KDF Marathon Training: Preventing Injuries

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KDF Mini marathonHere in Louisville many people put all their New Year’s resolutions to the test by training for the city races.  I have a few past Triple Crowns under my belt, but while I still run on occasion for exercise, I have not trained for a race in over nine years.  When Norton asked me to be the medical director for the Kentucky Derby Festival mini-Marathon/Marathon this year, I thought this would be the perfect opportunity to get back into training and run the races again.  In addition to the extra 10 years or so since I last trained, I also have about 15 extra pounds.  Why not combine the New Year’s resolution of losing weight with getting in shape and running?

Since a lot of people are training for the first time or, like me, for the first time in a long while, I thought I would share my experiences throughout my training by using my blogs.  I will post this on my regular blog at, and on the Norton SportsHealth Training for Race Day site at  The Norton site will also have training guides, running schedules, maps, and training tips that we have developed.  In addition to the training journal, I will also address a different running topic every two weeks from the medical point of view.

Some people have the goal to simply finish the races, and some have specific time goals in mind.  The reason that people do not meet their goals is usually not because of a lack of dedication or will power, but often it is due to injury.  There are four periods or time when runners are most vulnerable to injury:

  • During the initial four to six months of running
  • Upon returning to running after an injury
  • When the distance of running is increased
  • When the speed of running is increased

Everyone who trains for a race will likely have some aches and pains along the way, but when should these stop you from running and when should you just push through?  This is always a difficult question for runners and there is not a clear-cut answer, but here are some common signs that you may be developing an injury that needs treatment:

  • Pain or discomfort while running, especially pain that increases during a run
  • Pain that continues after a run or pain even at rest
  • Limping or change in gait
  • Stiffness
  • Pain/discomfort that causes inability to sleep

For mild injuries such as most sprains and strains, the RICE protocol is the first line of treatment.

  • Rest – Stop running and do not return while symptoms persist. When you do return, gradually ease in, increasing distance by no more than 10 percent per week.
  • Ice – Ice the injured area for 20 minutes at a time several times a day until swelling subsides.
  • Compression – A compressive dressing, such as an ACE wrap, can help control swelling.
  • Elevation – Elevate the injured area above your heart when possible to reduce swelling.

For injuries that do not respond to the RICE protocol, it is important to see a physician for evaluation, diagnosis and treatment.