Marathon Training and Recurrent Injuries: A Different Perspective

The range of complaints we encounter in clinical practice is incredibly diverse.

One moment, you are treating someone whose symptoms make it difficult to function in everyday life. Being able to help that person through osteopathy can be immensely rewarding.

But sometimes, the challenge lies in providing just that little bit extra.

Recently, I treated an exceptionally fit 25-year-old man who was training intensively for the New York City Marathon.

Over a period of five months, I treated him four times. During his training, he developed symptoms in the gluteal region, both knees and his lower leg.

As an osteopath, I look for the structure where I perceive the greatest restriction in mobility. I then try to understand whether, and how, this finding might be related to the symptoms.

Initially, my attention was drawn to the dura mater (the membrane surrounding the brain and spinal cord) at the base of the skull.

This is a finding I regularly encounter in my practice in people with a history of head trauma. Interestingly, this often involves a significant fall in which the back of the head struck a hard surface.

Following the treatments, he was doing well and was able to continue his training.

When he had built up his running distance to 30 kilometres, I saw him again.

Overall, things were going well. However, he was hesitant to increase his running distance further because he had started experiencing symptoms again on the outside of both knees.

This time, my attention during the assessment was drawn to a different structure: the sacrum, where I perceived increased intraosseous tension, slightly more pronounced on the left side.

During the treatment, he spontaneously mentioned that he recognised exactly the same lower back pain he had experienced after his most recent long training runs.

Something he had actually forgotten about…

And this is precisely what I find so fascinating about osteopathy. Searching for subtle restrictions in mobility, exploring possible connections and trying to understand why someone develops particular symptoms.

Whether this latest treatment will actually make a difference remains to be seen.

But above all, I hope he will be standing at the starting line with confidence, ready to enjoy those 42.195 kilometres through New York! 🏃‍♂️

“It is the little things that make the big difference in osteopathy.”

— Inspired by A.T. Still