All you need to know about running a marathon from physiotherapist Rebecca Nygren

Marathon training is an amazing journey. With good days, with bad days. With early mornings starts to days with wind and rain where you’d rather curl up in bed. But nothing beats the experience and the satisfying feeling you get after you’ve run. You may be at the start of your journey, or you may be at the finish line. If you’ve just started, congrats. You’re about to start on an incredible journey. If you’re at the finish line, you made it, well done! Either way, there will be things to consider no matter where in your journey you are. Below I will give some advice to help you through it.

Start of the journey

So, you signed up for a marathon. First, may I say, well done and enjoy it. It’s nothing to be taken lightly and you should give yourself all the credit for doing it. After the initial excitement dies down, it is perfectly normal to feel dread and to second guess yourself. But this will die down as you start the training and you realise that the 26.2 miles are possible. 1 step at a time. The first thing to do is to find some form of the training program. I highly recommend this, no matter what previous experience you have. There are plenty to choose from. The program you choose will depend on previous experience and how many times per week you’re able to run. Most programs have shorter and interval sessions in the week, with a longer, steadily increasing run at the weekend. If you’re a beginner, intervals are a great way to build up distance. As an intermediate or advanced runner, the intervals will improve your endurance, making the long run feel easier and may even increase your overall pace. For the first few weeks, focus on finding your pace and just get used to running. By halfway through the training, you will most likely have found your marathon pace. Don’t panic if you miss a session or 2, as this is normal. If you worry about rainy and cold weather, get the right clothes and get out there. You’ll feel amazing after. It may not be great weather on the day, so it’s good to have trained in any condition. There’s a Swedish expression that says, “there is no bad weather, only bad clothes (it rims in Swedish)”.

Cross training and injury prevention

You have now started running and will be settling into a routine. A good way to structure this is to mix the running with a different type of activity. Not only will this reduce the risk of boredom, but it’s an easy way to prevent injuries and niggles. This can be anything from swimming to cycling, to a fitness class or a gym session. Your body can get used to the repetitive movement of running and therefore create small injuries. These can lead to injury. By using your muscles in a different way, you reduce the repetitive strain and can more easily stay injury free. We’re only talking 1-2 sessions per week.

Running is always quality over quantity. This means that if you get to a stage where your legs are very achy or you’re feeling niggles in a tendon or a joint, go and do some cross training or even have a rest day instead. This will benefit you so much more, than pushing through a painful run. If you’re niggling, stretch, get a massage and/or cross train. If you do run, then slow down the pace and focus on your posture. Everyone has niggles, but we don’t want them to turn into an injury.

Injury prevention or prehab (prevention rehab) are words very commonly used in the fitness and sports world. Whilst there is no way to completely rule out an injury, there are ways that you can massively reduce the risk of them occurring. If you feel that your niggle is turning into something more or has kept coming on, then please see one of us at the Physio Company. We can assess and treat the injury and find the cause. For general injury prevention, below are a couple of exercises which I frequently give for various injuries.

Single leg squat/dips – this exercise is good for back, hip, knee and ankle issues. Fires up your glutes (bum), stabilises your ankle and knee. Should be pain-free, with tension only at the knee. Focus on small dips initially and build from there. The main thing to consider is that you want your knee to go in the same direction as the foot, not turning in or out. Just 10 reps randomly throughout the day. When waiting for the train, standing to brush your teeth or waiting for the kettle to boil.

  1. Single leg heel raises – to stabilise the ankle and strengthening the calves. Stand on 1 leg on a step, lower heel down past the step, go up as high as you’re able and come back down slowly, repeat 3 x to fatigue, 2-3/week. Make sure you give it a rest day in between.
  2. 90/90 stretch, to improve hip mobility and activate muscle around the hips.
    Start in a position where both legs are at 90 degrees (hips 90, knees 90). If your bum or leg aren’t touching the ground, put a towel under both or either. Start by leaning forward over the front leg, then sit up tall, then rotate around as far as comfortable whilst leaning back. All should feel stretchy and you should feel like your muscle has to work hard. It shouldn’t be painful or pinching. If this happens it may indicate a hip issue, where you should come and see us. Repeat x5/side.
  3. Heel-toe rocking, to stretch and strengthen shin and ankle as well as work on its mobility. Lean against a wall, back stays in contact with the wall the whole time. Go up on your tiptoes, lower down then rock back on your heels lifting your toes towards the ceiling. Repeat 10/way.
  4. Quad stretch, to improve flexibility and reduce tension on your kneecap. As a bonus, it also stretches your shin. Do if you’re stiff, having the front of the knee pain and after exercise. Grab your foot and bring leg behind you. Important notes: stand as tall as you can and keep knee close to other leg. If you can’t keep an upright posture do the alternative stretch below. For this stretch, you lie down, hug your knee to the chest, hang the leg over the edge of the bed, sofa or table and bring the foot underneath. Both as 30 sec holds. Should be a stretch on the front of your thigh.

End of your journey

You’ve made it! The final stretch is now here. By now you will have a lot of miles in your legs and have laid down all the groundwork needed to complete the marathon. If you haven’t managed 20 miles yet, don’t panic. The main thing is that you will pull through it. If you have managed those longer distances, then the marathon will be more enjoyable. The final 3-4 weeks will be a slow reduction in mileage, and by the final week, your longest will probably be a 6 miler. The reason behind this is that your body needs to heal itself and recover from all the training you have put in. You will have created small micro injuries. This is nothing serious, but if you can recover from them then the marathon will feel a lot smoother and easier (if we can use that word). This is a period where you may even mix in a cross-training session, to give your feet a break.

In the final 7-10 days before the marathon, you will just be doing short runs and do what’s called tapering. This means an active rest. You may find that the first few days of this you will be tired and achy, and run down. You may even get a cold. Don’t panic! This is normal, as your body is recovering. Drink plenty of water and eat well and get a good night sleep. The last run should be a few days before, or if you feel stiff, do a 2-3 miler the day before to get the legs moving.


I’m a physiotherapist, not a dietitian, so bear this in mind. All I’m giving is my own experience and advice, as well as advice I’ve received from dietitians. If you’re unsure, go and seek out professional advice.

You want to have carbs, protein and fats in your diet. The main thing that needs to change when training is the amount. You’re going to have to increase. Carbs are your fuel, without it you’re just going to crash. Protein is you building block, and fat is your energy. Around 1.5-2 x your body weight of protein is optimal. You can get it from meat, beans, grains, fish, eggs etc. Calorie burning varies from person to person, but a rough guide I use is 100 calories per mile.

You can run on an empty stomach, it’s a choice to make for yourself as everyone is different. I would say that if your aiming for over 75-90-minute of running, then you will need food before. Avoid heavy meat, as this requires a lot of blood to the stomach, and therefore takes longer to digest. Eat a larger meal 2-3 hours before or small snack 30-60 minutes before. I prefer porridge with nuts or nut butter, or eggs with wholemeal bread and a protein shake. Eat something within 30 minutes after.

During a run, food and water intake is something you need to practice. You don’t want to get to mile 15 at the marathon and be running for the toilet instead of the finish line. Sip water throughout the run, and on marathon day, drink at every station. Have some form of carbs with you. This includes gels, jelly babies, carb/protein balls, half a banana etc. I usually have one every 45 min. This is to make sure you don’t run out of energy. Nothing new on marathon day!!!

You will have heard of the phrase carb loading. This is a glorious time. You will be training less, but still get to eat the same food. In the final week leading up to the marathon you want to take in an extra 2500-2800 calories, that means 350-400 calories extra per day. This is the max, as your body can’t store more than that. This means extra energy on marathon day. It is mainly increase in carbs, but don’t forget the building block (protein) so that the body heals well. The night before the marathon have a good meal, that you have tried before. Nothing new!!!

The big day

After a good meal and a good night sleep the day has finally arrived. Make sure you get there in time, so you don’t have to stress. Lay out the clothes and pack the bag the night before. Nothing should be new on the day, same old leggings/shorts, pants, socks and shoes. Breakfast should be like what you’ve had during your training. I repeat, nothing new! Have a banana ready to eat just before the start. Warm up slowly, as you may not start straight away. Soak in the atmosphere and enjoy the satisfaction of getting there.

Start at your own pace. It’s easy to get swept into the crowd and start fast. Take your time and find your pace. Then you just keep going. Carb and water every 30-50 minutes. Enjoy it! Take inspiration from people around you and the crowds. If you struggle, walk for a bit and then start again. I tend to break the run into parts. One way is doing 4 x 10K, then it doesn’t feel as long. If you struggle towards the end, think about your posture and shorten your stride length.

When you cross that finish line, don’t be afraid of showing emotion and feeling proud. What you have done is phenomenal! Stretch, get some food, find your friends and family and enjoy the endorphins. You have earned it.