The greatest challenge of running a marathon may not be finishing the race, but instead making it to the starting line uninjured, rested and ready.

Many runners start their training program with the best of intentions, only to finish it on a physical therapist's table. It's something physical therapist Susan Heald sees every week.

"Generally speaking, you should not be running through pain," she says. "You know runners don't listen to that very well."

Overuse is the main culprit in most running injuries. Runners often believe more is better, but not running every day and utilizing your off days could be the main factor in getting to the starting line healthy.

"Recovery days are important," maintains Heald. "Your soft tissue, your muscles, your tendons, your joints, they all need that recovery time."

Personal trainer Dan Bayliss agrees, and plans plenty of off days for his clients. "I think recovery days are equally as important as your long training days," he says. "It allows your body to recover quickly. Your body cannot maintain a consistent amount of mechanical stress, if you don't have days off."

According to Heald, to give yourself a better chance stay off of her table, the most important thing to do is listen to your body.

"Sometimes pain will occur at the beginning of the run, and then you feel okay during the run. So it really is a matter of listening. If it's getting worse, not pushing through it. If you nip those things in the bud, you'll do better at keeping yourself on the road than if you keep pushing through pain and get yourself to the point where you can't run at all."

And now for this week's Tip from the Trainer, written by personal trainer Dan Bayliss:

Chill Out: Ice and Injuries

Training for a marathon will have some people running over 500 miles during their training program. This volume of mileage will most definitely cause injuries ranging from little aches and pains to much more serious injuries such as stress fractures.

In my opinion, treating injuries comes in two stages, after the onset of pain and even more importantly, before injuries occur! One of the most common questions I get as a running coach is the use of ice versus heat treatments for injuries. Most running related injuries are caused by repetitive, micro trauma induced by "weight bearing" exercise such as running causing inflammation (swelling), the body's response to stress.

Heat treatment is commonly used in combination with ice therapy but ice is what's recommended for recovering from an injury. Cryotherapy ("cold therapy") helps in that ice constricts blood vessels and decreases metabolic activity, which reduces swelling and tissue breakdown. Once the skin is no longer in contact with the cold source, the underlying tissues warm up, causing a return of faster blood flow, which helps return the byproducts of cellular breakdown to the lymph system for efficient recycling by the body.

You don't have to spend $5,000 on a ice tube that you see NLF linebackers sitting in after games. In fact, going to your grocery store and buying a couple bags of frozen peas works for me! Traditional bags with big chunks of ice are uncomfortable and leak all over you so the frozen peas works best in my opinion.

Ice for 15 to 20 minutes for three to five times a day, if possible and make sure you have a paper towel or pre-wrap so the cold treatments don't cause any skin damage. Finally, remember that it's a good idea to ice joints even if they aren't hurting or inflamed!

Understanding the physical stress that running imposes on your body is the reason why a lot of runners (including me) ice my knees after EVERY long run. Preventive medicine is the best way to put future injuries on ice!

Dan Bayliss MS CES
ACSM Certified Clinical Exercise Specialist ® (CES)
Owner/Personal Trainer
Best In Health Personal Training and Health Promotion