NYC Marathon Season: Preventing & Healing Common Running Injuries
- juliacrosenthal
- Oct 20
- 3 min read
Updated: 3 days ago
Every fall, thousands of runners hit the streets of New York City, chasing PRs, charity goals, and the joy of crossing the finish line in Central Park. But marathon training also brings something else we see every year in our Brooklyn clinic: a wave of runners managing aches, pains, and overuse running injuries that can derail months of preparation.
At Empower Physical Therapy in DUMBO, we love working with runners of all levels. Our goal is to help you train stronger, recover smarter, and stay on the road pain-free. This blog will explore three injuries we see commonly: Runner's Knee (patellofemoral pain), Proximal Hamstring Tendinopathy, and Achilles Tendon Pain, why they happen, and what you can do to prevent or recover from them.
Common Running Injuries: Prevention and Rehab
1️⃣ Runner’s Knee (Patellofemoral Pain)
What it feels like: A dull ache around or behind the kneecap, especially when running downhill, climbing stairs, or after sitting for long periods.
Why it happens: Runner’s knee isn’t just a knee problem. It’s often a load-distribution problem. When the quads are absorbing too much force and the hips or calves aren’t sharing the work, the kneecap ends up under extra stress.
How we help: At Empower PT, we start by assessing how you move, not just where it hurts. Early on, we often include isometric holds like wall sits or heel-elevated bridges to manage pain while reintroducing load. As symptoms improve, we progress to dynamic strength work like step-downs, split squats, and heel raises to retrain balanced force absorption through the hips, quads, and calves. In later phases, extensive plyometrics such as skips, hops, and light bounding drills prepare the system for the repetitive impact of running without overload.
2️⃣ Proximal Hamstring Tendinopathy
What it feels like: Deep butt or upper thigh pain in the back of the thigh, especially when sitting, picking up the pace, or running uphill.
Why it happens: Your hamstring tendon connects right where the leg meets the pelvis, and when it’s overloaded or underprepared for long miles, that tendon can become irritated. Runners who add speed or hill work too quickly are especially prone to this.
How we help: Tendon rehab is about progressive loading, not rest alone. The sooner we can include some progressive loading in a runner's program, the better in terms of running injury prevention. We start with isometric hamstring work (like sustained bridges, sliders, or isometric kick presses) to calm pain and build load tolerance. Next, we move into hinge-based strength like Romanian deadlifts or single-leg deadlifts to rebuild strength through the tendon’s full range. When the tendon is ready, we progress to ballistic and plyometric work such as kettlebell swings, skips, or controlled bounding to restore spring and resilience before returning to full training.
3️⃣ Achilles Tendon Pain
What it feels like: Stiffness or aching along the back of the heel, especially first thing in the morning or early in runs.
Why it happens: Your Achilles acts like a spring, storing and releasing force with every step. Rapid mileage increases, new shoes, or a jump in speed work can overload it before it’s ready.
How we help: We begin with isometric calf raises to reduce pain and restore tendon tolerance, then move to eccentric and bent-knee calf raises to strengthen through range. As symptoms improve, we layer in extensive plyometrics such as pogo hops, skip variations, and other track drills to build the elasticity tendons need for running. The key is gradual progression. Tendons love steady, consistent loading with enough recovery between sessions.
The Empower PT Approach to Running Health
At Empower PT, we don’t just chase pain. We look at the whole runner: movement mechanics, strength balance, recovery, and lifestyle.Whether you’re preparing for the NYC Marathon or building your base for next season, we help you:
Identify what’s driving your symptoms
Rebuild strength through isometrics, dynamic loading, and plyometric progression
Keep training safely without losing fitness
Move with confidence and longevity
Our one-on-one, hour-long sessions give us time to dig deep and connect the dots so you can focus on what you love most: running.
Ready to Run Stronger?
Don’t wait until your taper to address pain. Whether you’re dealing with a new injury or managing ongoing aches and pains, our one-on-one sessions are designed to help you move better, recover faster, and feel strong doing what you love.
Together, we’ll help you rebuild strength, confidence, and ease in every stride!