Fitness Friday: Training for the NYC Marathon

by Julie Khan
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On Monday, September 16, 2013, New York Road Runners hosted a live Facebook chat with HSS physical therapist Julie Khan to talk about training, aches, pains, and feeling your best in time for the ING NYC Marathon. The following is an excerpt from the chat, with answers provided by Julie, as well as lower body exercises to use when training.

After my long run this weekend (16 miles), I woke up with my left Achilles tendon clicking when I go up and down the stairs. It doesn’t hurt, but it clicks. Is that a reason for concern?
I would advise you to take a couple days off to rest. Generally, non-painful clicking is not something to worry about. If this does continue, I would advise you to see a sports medicine doctor or a PT.

How can one tell the difference between healthy soreness, for example in and around the knees after a run, and an emerging injury?
DOMS (delayed onset muscle soreness) usually peaks at 48 hours, so something lasting longer than this might be an emerging injury. I would ice and take it easy for a few days. Remember not to run through the pain.

I always feel significantly sore after my long runs, and despite the training, I also do during the week. I feel like my body isn’t adjusting to the miles. I started training in mid-June. Any thoughts on what might be causing the soreness and what are some ways to address it?
I would try doing a cold ice bath after the long runs. They help to decrease inflammation that can lead to soreness and pain. I would also try to foam roll after the long run. It can be quite painful to use the roller, but it can really help to work out these tight areas.

I’m training for my 8th marathon coming up in just a few weeks. I just finished a 20 mile training run and the last two miles or so I had a sharp pain in the front of my knee. I’ve never had pain like this in my knee. Aside from stretching and icing, do you have any advice? Are those knee bands or braces beneficial?
The knee bands can be helpful, but most likely you need to be strengthening your glutes and core. It sounds like fatigue is an issue for you since this happens at the end of your run. See a trainer or a PT to get some specific exercises.

My knee starts hurting after 8 miles, I was told to roll out my ITB, is there anything else that I can do to be better prepared for my long runs?
You might want to try a dynamic warm up before your runs. High kicks, high knees, butt kicking, hopping and leg swings can help warm up the body. Also, make sure you are doing leg strengthening exercises like squats and lunges.

Here are the top lower body exercises runners can do about three times a week to increase strength and endurance:

1)      Plank and Side Plank: Start with three reps of 30 seconds, then increase up to 45 seconds to a minute. Then you can do side planks on each side, where you lie on your side and lift the top leg up, keeping the other heel on the ground. Planks work the core, while the side planks (with and without the hip abduction) work the core and glutes.

2)      Single Leg Bridge: Lie on your back with one leg bent and one leg straight. Engage your core muscles, then press down through the bent leg and push your pelvis towards the ceiling activating your buttocks. Make sure to keep your pelvis level. Do three sets of 10 reps on each leg. This exercise targets your core, gluteus maximus and legs.

3)      Fire Hydrant: Go on your hands and knees with a theraband tied around your thighs. Bring one leg out to the side, hold it, and then bring your leg back. Perform three sets of 10 reps on each leg. This exercise targets gluteus medius.

4)      Standing Hip Abduction: Stand with a theraband around your legs, or around one ankle with the other around a post or chair leg. Bring the leg with theraband wrapped around it back and to the side (4 o’clock) while keeping the knee straight. Do three sets of 10 reps for each leg. This exercise targets gluteus medius.

5)      Lunges: Perform three sets of 10 reps. Lunges target your quads and gluteus maximus. For all exercises, keep your core tight and pelvis stable.

Videos from our New York Road Runners Learning Series “Strategies for the Marathon Runner: Keeping You on Your Feet and Through the Finish Line” are now posted online! Click here for training advice on injury prevention, running form, and nutrition.

Julie Khan is a Physical Therapist in the HSS Rehabilitation Department. Julie graduated from Columbia University with both her Masters and Doctorate of Physical Therapy. Her clinical interests include post-surgical sports related injuries and running mechanics. Julie is a runner and has completed over 20 half marathons and 5 marathons and is currently training for her 6th marathon which will be the ING NYC Marathon this fall.

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The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

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