healing and recovery, marathon

Late-stage marathon training injuries and fatigue and how to deal

Knees on ice

OK — I have been obsessing for weeks over my pains and aches, especially my knee. I know I am not alone. Especially as we get a few weeks out from race day, when training for a marathon, our bodies tend to start screaming at us. After all, most training programs aim to push you to the brink, before allowing you to heal a bit by reducing long runs during the last three weeks.

But it is most vital at this stage to make the right decision when it comes to either pushing hard or pushing over the edge — the wrong decision can break us on race day. And when you’re paying $500+ to attend race day in Philadelphia (or New York or any outta-town event) you really don’t want to blow it.

That type of decision is central to a note I started composing to this “Ask the Doc” -type forum, but as I wrote, I pretty much realized I could answer it myself or at least research the answers. Here’s my situation:

Throughout the summer I ran about 40-50 miles per week. Started training for a November marathon in August and upped mileage to 50 miles per week and steadily climbed to about 65 miles a week. (Not bragging CJ Wilson style, there is a point to mentioning this.)

For six weeks I ran 50-65 mpw including 1-2 quality workouts (intervals, hills or tempo runs) and I have done four 18-20 mile runs in the last several weeks. Around week five of that, my right knee really started hurting and swelling.

 X-Rays show nothing in particular; the sports chiro diagnosed possible bursitis, but said it was more likely a back issue, such as a slipped disk that is causing referred pain in the knee. He suggested I stop running for about six weeks and I punched him in the face. Just kidding. I told him ‘no can do’ and he compromised and told me stick to quality-work days only and to cross train or do yoga on the off days.

Here’s my fear: my advanced marathoning schedule, was precisely created through painstaking research to produce a marathon of a particular time. (I know it’s working. My 15k tune up a couple weeks ago produced a 2-minute personal best.)

Because of tremendous pain, I cut my mileage justabout in half the last two weeks, but was able to run a confidence-boosting, relatively pain free (until my slow cool-down mile) 20-miler last weekend. 

Am I better off fighting through the miles for the next couple weeks and then trying to spend the last month mending and reducing mileage, or should I just turn my focus to keeping the knee healthy? How much endurance/fitness/strength will I lose by sacrificing a couple of long tempo runs and hill runs six weeks out?

My answer to myself:

OK—whether you have plantar fasciitis, bursitis, fatigue or some undiagnosed pain, the first thing we have to admit is that there is no perfect answer. You have to be honest with yourself about the seriousness of your injury or pain. Even the pros who have coaches advising them have to ultimately decide for themselves whether to keep pushing or not. Decide to go through with the race or not, at least we know we aren’t alone.

(Remember, if you weren’t a stud, this wouldn’t bother you. You’d just stop running when it hurts, like normal folk.)

Since I’ve decided to run my race — assuming I can walk on that day, here are a few nuggets of wisdom I’ve uncovered.

If you have a strong foundation — you’ve been running 35-50 miles a week for several months, including some long runs of two or more hours, your base is going to hold up, even if you had to take a couple weeks off. Here’s what Olympian and sports psychologist Pete Pfitzinger told Running Times, in an article that is about this very decision making topic:

“If you’ve been out one to two weeks, enjoyed a consistent block of training before the layoff, have at least four weeks before your race, and are 100 percent healthy, you can probably shoot for your original goal.” Otherwise, he says, scale back your expectations.

Coach Greg McMillian says in the same article, “If you’ve been running consistently for years, all else being equal, your fitness won’t erode as quickly as it will if you’re relatively new or have had other recent setbacks. The more consistent you’ve been leading into a break, the more ‘savings’ you have to draw on, within reasonable limits.”

Rather than choosing all or nothing, the author suggests experienced marathoners can tweak plans to prevent further injury and possibly still reach goal time — like how my doc suggested just doing my quality workouts.

Sure it was confidence- and strength-building to run 65 miles a week, but if that’s going to keep my knee swollen and painful, I can do 30 miles of tempo, speed and/or long runs and 4.5 hours of yoga and/or pool running instead without much altering my fitness. And that is what I plan to do up until my Nov. 20 race.

Sometimes I wonder whether it’s the actual injury or normal late-stage fatigue and general marathon training weirdness that causes really bad training days. A recent interview by Peter Gambaccini with 5k specialist Lauren Fleshman, who is running her first marathon at NYC, reveals that even really good runners with professional coaches run into fatigue, confusion and mental and physical chaos when training hard for the for the 26.2.

“Marathoning is a sport of extremes,” she says, “Yesterday, I woke up and could hardly run.  I just felt terrible. It was supposed to be a 90-minute run, I thought, ‘There’s no way I’m going to get through this.’ It was awful the whole way. And then today I was thinking I was going to maybe take a day off or cross-train; there was no way I was going to be recovered from yesterday. And then I talked myself out the door and I felt amazing. It made no sense. That’s what I found more than anything with marathon prep, is that day to day, you can have so much variety in how you feel. And you just have to roll with it.”

She also talks about feeling fuzzy brain and mental fatigue. One thing I find interesting about this interview is that Fleshman’s marathon training consists of about 70-80 mile weeks, same as her 5k training, only with the “puzzle pieces fitting together differently.”

Oh, I also learned through reading that interview that Lauren Fleshman maintains a kick-ass running blog.  I’ll leave you with her timely metaphorical words about the edge between “build and taper”:

“For seven weeks I’ve been filling and filling and filling a water balloon without any problems, and suddenly I see that the skin of that balloon is stretched dangerously thin.

“Now here I am carrying this swollen balloon towards the promised land of the taper, aware that the slightest bump from the dullest branch can irreparably rupture what it would have taken a machete to pop five weeks ago.”

She adds that some days she and her balloon are better off spending the day on the couch.


2 thoughts on “Late-stage marathon training injuries and fatigue and how to deal

  1. Thanks so much for this article!! It really is the light at the end of the tunnel for me. Training for my first full in Moline, IL and am 3 weeks out with knee pain (along with exhaustion and fuzziness of the brain) and frustrated on which direction to go with the remainder of my training. The hard part is done… thank you!

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