better match your natural movement.
Listen to Your Body: Early Warning Signs You Shouldn’t Ignore
Some soreness is normal. But not all pain is.
“If pain doesn’t go away in 24 hours, that’s something you want to listen to,” says Dr. Bernholt.
Normal soreness:
- Dull ache
- Improves with movement
- Goes away within a day
Warning signs:
- Pain lasting >24 hours
- Increasing pain
- Sharp or localized discomfort
- Changes in how you run
Ignoring these signs can turn small issues into long-term injuries.
UC Health + Flying Pig Marathon: Supporting You Every Mile
As the official healthcare partner of the Cincinnati Flying Pig Marathon, UC Health’s Orthopaedic and Sports Medicine team helps runners stay healthy from training to finish line. Our experts support runners at every stage of training—from preventing injuries early to diagnosing pain quickly and creating personalized recovery plans when needed.
Meet with one of our orthopaedic specialists in Cincinnati, West Chester or Northern Kentucky by calling 513-475-8690 or schedule online.
