Marathon Mania: Strain check

During my long run this week, I felt a familiar stabbing pain in my right knee. I grimaced at the pain caused by an iliotibial (IT) band that's tighter than a piano string.

Runners are no strangers to injury. In a study of 725 male marathon runners published in the Scandinavian Journal of Medicine & Science in Sports in 2008, 54.8 per cent had sustained one or more injuries in the year prior to a race.

"Among the 50 marathon clinic participants last year, 20 of them had some sort of musculoskeletal complaint in the course of their 12-week preparation," says Dr Simon Yeung, director of Standard Chartered Hong Kong Marathon's free training clinic.

The main cause of running injuries is a rapid increase in mileage or intensity, says Dr Michael Tse, director of the Active Health Clinic at University's of Hong Kong's Institute of Human Performance. "It is important to progress slowly, increasing your distance by about 10 per cent each week, until you reach your maximum training distance."

For more intense workouts, a dynamic warm-up may help reduce potential injury risk. Tse suggests light jogging, followed by movements such as butt kicks, knee lifts and lunges. "Work on the hot spots, like tight hamstrings, hip flexors and ankles," he says.

Yeung also recommends alternating terrain to work different muscles and avoid overloading any particular one. Unfortunately, some people are more injury prone than others due to biomechanics, joint flexibility, musculoskeletal balance and technique.

Before you start running seriously or if you are feeling a twinge of an injury, Tse recommends getting a postural assessment and spending time working on correct form. Incorporating strength training in your programme will help you recover faster.

While injuries should be treated by a professional, some simple preventative measures can help.

Ilotibial band syndrome

What: A stabbing pain on the side of the leg, just above the knee, made worse by running downhill.

Cause: The main cause, says Yeung, is tightness in the hip abductors and IT band - a tough group of fibres that run on the outside of the thigh from hip to shin.

Tip: Using a foam roller may help release the IT band, says Tse. Gently roll the foam roller up and down the length of the IT band.

Tightness in the hip flexors, the group of muscles that are responsible for lifting your knee, can contribute to IT band pain. Remember to stretch them.

Patellofemoral pain syndrome (aka runner's knee)

What: A constant ache underneath your kneecap when running that gets worse as the intensity of running increases.

Cause: An imbalance of the quadricep muscles, says Yeung. Typically this means weakness in the muscle above the inside of the knee and tightness in the muscle on the outside of the knee.

Tip: Strengthen the weak muscle and reduce tension in the tight one to keep your kneecap better aligned, says Tse. He recommends using a leg extension machine in the gym to work on developing the weak muscle, or sitting on a chair with an ankle weight on the affected leg and slowly raising the foot at a slight outwards angle.

Plantar fasciitis

What: Sharp pain at the base of the heel, particularly in the morning.

Cause: "Overtraining may cause microtears in the fascia - the muscle fibres in the arch of the foot - which causes inflammation and extreme pain at the heel," says Tse. Other possible causes include having the wrong shoes or being flat footed.

Tip: Roll the arch of the foot on a hard round object, such as a golf ball. "It will cause some pain, but if you do this exercise regularly, the pain will subside," says Tse.

Stretch your calves: the easiest way is by standing on the edge of a step and putting downwards pressure on the heel. "Tightness can lead to increased Achilles and calf tension during each stride and put a lot more stress on the plantar fascia," says Tse.

Marathon Mania is a 12-week series leading up to the Hong Kong Marathon on February 24. For more preparation tips, go to facebook.com/hkmarathon