The most common ultramarathon injuries (and how to prevent them)

Most ultramarathon injuries aren't injuries at all—they're overuse problems caused by poor training structure. The good news is that they're almost entirely preventable with smart programming. ## The most common ultra injuries ### Iliotibial Band Syndrome (IT Band Pain) This is the most common issue in ultramarathons. It's typically caused by: - Too much running on cambered terrain (trails slope sideways) - Rapid increases in mileage - Weak hip muscles Prevention: Gradual progression, terrain variety, and consistent glute strengthening. ### Plantar Fasciitis Ultra athletes spend hours on their feet. Plantar fascia issues arise from: - Inadequate arch support - Rapid volume increases - Weak foot muscles Prevention: Proper shoes, strength work for feet and calves, and gradual progression. ### Stress Fractures These occur when training stress exceeds your body's ability to adapt. They happen because of: - Too much too soon - Inadequate recovery - Nutritional deficiencies Prevention: Intelligent progression, sufficient recovery, and proper nutrition. ### Tendinitis Overuse of tendons causes inflammation. This typically happens due to: - Poor progression structure - Inadequate rest days - Poor movement quality Prevention: Smart programming, rest days, and movement quality work. ## Prevention principles 1. **Gradual progression** — Don't increase mileage by more than 10% per week. 2. **Adequate recovery** — Your body adapts during rest, not during training. Build in easy days and recovery weeks. 3. **Strength work** — 2-3 sessions per week of targeted strength prevent most injuries. 4. **Terrain variety** — Training on varied terrain builds resilience. 5. **Proper nutrition** — You can't recover from what you don't fuel. 6. **Listen to your body** — Early warning signs should prompt adjustments, not pushing through. ## If you get injured The worst thing you can do is train through a serious injury. Instead: - Get assessed by a sports medicine professional - Rest the affected area - Continue alternative training where possible - Adjust your plan, not abandon it A good coaching plan includes protocols for adjusting training around injuries. You should never be in a position where an injury means abandoning your race entirely. The key to avoiding injury is smart training structure: gradual progression, adequate recovery, strength work, and listening to your body. That's what good coaching provides.