Why Strength Training Is Essential for Injury Protection in the London Marathon

Training for the London Marathon is a huge physical undertaking. Over 26.2 miles, your body absorbs thousands of repetitive loading cycles. Every step places forces of two to three times bodyweight through your feet, ankles, knees and hips. Multiply that by 35,000–45,000 steps and it’s easy to see why injury rates in marathon training are high.

The common misconception? That more running is always the answer.

In reality, strength training is one of the most effective tools we have for injury protection in marathon runners. At our clinic in SW18, we regularly see runners who could have avoided weeks off training with a smarter strength foundation.

Here’s why it matters — and what to focus on.

The Marathon Is a Muscular Endurance Event

Marathon training is not just cardiovascular — it is muscular endurance under fatigue.

As fatigue builds:

• Stride length shortens

• Cadence drops

• Hip control reduces

• Ground contact time increases

This alters load distribution through the lower limb. When tissues fatigue, joints absorb more force. That’s when problems start.

Common marathon injuries include:

• Achilles tendinopathy

• Plantar fascia irritation

• Patellofemoral knee pain

• IT band pain

• Bone stress injuries

In many cases, the root cause is not “tightness” — it’s insufficient strength and tissue capacity for the demands placed upon them.

Strength Improves Tissue Capacity

Every tendon, muscle and bone has a load tolerance threshold. Training increases that threshold.

When you perform progressive strength training:

• Tendons become stiffer and more resilient

• Muscles generate force more efficiently

• Bones respond to loading by strengthening

• Neuromuscular control improves

This creates what we call load capacity — the ability to tolerate marathon training without breaking down.

Without this, your running volume can outpace your body’s ability to adapt.

The Calf Complex: The Unsung Hero

The calf complex (gastrocnemius and soleus) is one of the most overloaded structures in marathon running.

The soleus, in particular, works tirelessly to control forward momentum and absorb force during stance phase. As fatigue builds late in the race, reduced calf capacity often leads to:

• Achilles overload

• Plantar fascia strain

• Shin pain

Specific strength work should include:

• Straight-leg calf raises (gastrocnemius bias)

• Bent-knee calf raises (soleus bias)

• Heavy, slow resistance work

• High-repetition endurance sets

Many runners underestimate how strong their calves need to be for 26.2 miles.

Hip Strength Protects the Knee (your knee IS your hip!!!)

Poor hip strength and control can increase load through the knee and IT band.

When the gluteal muscles fatigue:

• The knee drifts inward

• Femoral rotation increases

• Patellofemoral stress rises

Over thousands of strides, this becomes painful.

Key exercises include:

• Single-leg deadlifts

• Split squats

• Step-downs

• Lateral band walks

• Side planks

The goal is not bodybuilding. It is controlled, unilateral strength under load.

Strength Reduces Fatigue-Related Breakdown

Research consistently shows that strength training:

• Improves running economy

• Reduces ground contact time

• Enhances force production

Better economy means less energy cost per stride. That translates to reduced fatigue late in the race — and fewer compensatory movement patterns.

Injury risk increases significantly in the final third of marathon training blocks, when mileage peaks and cumulative fatigue is highest. Runners who maintain strength work during this phase tend to cope better.

“But I Don’t Want to Be Too Sore to Run”

A common concern.

The solution is intelligent programming:

• Two sessions per week

• 30–40 minutes

• Focus on lower limb and trunk

• Avoid excessive new exercises during peak mileage

• Reduce volume slightly in taper phase

Strength training should complement running, not compromise it.

Heavy lifting during base phase. Maintenance during peak weeks. Light activation during taper.

Bone Health and Stress Fracture Protection

Bone responds positively to load — but it needs varied stimulus.

Running is repetitive. Strength training introduces different loading patterns that stimulate bone adaptation.

This is especially important for:

• Female athletes

• Masters runners

• Runners increasing mileage

• Those with a history of bone stress injury

Under-fuelling combined with high mileage and no strength training is a high-risk scenario.

Practical Weekly Structure (just some ideas…)

A simple template might look like:

Day 1: Lower Limb Strength

• Split squats

• Romanian deadlifts

• Straight-leg calf raises

• Core control

Day 2: Stability and Endurance

• Step-downs

• Bent-knee calf raises

• Single-leg bridges

• Side planks

Keep it progressive. Add load when movements feel controlled and technically sound.

Strength Training Is Performance Training

This isn’t just about avoiding injury.

Stronger runners:

• Maintain pace longer

• Resist form breakdown

• Produce more force per stride

• Feel more robust during peak training

The London Marathon rewards durability.

Final Thoughts

Marathon training already places huge demand on the body. Relying on running alone is often not enough to prepare tissues for the cumulative load of 26.2 miles.

Strength training:

• Increases tissue capacity

• Reduces fatigue-related movement breakdown

• Protects against common overuse injuries

• Improves performance

If you’re building towards the London Marathon, investing in strength now could be the difference between standing on the start line — or sitting out injured.

Run consistently. Lift intelligently. Arrive strong.

For more advice book into see one of our osteopaths at the clinic in Wandsworth SW18.

Look at our blog on bone stress injuries here

By James Dodd BSc (hons) Ost. FAFS.

GOsC registered

London Marathon 2026: A Complete Guide to Bone Stress Injuries in Runners

With the London Marathon 2026 training cycle now building momentum, this is the period when we commonly see bone stress injuries emerging in runners across Earlsfield, Wandsworth and SW18.

Understanding the early signs can be the difference between finishing the race — or missing the season entirely.

What Is a Bone Stress Injury?

Bone stress injuries (BSIs) occur when repeated impact loading exceeds the bone’s ability to remodel and recover. They sit on a spectrum:

1. Stress reaction (early overload)

2. Stress fracture (structural crack)

During marathon training, runners may take 30,000–50,000 steps per long run. If recovery, nutrition and strength capacity don’t match the load, bone tissue begins to fail.

Common Locations in Marathon Runners

Tibia (shin) – the most common site

Metatarsals (forefoot) – pain during push-off

Calcaneus (heel) – deep heel ache

Femoral neck – deep groin pain (higher-risk and needs urgent assessment)

Early Warning Signs

Bone stress injuries rarely start dramatically. They build gradually.

Watch for:

• Localised pain (you can pinpoint it precisely)

• Pain that appears earlier in each run

• Pain on single-leg hopping

• Pain that persists after the run

• Pain that begins to hurt during walking

• Night pain (more concerning)

If pain is broad and diffuse, it may be shin splints. If it is sharp and focal, think bone.

Why They Increase During Marathon Training

Several risk factors stack up during London Marathon preparation:

1. Rapid Mileage Progression

Jumping from 15km to 25km long runs within weeks.

2. Hard Winter Surfaces

More pavement running, less terrain variation.

3. Inadequate Recovery

Busy professional schedules often compromise sleep and fuelling.

4. Low Energy Availability

Under-fuelling reduces bone turnover and resilience. This is particularly relevant in endurance athletes and female runners, but affects men too.

5. Lack of Strength Training

Bone responds to heavy load and varied force. Many marathon runners accumulate mileage but neglect progressive strength work.

Prevention: What Actually Works

Evidence supports:

• Gradual mileage increases (avoid >10% weekly spikes)

• Heavy calf raises (straight and bent knee)

• Split squats and single-leg strength

• Progressive plyometrics

• Adequate carbohydrate intake around training

• Sleep >7 hours per night

Bone health is influenced by both load and energy availability.

When to Stop Running

You should stop and seek assessment if:

• Pain is focal and worsening

• Walking becomes painful

• Hopping is painful

• Pain is deep in the groin

Continuing to train through a stress reaction often progresses it into a full stress fracture.

How We Help at Back to Back Osteopaths (SW18)

For runners in Earlsfield and Wandsworth training for London 2026, we assess:

• Load management and weekly mileage

• Strength capacity vs training demand

• Running mechanics

• Recovery strategies

• Nutrition risk factors

Early intervention often means modifying training rather than stopping completely.

If you are preparing for London 2026 and experiencing persistent, localised pain — don’t ignore it.

A small problem in February can become a season-ending injury by April.

By James Dodd BSc (hons) Ost. FAFS.

GOsC registered