Every spring, thousands of fans line the course of the Boston Marathon to cheer on the runners who are challenging themselves to complete the famed grueling 26.2-mile race.

Every spring, thousands of fans line the course of the Boston Marathon to cheer on the runners who are challenging themselves to complete the famed grueling 26.2-mile race.


This year, more than 22,000 runners embarked on this challenge despite the record heat. Such a feat inspires many to begin running for the first time, or it may inspire past runners to resume running.


What could be simpler? Lace up your shoes, and you’re out the door! More than 30 million people in the United States alone participate in some form of running. Unfortunately, for many without the proper preparation, this can lead to injury. In fact, up to 70 percent of runners will sustain some type of exercise-related injury.


Healthy running, whether at the novice or elite level, requires more than just running attire and a pair of sneakers. The most important piece of equipment a runner has is their body. Without sufficient strength, and because of the repetitive nature of running, many overuse injuries occur. Fortunately, there are steps any runner can take to prepare their body for a lifetime of running.


Although any part of the body can sustain injury, the most common overuse injuries in runners involve the knee, lower leg and foot. Often you hear these injuries referred to as patellofemoral pain syndrome, or runner’s knee; medial tibial stress syndrome, or shin splints; Achilles tendonitis; plantar fasciitis; iliotibial band, or ITB, syndrome; and hamstring strains.


While the specific cause of each of these injuries varies, there is an underlying theme that can actually predict that these injuries are more likely to occur: weakness. It is not as simple as strengthening the thigh muscles to protect the knee or the lower leg muscles to protect the ankle. Just as the old children’s song goes, “the hip bone’s connected to the thigh bone…” So weakness in the hip can impact the stability of the ankle, which may lead to Achilles tendonitis, plantar fasciitis, shin splints or knee pain. Weakness at the hip can also impact the position of the knee, which may lead to knee pain. Weakness in the abdominals can impact control at the hip, which may create instability at the knee and ankle, and in turn, may contribute to all of these injuries.


In order to prepare the body for injury-free running, a strength-training program should include all of these body areas: abdominals/core muscles; muscles surrounding the hip; hamstrings and quadriceps. A quality strength program can involve exercises using one’s own body weight, the use of resistance bands and/or the use of weights. As research has shown us, it is not just the pure strength of a muscle that is important but the balance of strength between the muscle groups. Muscle imbalances in the hip and leg are the leading cause of overuse injuries in runners.


A comprehensive conditioning program should include strengthening, flexibility and cardiovascular training in order to be successful. A physical therapist can identify faults and help target your areas of weakness to develop a conditioning program to fit your individual needs and assist you in becoming a stronger runner.


Leah Jensen, PT, DPT is a Physical Therapist and Clinical Supervisor at Spaulding Outpatient Center Framingham (Mass.) treating patients with orthopedic and sports-related injuries.