Preparing for Your First Marathon: A Physiotherapist’s Guide to Running Strong and Injury-Free

Training for your first marathon is an exciting goal. It’s also one of the biggest physical challenges many active adults will ever take on. At Body Fit Physiotherapy, we regularly see runners aged 18–55 who are motivated, committed, and doing “all the right things” — yet still end up injured partway through their preparation.

The good news? Most marathon-related injuries are preventable with the right approach.

This article explains, in plain English, how to prepare your body for the demands of a marathon, how to minimise injury risk, and when physiotherapy can make a meaningful difference.

Why Marathon Training Is So Demanding on the Body

A marathon places repetitive, high loads through your muscles, tendons, bones, and joints. Over the course of a single race, each leg absorbs tens of thousands of impacts — often under fatigue.

Injury doesn’t usually occur because running is “bad” for you. It happens when tissue capacity is exceeded faster than it can adapt.

Preparing well is about building capacity gradually, not pushing through pain or blindly following a generic training plan.

How to Minimise Your Injury Risk

The most common running injuries we see during marathon preparation include:

• Achilles tendinopathy

• Plantar fasciitis

• Knee pain (patellofemoral pain, ITB-related pain)

• Bone stress injuries

• Calf and hamstring strains

Across all of these, the key driver is usually training error, not poor biomechanics or “weak feet”.

Key principles to reduce risk:

• Gradual exposure to load

• Adequate recovery between sessions

• Strength training alongside running

• Responding early to warning signs

Pain is not a badge of honour. It’s feedback.

Load Management: The Cornerstone of Marathon Preparation

Load management refers to how much stress you place on your body relative to what it is prepared to tolerate.

What this means in practice:

• Increases in weekly mileage should be gradual

• Long runs should progress conservatively

• Speed work adds significantly more load than easy running

• Recovery weeks are not optional

A common mistake is increasing distance, intensity, and frequency at the same time — a fast track to injury.

If you’re introducing faster sessions (tempo, intervals, hills), something else usually needs to reduce temporarily.

Giving Yourself Ample Preparation Time

One of the biggest predictors of successful marathon completion is how long you’ve been running consistently beforehand.

From a physiotherapy perspective:

• Bones adapt slower than muscles

• Tendons adapt slower than fitness

• Cardiovascular improvements outpace tissue adaptation

For most first-time marathon runners, a minimum of 6–9 months of consistent running is recommended before race day.

This includes:

• A base phase (building consistency)

• A structured training phase

• A taper period

Trying to “cram” marathon training into a short window dramatically increases injury risk.

Essential Strength Exercises for Marathon Runners

Running alone does not adequately prepare your tissues for the cumulative load of marathon training.

Evidence strongly supports strength training to reduce running-related injuries and improve performance.

Key areas to target:

1. Calves and Ankles

Your calves absorb and release large amounts of energy with every step.

• Seated and standing calf raises

• Single-leg variations

• Progressive loading (not just high reps)

2. Quads and Glutes

Critical for shock absorption, propulsion, and knee control.

• Split squats

• Step-ups

• Hip hinge patterns

3. Hamstrings

Important for speed control and late-stage fatigue resistance.

• Romanian deadlifts

• Hamstring bridges

• Nordic variations (progressed carefully)

4. Trunk and Pelvic Control

Not about “six-packs”, but load transfer efficiency.

• Anti-rotation exercises

• Single-leg stability tasks

• Controlled trunk endurance work

Two well-planned strength sessions per week can make a meaningful difference.

Common Marathon Training Myths (and Mistakes)

❌ “If I just run more, I’ll be fine”

Running fitness improves quickly; tissue resilience does not. More isn’t always better.

❌ “Pain is normal during marathon training”

Some discomfort is expected. Persistent, worsening, or focal pain is not.

❌ “I’ll deal with niggles after the race”

Small issues often become big ones under marathon loads.

❌ “Stretching will prevent injury”

Flexibility alone does not protect against overload injuries.

How Physiotherapy Helps Marathon Runners

Physiotherapy isn’t just for when something is “broken”.

At Body Fit Physiotherapy, we support runners by:

• Identifying early overload before it becomes injury

• Assessing strength, capacity, and load tolerance

• Modifying training without derailing your race goals

• Guiding return-to-run progressions

• Managing pain while maintaining fitness where possible

We focus on keeping you running, not unnecessarily stopping you.

When You Should Seek Help

Early intervention matters.

You should consider seeing a physiotherapist if you notice:

• Pain that worsens during or after runs

• Pain that doesn’t settle within 24–48 hours

• Localised tenderness over bone

• Increasing stiffness or weakness

• Changes in running mechanics due to pain

• A sudden drop in performance or confidence

The earlier these are addressed, the more options you have — and the less training you’ll likely miss.

Preparing Your Mind as Well as Your Body

First marathons are as much psychological as physical.

Fear of injury, uncertainty around training decisions, and pressure to “stick to the plan” can all influence outcomes.

A good preparation process builds:

• Confidence in your body

• Understanding of load and recovery

• Trust in how your body responds to training

Education is a powerful injury-prevention tool.

Final Thoughts: Marathon Preparation Is a Process

Preparing for your first marathon is not about perfection — it’s about consistency, patience, and adaptability.

You don’t need to train harder than everyone else.

You need to train appropriately for you.

When training is well-managed and strength is prioritised, most runners can reach the start line healthy and confident.

How Body Fit Physiotherapy Can Support Your Marathon Journey

If you’re preparing for your first marathon — or considering one in the future — physiotherapy can help you:

• Reduce injury risk

• Train with confidence

• Address small issues before they escalate

• Enjoy the process, not just survive it

If you’d like individual guidance, assessment, or support with your training, our physiotherapists in North Adelaide are happy to help.

Booking early, even before pain starts, often makes the biggest difference.