group of people running in a marathon

Running is one of the most effective forms of exercise the human body can ever engage in.

Long distances and the intense training involved in marathon running can put a serious strain on the body’s various parts.

Running a marathon has been compared to the same level of trauma as having heart surgery because everything from the joints to muscles, organs, and hormones are affected by those epic 26.2 miles.1

Here are some examples of how running marathons affects the body, as well as tips for running knee support and pre- and post-run stretches for better joint health.

Knee Pain After Marathon Running

Running puts a lot of stress on the knees, which are joints made up of the femur, tibia, fibula, and patella. There are also several major ligaments and tendons involved in the movement of the knee, all of which are heavily affected by long-distance running.2 Patellar tendinitis and patellofemoral pain syndrome are common knee conditions associated with running.3,4,5,6 Poor footwear and muscular strength imbalances, such as flat feet, can make knee problems worse.3,5

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Hip Pain Running Concerns

The hips are constantly in motion while running, and pain in this region is often caused by hip alignment issues.6 Many people have one leg that is slightly longer than the other, which can lead to hip pain during and after running. Strength imbalances, a history of injuries, poor posture, and bad habits that favor one side of the body over the other can exacerbate hip issues.7 Hip misalignments should be diagnosed by a professional after testing the range of motion and determining the cause of the problem. Active release techniques, massage, and strength training are often recommended to prevent and alleviate hip pain.8

Foot Pain Running Concerns

Foot pain while running can also be very debilitating because the feet are made up of many small bones, tendons, muscles, and ligaments. Some of the most common causes of foot pain in runners are plantar fasciitis, stress fractures, extensor tendonitis, and adductor and abductor hallucis.9,10 Also, many athletes neglect to stretch their feet before and after runs like they would other parts of the body. Arch raises, toe pulls with resistance bands, and seated toe stretches are all great for getting the feet warmed up and ready to run.11

How to Stretch Before a Run

It is important to stretch both before and after a run of any length or intensity, but especially during marathon training. Dynamic stretches that use movement to warm up the joints and take joints through a full range of motion are wonderful to practice before a run.12 Walking lunges, side stretches, yoga pigeon pose, hip circles, and calf raises are all pre-run stretches that help prevent injury and mobilize the joints. These are also good stretches to maintain flexibility in the various joints over time.

Great Post-Run Stretches to Try

Many people are relieved at the end of the run and ready to sit down and relax. However, post-run stretches are just as important as pre-run stretches.12 Incorporate hamstring stretches, sitting glute stretches, hip flexor stretches, and foot and ankle rolls into a post-run routine for the best long-term results. Even spending just five or 10 minutes on stretching before and after a run can make a huge difference in how well a person runs, their recovery, and therefore may impact how many marathons can be completed.

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1. Foley, K. E. (2017 March 28). Running a marathon is as traumatic for your body as having heart surgery. Quartz. Retrieved November 1, 2018 from
2. Cole, A. J. (2014 May 23). Common running injuries: Knee pain. Sports Health. Retrieved November 2, 2018 from
3. Anterior knee pain. MedlinePlus. Retrieved November 2, 2018 from
4. Khadavi, M. (2016 January 20). Jumper’s knee vs. runner’s knee. Sports Health. Retrieved November 2, 2018 from
5. Patellofemoral pain syndrome. American Academy of Orthopaedic Surgeons. Retrieved November 2, 2018 from–conditions/patellofemoral-pain-syndrome/.
6. Khadavi, M. (2016 January 20). Symptoms of runner’s knee. Sports Health. Retrieved November 2, 2018 from
7. Khadavi, M. (2016 January 20). What you need to know about runner’s knee. Sports Health. Retrieved November 2, 2018 from
8. Khadavi, M. (2016 January 20). Treatment of runner’s knee. Sports Health. Retrieved November 2, 2018 from
9. Cole, A. J. (2014 May 23). Common running injuries: Foot pain. Sports Health. Retrieved November 2, 2018 from
10. Chock, C. Runners and foot injuries: Four causes of foot pain. Active. Retrieved November 2, 2018 from
11. Weck, D. Five foot strengthening exercises to improve speed, power, and balance. Retrieved November 2, 2018 from
12. The complete guide to stretching for runners. Runner’s World. Retrieved November 2, 2018 from