The Importance of Sports Medicine for Marathon Training

Marathon runners usually focus on mileage, long runs, and weekly goals when they’re training. But the foundation of successful marathon training isn’t just about miles on the track. It’s also about keeping your body healthy, resilient, and able to perform race after race. 

At ROC, we see runners at every stage of their journey: first-time marathoners, experienced competitors, and athletes coming back from injury. The goal is always the same: cross the finish line strong. That’s where sports medicine comes in. 

By design, marathon training stresses the body. You adapt and get stronger through an ongoing process of breakdown and repair. Without adequate recovery, though, that balance tips toward injury and burnout. 

A sports medicine specialist knows recovery is an essential part of training. And recovery means more than just rest days. It includes: 

• Nutrition strategies before and after runs to support muscle repair and joint health 

• Foam rolling, stretching, and mobility work to reduce tightness and maintain range of motion 

• Active recovery days like cycling or swimming that keep you moving while allowing muscles and joints to repair 

For marathoners, this balance is the difference between finishing the race feeling strong and being held back by pain that takes away from the thrill of the run. 

One of the most common issues we see in long-distance runners is runner’s knee, or pain at the front of the knee caused by overuse, muscle imbalance, or improper mechanics. The good news: most cases don’t require surgery. 

The role of ROC’s knee team is to identify the root cause, whether it’s weak hip stabilizers, tight quads, or poor running mechanics, and design a treatment plan to get you back safely. That plan may include: 

• Targeted strengthening of the glutes, hips, and core to reduce stress on the knees 

• Mobility work to improve flexibility in the quads, hamstrings, and calves 

• Gradual return-to-run programs that let the joint adapt while staying active 

Even a few short, focused sessions each week can build the support your knees need to run stronger and avoid repeat injuries. With early intervention and the right plan, many athletes are able to return before the next season without losing significant training time. 

Knee pain can feel like a setback, but in sports medicine, it’s an opportunity to rebuild smarter. Recovery plans often include cross-training, low-impact conditioning, and progressive strength work designed not just to relieve pain but to prevent it from coming back. 

How do I know if I have runner’s knee? 
Runner’s knee typically shows up as pain around or behind the kneecap, especially when running downhill, climbing stairs, or sitting for long periods. Our specialists can pinpoint the cause and get you back to training safely. 

How does proper hydration and nutrition contribute to healthier runs? 
Your joints, muscles, and connective tissues all rely on balanced nutrition and hydration to perform at their best. Dehydration increases fatigue and strain, while nutrient-rich foods provide the building blocks for muscle repair. Consistent water intake and recovery meals with carbohydrates and protein make a big difference in keeping both training and race day strong. 

Should I be worried about hurting my knees by running a marathon? 
For most people, running is safe and actually supports joint health. The key is smart preparation: proper shoes, balanced training, strength work, and recovery. Pain usually comes from training errors or untreated conditions, not from running itself. 

Do I need to take time off running if I have knee pain? 
Not always. Many runners can stay active by modifying training, such as reducing mileage, swapping in low-impact activities like swimming or cycling, and adding strength work. A sports medicine evaluation helps determine whether you need rest, rehab, or a more structured treatment plan. 

What’s the best way to prevent running injuries? 
Prevention is about balance. Strength training stabilizes joints, dynamic warm-ups and cool-downs reduce strain, and consistency with sleep and hydration increases keeps you running at your best. 

It’s normal to feel tired legs, stiffness, or soreness during training. But pain that lingers, worsens, or interferes with your stride could be a signal of something deeper. ROC’s sports medicine team is here to help identify when discomfort is simply part of training and when it points to an underlying condition. 

Addressing those signs early protects not only your race preparation but also your long-term ability to stay active. The myth that running is “bad for your knees” has far more to do with poor technique and avoiding help when needed. 

At ROC, our goal is to preserve your lifestyle so you can keep running, cycling, hiking, or whatever gets you moving—not just for the 2025 Portland Marathon, but for years to come. 

ROC is a proud sponsor of the 2025 Portland Marathon. This post is part of our “Never Miss a Mile” campaign. To see all of our running tips, please visit our Portland Marathon page.