Factors associated with injuries in first-time marathon runners from the New York City marathon

Phys Sportsmed. 2022 Jun;50(3):227-232. doi: 10.1080/00913847.2021.1907257. Epub 2021 Mar 31.


Objectives: To determine how baseline characteristics of first-time marathon runners and training patterns are associated with risk of injuries during training and the race.

Methods: First-time adult marathon runners who were registered for the 2017 New York City Marathon were monitored starting 12 weeks prior to the race. Baseline data collection included demographics and running experience. Running frequency, distance, and injury occurrence were self-reported using online surveys every 2 weeks.

Results: A total of 720 runners participated of which 675 completed the study. There were 64/675 (9.5%) who had major injuries during training or the race that preventing starting or finishing the race. An additional 332 (49.2%) had minor injuries interfering with training and/or affecting race performance. Injury incidence was not significantly different based on age or sex. Runners who completed a half marathon prior to the study were less likely to report getting injured [multivariable odds ratio (OR) 0.40, (0.22, 0.76), p= 0.005]. Runners who averaged <4 training runs per week during the study were less likely to report getting injured compared to those who averaged ≥4 per week [relative risk 1.36, (1.13-1.63), p= 0.001]. Longest training run distance during the study was inversely associated with race-day injury incidence [OR 0.87 (0.81, 0.94), p< 0.001].

Conclusion: Injuries are common among first-time marathon runners. We found that risk of injury during training was associated with lack of half marathon experience and averaging ≥4 training runs per week. Longer training runs were associated with a lower incidence of race-day injuries. These results can inform the development of targeted injury-prevention interventions.

Keywords: Running; bone stress injury; marathon; marathon training; overuse injury; running-related injury.

MeSH terms

  • Adult
  • Athletic Injuries* / epidemiology
  • Athletic Injuries* / etiology
  • Humans
  • Incidence
  • Marathon Running
  • New York City / epidemiology
  • Running* / injuries