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Pain During Marathons | How to Reduce Pain During a Marathon


  • New research suggests 99.8 percent of people experience some level of pain during a marathon, with 80 percent experiencing an intense level.
  • This may be due to injuries, hilly training routes, or high-intensity efforts during training could have carried over to the race day.
  • To mitigate pain during a marathon, embrace low-intensity, steady-state running and recovery during training, and don’t be afraid to slow down or stop to stretch during the race itself.

    If you’ve ever run a marathon—or honestly, even if you haven’t—you know how taxing it can be on your body. During a long-distance race like this, the majority of participants experience some level of pain. In fact, a recent study suggests only 0.2 percent people don’t report any pain.

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    Research published in Frontiers in Sports and Active Living looked at 1,251 runners who completed an online survey about the location and intensity of their primary pain during a previous marathon. The questionnaire also collected info on typical pain intensity during training runs, perception of effort during the marathon, and percentage of training days with run-induced pain.

    Respondents were asked to select their primary pain location from a list of 27 body sites covering the entire body, and to rate the pain on a scale of zero to 10.

    All but two runners—so 99.8 percent of the study participants—reported pain during their last marathon, most frequently in the thigh, followed by hamstring and calf. The overall pain rating was about a 5, and typically occurred around miles 15 or 16 of the race. Overall, pain intensity during the race was associated with pain during training runs.

    “Essentially, everyone experiences some pain while running a marathon,” study author Patrick O’Connor, Ph.D., professor of kinesiology at the University of Georgia, told Runner’s World. “The pain tends to be worse among those who have run fewer than two marathons or whose effort during the marathon is rated as ‘hard’ or greater.”

    The biggest surprise in the findings, he added, was how many runners reported experiencing high-intensity pain during a marathon—about 80 percent stated they had that level of pain at some point on the course.

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    Why does this type of pain occur in the first place? O’Connor hypothesizes that injuries, hilly training routes, or high-intensity efforts during training could have carried over to the race day. “Alternatively, non-running related variables could be important moderators, including genetics, family history of hypertension, typical sleep duration, and health status,” he states in the study.

    That doesn’t mean pain needs to be inevitable, however. O’Connor suggested that marathon-related pain can be averted to some degree with more appropriate training that includes more rest and recovery after long training runs. During a marathon, he advised a slight reduction in pace when pain becomes present, especially on hills, and selecting a marathon with a flatter course—such as Chicago, Houston, or Phoenix—may also minimize pain.

    It can help to think of strategies as pain mitigation rather than elimination, added running coach Kourtney Thomas, C.S.C.S. She told Runner’s World that often means embracing low-intensity, steady-state running (LISS).

    “That means low heart rate, and you can talk the entire time without huffing and puffing,” she said. “Make sure the bulk of your training is at the least taxing pace, and you’ll still be getting the training adaptations you want. But it allows you to recover the best way, and that will reduce your pain. The more workouts you do where you push too hard, the more accumulated fatigue and pain you’ll start to have.”



    Proper recovery helps as well, she added, and that means regular stretching, massage, Epsom salt baths, good nutrition, and lots of sleep. But during a marathon? Buckle down.

    “It’s your longest, hardest effort, and it’s going to hurt, especially in those last few miles,” she said. “At that point, it’s more about mental toughness. But you also have the choice of slowing down or even stopping and stretching.”

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