marathon course
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Marathon popularity has been steadily growing over recent years. Unfortunately, with long-distance running sometimes also come the undesired injuries, often located in the lower limbs. The incidence of injuries among long distance runners is somewhere between 6 and 44%.

Among the risk factors for running related injuries a recent article has pointed out three factors:

  • history of previous injuries
  • absence of interval training
  • insufficient running experience (< 5 years)


The study

A recently published study has investigated preventive measures taken by runners in the 16-week preparation period before a race. Therefore, the SUMMUM-2016 study recruited participants who had signed up for the Utrecht marathon and half-marathon and followed them for 16 weeks until race day (March 20th, 2016).

Runners received a questionnaire at the start of the 16 weeks period. It was determined to know demographic factors such as: sex, age, height, weight, educational level, lifestyle (smoking, diseases, food supplements…) and training methods (training surface, experience and training levels, use of heart rate monitoring systems…).

After this initial assessment runners received another two questionnaires, one every 2 weeks related to injuries (in muscles, tendons, joints or bones related with running), and another one, once a month, related to preventive measures (warming-up, cooling-down, stretching, compression socks, kinesiotape or type of shoes).

In these questionnaires runners had to evaluate the severity of their injuries, to distinguish between substantial and non-substantial injuries, to exclude minor symptoms not impairing the training level and uniquely an expected outcome of heavy training.

The number of runners included in the study was 161 (response rate 74.1%), with the following characteristics:

  • average age 40.7 years
  • average height 177.7 cm
  • average weight of 72.6 kg
  • 78% highly educated
  • 44% women
  • 23% used food supplements
  • 6% were already in training
  • 4% registered for the half-marathon and 28.6% for the full distance
  • 9% of the runners had completed one or more full marathons and 72.7% one or more half marathons
  • 6% of runners at baseline reported a running-related injury in the previous 12 months


The results

During the 16-weeks preparation period 17.7% of participants reported substantial injuries. The location of these injuries was as follows: lower leg (4.3%), ankle (3.0%), foot/toe (2.8%) and knee (2.6%).

Runners with a previous history of injuries used at least one additional, and not previously used, preventive measure. The most used preventive measures were asking for advice on running shoes (60%) and stretching exercises before/after training (46%). Other less popular measures were the use of compression socks (21.1%) braces, bandages or kinesiotape.

Maybe these runners decided to use these extra measures because they didn´t feel fully recovered from their previous injuries.


The conclusion

Although the number of runners in the study was limited, and there was no distinction between those running the half-marathon and those going for the full distance, the use of preventive measures could be an indication for health professionals about the potential for upcoming running related injuries.



In training for a marathon: Runners and running-related injury prevention.

Hofstede H, Franke TPC, van Eijk RPA, Backx FJG, Kemler E, Huisstede BMA

Phys Ther Sport. 2020 Jan; 41:80-86. doi: 10.1016/j.ptsp.2019.11.006. 

marathon course
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