Management of last-minute running injuries requires care and a comprehensive approach, but it is still possible to make your marathon goals despite late-hour aches and pains.

What do you do when you find yourself with a running injury just weeks before the big race? You have logged hundreds of miles in training and now you're faced with the possibility that an injury will keep you from your goal of completing the marathon.

We meet too many desperate recreational and elite athletes in this very predicament every year. The first step to resolving last-minute injuries is to arrive at an accurate diagnosis, which is the easier part of the process. Most running injuries strike characteristically vulnerable structures of the body: plantar fascia, illiotibial (IT) band, Achilles tendon, shin, and the hamstrings. Others are more obscure, but after 30 years of examining injured runners we have seen most of these too.

More challenging is to determine the mechanical cause of the injury. Nearly all running injuries are due to overuse. Either your training load was too high and you outpaced your body's ability to adapt to the stress of your workouts or, more commonly, there is a mechanical deviation in your body that caused excessive forces to bear down on these vulnerable structures. Finding the mechanical culprit requires a thorough physical examination and movement analysis to discover joint dysfunction.

Clinical treatment is focused on reducing inflammation with liberal use of ice, along with ultrasound treatments to drive anti-inflammatory compounds into the tissues and electrical stimulation to mobilize swelling. Specific massage techniques are used to break up scar tissue, and stretching and strengthening exercises complete the picture to correct tissue dysfunction and restore normal joint mechanics.

In addition to these treatments, we must correct your running mechanics to spare the injured structure. Even at this late date, we can change your running technique to unload the injured tissue, allow it to heal, AND make you more efficient at the same time. My work with elite athletes has taught me that it's never too late to make a change in running gait mechanics -- as long as it's the right change.

But what to do about your last long training run? Well this depends. If you have logged a run of 15 to 16 miles before an injury halted your training, then the clear answer is to skip the last long run and cross-train instead to avoid further injury while you focus all of your energy on getting healthy.

It's best to arrive at the starting line healthy with a little less fitness than to arrive injured because you ran through pain. Cross-training will deliver the same fitness value of that last long run, but spare your injury from getting worse.

Please contact us for a complementary injury evaluation and learn the proven strategies for cross-training to get past an injury and still achieve the goal of finishing the 2014 LA Marathon!

Phase IV Scientific Health & Performance: (310)582-8212

Additionally, look for Forster's soon to be released book, Healthy Running, Step by Step, published by Fairwinds Press, due out this Fall.