Training for the London Marathon? Common Injuries and Treatments

Dog running - london marathon injury

Its that time of the year again when, sweeping away the excesses of festivities, keen and beginner runners start training for the London Marathon—how exciting!!

New trainers, new running leggings, FitBit on your wrist and off you go carefully pacing your running over the course of the next few weeks in order to make it under 5 hours on the big day.

However, the process isn’t often as smooth as you would like and you may encounter hiccups en route. Achy lower backs, tight calves and sore feet are just a few of the symptoms that can occur. Ankle, knee and hip sprains are among the more traumatic injuries that a fall or misstep can lead to.

Toe or heel runner?

There are broadly two running types: the bouncy forefoot lander and the sturdy heel striker. Although the difference between the two is mainly made by the preferred running technique, different types of injuries affect different types of runners.

Toe runner’s injuries

Calf fatigue. Characterised by a feeling of tightness and heaviness of the calf muscle often associated with areas of hardening of the calf itself and it is due to the prolonged muscle activation caused by the ‘tiptoeing” running habit.

Achilles tendonitis +/- or heel pain. A chronically fatigued calf will increase its pulling action on the Achilles tendon. The tendon may become inflamed and become tendonitis. The inflammation can consequently spread to the tendon attachment on the heel making this painful too.

Plantar fasciitis. The inflammation of the plantar fascia is a painful condition affecting the sole of your foot in your arch or heel. This is a consequence of chronic calf tightness and heel pain.

Back pain. A slightly tilted forward running posture loads your posterior muscular chain. This chain comprises all the muscles running from the base of your skull down your neck, back, butt, and legs to the sole of your foot. The strain of one or more of these muscles often leads to a sore back, with upper back and lower back pain being the most commonly affected areas.

Heel strikers’ injuries

Shin pain (shin splints): Because of your tendency to pull your toes up as you strike the ground with your heel your shin muscle – tibialis anterior – becomes overloaded. If it is chronically fatigued it can develop into shin splints, a painful condition affecting the front of your shin.

Heel pain. This pain is traumatic, and caused by the direct impact occurring at heelstrike. Over time your calcaneal bone (the heel) can bruise, resulting in pain and/or into a thickening and cracking of the sole.

Plantar fasciitis. As for the toe runners, the heel striker can get plantar fasciitis. However, it is more likely to develop as a consequence of the traumatic heel striking: inflammation spreads from the heel to the arch of your foot, making toe-off uncomfortable while striding.

Back pain. Athletes who run this way tend to have “sway back” running posture. This increases the loading and compression on your lumbar spine facet joints resulting in lower back pain and gluteal tightness (buttocks).


Whether you are a toe runner or heel striker, osteopaths and physiotherapists can evaluate your running technique and discuss with you the best course of treatment to prevent these injuries from occurring and treat them if you’re already suffering! Your complete case history plus a careful examination inform us which treatments are most appropriate for you whilst you train.

Don’t put up with the niggle and wait for it to go. You want to keep training, we want you to keep training, and niggles whilst training can get worse, meaning you may need to stop training.

Physiotherapy, osteopathy, exercises and stretches, kinesio taping, massage therapy and dry needling acupuncture are the most successful ways of managing sports injuries to help you achieve your goal.


If you’re not sure whether we can help, please give us a call on 020 7735 6813 or email