Marathon training season has kicked into high gear. Injuries often come when training for a marathon due to the volume of training. The most common injuries in marathon runners are shin splints, stress fractures, muscle strains, patellofemoral pain syndrome, which causes pain under and around the knee and ITB Syndrome (iliotibial band), which causes to pain on the outside of the knee and hip.

Due to the forward running motion, various muscle groups tend to overdevelop creating overuse syndromes and imbalances. The calf muscles develop more than the anterior shin muscles; the quadricep muscles develop more than the hamstrings and the lower back muscles tend to develop more than the abdominal muscles.

Haemi Choi, MD, a sports medicine specialist at Loyola says, "These injuries often result from overtraining or increasing mileage too quickly. It's important to schedule rest days and build up slowly."


Consume an appropriate amount of filtered water daily. Your body is 85 percent water and physiologically water works as a catalyst to most functions within your body. Dehydration causes joint pain, low back pain and a decrease in performance. To figure out the number of ounces take your bodyweight and multiple it by .7, this will give you the number of ounces daily for you to personally consume. Add a pinch of unprocessed sea salt or Himalayan salt to your water. This helps you absorb water and provides additional minerals lost through sweating.

Paula's Healthy Winning Formula Electrolyte Replacement Beverage:

• 48 ounces of filtered or spring water

• 8 ounces coconut water

• 8 ounces of one of the following: Triple Berry Juice or Just Cherry (all found at Trader Joe's)

• 1 teaspoon of unprocessed sea salt


Women especially overlook the importance of their diet when it comes to the rigorous training that marathons require. When the volume of training increases, so do your energy requirements. Eating small, balanced meals from whole foods every three to four hours will support your training needs.

Endurance athletes perform better when their fat intake is approximately 25 percent to 30 percent of total caloric intake. Healthy sources of fat include nuts and seeds, avocado, coconut oil and olive oil. Due to the vast amount of stress placed upon the body with marathon training, protein requirements increase. Without adequate protein, your muscles will not be able to go the distance, recover or repair afterwards. Healthy sources of protein include organic poultry, beef, buffalo, wild fish, hypoallergenic, lactose-free, digestible whey protein powder or vegetarian protein powder such as Pure Lean.


Training for a marathon increases oxidative stress. According to endocrinologist Dr. Diana Schwarzbein (author of The Schwarzbein Principle II ), "oxidation" is a process that forms free radicals in the body. Normally the body can neutralize free radicals with substances known as antioxidants. It is only when there is an excessive build-up of free radicals that the body cannot neutralize all of the free radicals.

Consider the following supplements:

• Multi vitamin/mineral

• Antioxidants

• Vitamin D

• Essential fatty acids

• BCAAs and L-Glutamine


Invest in new shoes every 300 miles. Avoid wearing new shoes on race day. If necessary, they should be replaced three or four weeks prior to the marathon to ensure your feet adjust to the new fit.

Sleep, rest, recovery

Sleep allows your muscles to restore energy required for recovery and training. Exercising too close to bedtime may keep you awake. According to the NIH (National Institutes of Health), the physical body repairs between the hours of 10 p.m. and 2 a.m. The mind/emotional/spiritual body repairs between the hours of 2 to 6 a.m.

Make sure to schedule in rest days. Listen to your body and definitely rest if you feel sluggish or tired, experience sudden weight loss of 5 or more pounds, are excessively thirsty, your resting heart rate is 5 BPM or more, or you feel a sore throat or cough coming on.

Cross train and prioritize your training program (a smart training program that is planned out interspersing volume and intensity). Marathon runners as well as triathletes can increase their VO2 max close to 4 percent and raise the lactate threshold over 8 percent when they add one to two days of interval training to their training regime. The study used six to eight 30-second all out sprints on a stationary bike followed by a 3.5 minute rest.

Treat yourself to a massage to prevent injuries and avoid overtraining. Soak in a tub with Epsom salt. Your skin absorbs the magnesium from the Epsom salt, helping muscles to relax.

Schedule an appointment with your chiropractor for maintaining proper spinal alignment and optimal nerve function.

Stretching, myo-fascial release

Dynamic warm up before exercise is essential in preparing your body for optimal performance. Static stretching and self-myofascial release (SMR) using the foam roller will help with injury prevention, flexibility and muscle recovery. Myo = muscle and fascia = fibrous connective tissue encasing the muscles.

SMR can release muscle and joint pain. SMR is an extremely effective rehab technique for ITB syndrome. Daily use helps to increase flexibility. For a small investment, usually under $20, a foam roller is a must for all marathon trainees.

On the foam roller for the ITB - Illiotibial Band: Position yourself on your side so your outer thigh is resting on top of the roller. Place the foot of the opposite leg on the ground in front of you. Make sure you do not turn too far on to the front or back of the thigh. Start in the middle of the ITB and work toward the top of the muscle. Continue to work all the way down the outer thigh ending above your knee.

Ahwatukee Foothills resident Paula Owens is a nutritionist, fitness expert and weight loss coach with more than 20 years of experience. Reach her at


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