How to cope with injury

Here's how to keep your injury in perspective, while making sensible choices to guide your recovery and come back stronger.

If you’ve been out on a training run and feel a twinge – minor or major – it’s worth looking up your symptoms on the NHS site to find out how serious your injury might be and what your next steps should be. 

Unless you suspect you’ve broken something – in which case you should go to A&E at your nearest hospital – it’s wise to book an appointment with a physio, who can assess your injury properly. Ideally look for a physio who specialises in running-specific injuries.

It can be hard to accept that your injury will stop you from participating, says Nicky Edwards, physio and director at Chiltern Physiotherapy, but her advice to runners is: “There will always be other marathons but there is only one you.”

There can be a kind of grieving process, she says, where you go through denial, anger, and sadness, because you’ve worked so hard for this goal that’s now been taken away. “Perhaps you’re running on behalf of a loved one who’s died or has cancer, and it all means so much,” she says, but you have to do what’s best for your body in the long term.

Nicky also notes that runners who can’t participate shouldn’t feel guilty about all the sponsorship money they’ve raised. “People wanted to donate to that worthy cause, so you’ve still had a positive impact,” she says.

This is also when it’s helpful to have seen a physio or doctor and been told you can’t take part, as you know you’re not imagining it or overexaggerating the issue – you have a genuine medical reason not to run, which can give you peace of mind.

“Getting injured while training for a big event or when on a roll with your fitness can leave you questioning whether you’ll ever get back to where you were physically,” says Alice Sunderland, a 49-year-old personal trainer, running coach and elite marathon runner, who is currently ranked first in her age group in the UK. But, she believes, with the right mental and practical approach, you can actually come back stronger.

On 26 December 2023, Alice tore a hamstring which meant she was out injured for five weeks in the lead-up to the TCS London Marathon, which was all the more devastating as just weeks before she’d placed as the third female in the Verona Marathon. “It would have been easy to sink into despair or to try and train through the pain, but past experience reminded me of the need to be patient and to focus on what I could do to help my body heal,” she says.

Alice went to see a physio straight away – and urges her clients to do the same – and then to do all the exercises they prescribe, however arduous they seem. “Sometimes injuries are a way of telling you that something needs to change, and for me that was addressing some muscle imbalances due to scoliosis,” she says. “I focused on single-leg exercises to build up my weaker side and core strength.”
 

Being injured offers you a chance to concentrate on what you can control, says Alice, and to focus on the aspects of the sport that runners often neglect in favour of clocking up the miles. “This includes strength and conditioning, stretching, cross-training, good sleep, nutrition, meditation, and visualisation,” she says. “Doing these things gives your body the optimum chance to repair itself and puts your mind at ease because you’re doing something positive and beneficial.”

Alice also thinks being injured is a good time to restart a forgotten hobby you’ve neglected, or to plan fun things with family and friends who were perhaps feeling sidelined by your long runs.

“Taking a few weeks out for injury won’t result in as much loss in fitness as you might imagine, and muscle memory is a powerful tool in recovery,” says Alice. But if you’re injured for more than a month, you may need to revise your goals. “Try to be flexible and set yourself a more realistic target, one that will be all the more rewarding when you do get to the Start Line,” she says.

If you’re competing in the TCS London Marathon and injure yourself on the day, be assured there will be plenty of medical support along the route. It’s a role Nicky has undertaken in the past and she says common problems that occur during the event include cramp and muscle aches, which can be alleviated with stretching and soft tissue massage.

There are occasions where you would have to tell someone to stop so they don’t damage themselves further, she says, such as for a stress fracture and of course with any kind of chest pain. She also notes that runners should avoid taking anti-inflammatory drugs in the 48 hours before the event – something runners sometimes do as they think it will reduce leg pain during the marathon – as they can impact kidney and heart function.

Written by Sam Haddad. Sam is a freelance journalist based in Brighton, she's been writing about sport and the outdoors for over 20 years.