Skip to main content

Epidemiology and Aetiology of Marathon Running Injuries


Over the last 10–15 years, there has been a dramatic increase in popularity of running marathons. Numerous articles have reported on injuries to runners of all experience, with yearly incidence rates for injury reported to be as high as 90% in those training for marathons. To date, most of these studies have been cohort studies and retrospective surveys with remarkably few prospective studies. However, from the studies available, it is clear that more experienced runners are less prone to injury, with the number of years running being inversely related to incidence of injuries. For all runners, it is important to be fully recovered from any and all injury or illness prior to running a marathon. For those with less experience, a graduated training programme seems to clearly help prevent injuries with special attention to avoid any sudden increases in running load or intensity, with a particularly high risk for injury once a threshold of 40 miles/week is crossed. In both sexes, the most common injury by far was to the knee, typically on the anterior aspect (e.g. patellofemoral syndrome). Iliotibial band friction syndrome, tibial stress syndrome, plantar fasciitis, Achilles tendonitis and meniscal injuries of the knee were also commonly cited.

This is a preview of subscription content, access via your institution.


  1. Lysholm J, Wiklander J. Injuries in runners. Am J Sports Med 1987; 15: 168–71

    Article  PubMed  CAS  Google Scholar 

  2. Satterthwaite P, Larmer P, Gardiner J, et al. Incidence of injuries and other health problems in the Auckland Citibank Marathon, 1993. Br J Sports Med 1996; 30: 324–6

    Article  PubMed  CAS  Google Scholar 

  3. Marti B, Vader JP, Minder CE, et al. On the epidemiology of running injuries: the 1984 Bern Grand-Prix study. Am J Sports Med 1988; 16: 285–94

    Article  PubMed  CAS  Google Scholar 

  4. Wen DY, Puffer JC, Schmalzried TP. Injuries in runners: a prospective study of alignment. Clin J Sport Med 1998; 8: 187–94

    Article  PubMed  CAS  Google Scholar 

  5. Macera CA, Pate RR, Woods J, et al. Postrace morbidity among runners. Am J Prev Med 1991; 7: 1948

    Google Scholar 

  6. Maughan RJ, Miller ID. Incidence of training-related injuries among marathon runners. Br J Sports Med 1983; 17: 162–5

    Article  PubMed  CAS  Google Scholar 

  7. Taunton JE, Ryan MB, Clement DB, et al. A Prospective study of running injuries: the Vancouver Sun Run “In Training” clinics. Br J Sports Med 2003; 37: 239–44

    Article  PubMed  CAS  Google Scholar 

  8. Walter SO, Had LE, McIntosh JM, et al. The Ontario cohort study on running-related injuries. Arch Inter Med 1989; 149: 2561–4

    Article  CAS  Google Scholar 

  9. Satterthwaite P, Norton R, Larmer P, et al. Risk factors for injuries and other health problems sustained in a marathon. Br J Sports Med 1999; 33 (2): 226

    Google Scholar 

  10. Niemuth PE, Johnson RJ, Myers MJ, et al. Hip muscle weakness and ovemse injuries in recreational runners. Clin J Sport Med 2005; 15 (1): 1421

    Article  Google Scholar 

Download references


Michael Fredericson receives royalties from orthopaedic physical therapy products.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Michael Fredericson.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Fredericson, M., Misra, A.K. Epidemiology and Aetiology of Marathon Running Injuries. Sports Med 37, 437–439 (2007).

Download citation

  • Published:

  • Issue Date:

  • DOI:


  • Knee Injury
  • Ankle Sprain
  • Overuse Injury
  • Marathon Runner
  • Meniscal Injury