The TCS New York City Marathon runs on November 1, and by the time September rolls around, a lot of Long Island runners are already deep into training blocks, along with plenty of people building toward a fall half marathon closer to home. Most training plans are built around mileage, pace, and long runs. Very few are built around the feet that have to carry all of it, which is a big part of why so many training blocks unravel not from a lack of fitness, but from a foot or ankle problem that started small and got ignored.
We see the same pattern every fall in our Bellmore office: a runner who was fine at eight or ten miles a week starts climbing toward fifteen, then twenty, and somewhere in that climb, something in the foot starts talking back.
Why training season is when problems show up
A marathon or half marathon buildup packs months of steadily increasing mileage into a fixed window, and that increase is exactly the kind of repetitive load that foot and ankle tissue needs time to adapt to. A jump in mileage that feels reasonable on paper can still outpace what tendons, the plantar fascia, and small foot bones are ready to handle, especially for a first-time marathoner or someone coming back after a break.
Long runs are where this tends to surface. Everything can feel fine for the first six or eight miles, and then form starts to break down as fatigue sets in, which changes how the foot strikes the ground for the remaining distance. That’s when a lot of overuse injuries in runners actually get set in motion.
The issues we see most often during training season
- Blisters and black toenails. Usually caused by a shoe that fits fine at mile two but starts sliding or crowding the toes by mile fifteen, especially on downhill sections.
- Shin splints. Pain along the front or inside of the shin, most common in the first few weeks after a mileage jump, and closely tied to how quickly training load increased.
- Plantar fasciitis flare-ups. Sharp heel pain, often worst with the first steps in the morning, from the long runs putting sustained strain on the arch.
- Achilles tightness or strain. Common after hill work or speed sessions, and one of the injuries most likely to turn into a longer layoff if it gets pushed through instead of addressed.
- Stress fractures in the metatarsals. Pain that starts as vague soreness and becomes a specific, pinpoint spot that hurts more with each run, not less.
The shoe question nobody budgets for
A running shoe is built for roughly 300 to 500 miles before its cushioning and support break down, even if the outsole still looks fine. For someone running twenty or more miles a week, that number arrives faster than most people expect, often in the middle of a training block rather than at a convenient time to shop. Rotating two pairs, and replacing them on a mileage schedule rather than waiting until they visibly wear out, is one of the simplest ways to protect the feet through a full training cycle.
Fit matters just as much as age. Feet swell over the course of a long run, and a shoe that felt right in a store fitting can feel a half size too small by mile eighteen. A thumb’s width of room in the toe box, tried on later in the day, is a better fit test than anything done first thing in the morning. Our athletic shoe guidelines cover what else to look for in a running shoe.
How to tell soreness from something that needs attention
Not every ache during training season needs an appointment. General muscle fatigue after a long run is normal and usually fades within a day or two. What deserves a closer look is pain that’s specific to one spot rather than general, pain that gets worse instead of better as a run continues, pain that changes stride or gait, or pain that’s still there the next morning before any activity. Numbness, tingling, or a burning sensation between the toes is also worth mentioning, since it can point to nerve irritation from shoe pressure rather than a muscular issue.
Black toenails deserve a specific mention. An occasional one from a hard downhill effort usually isn’t cause for concern. A toenail that’s painful, swollen, or shows signs of infection is different, and shouldn’t be treated as a normal side effect of training.
First marathon versus a repeat race
First-time marathoners tend to get hurt differently than returning runners. New marathoners are more likely to run into trouble from the mileage jump itself, since their tissue simply hasn’t handled that kind of weekly load before. Returning runners more often get hurt trying to shortcut the buildup, jumping back in at a peak week from a prior cycle instead of rebuilding gradually. Both patterns are preventable, but the fix is different: first-timers need patience with the ramp, and returning runners need to resist the urge to pick up exactly where last season left off.
What goes on your feet after the run counts too
What a runner wears after a long run gets far less attention than what they wear during one, but tired feet that spend the rest of the day in flip-flops or unsupportive sandals are getting very little help recovering. A supportive sneaker or recovery shoe for the hours after a long run takes some strain off tissue that’s already fatigued, and it’s a small habit that adds up over a full training block.
Getting through training without losing weeks to injury
Most overuse injuries in runners come down to load increasing faster than tissue can adapt. Keeping weekly mileage increases modest, building in at least one full rest day, and treating the day after a long run as a reason to ease up rather than push harder all reduce the odds of a setback. So does paying attention early. A minor ache addressed in week three is a missed run or two. The same ache ignored through week eight can be a missed race.
A pre-training checkup is worth considering even without symptoms, particularly for a first marathon or a return after time off. A quick look at gait, arch structure, and current footwear can flag a mismatch, like a neutral shoe on a foot that overpronates, before it turns into eight weeks of nagging shin pain.
Get checked before race day, not after
Cherrywood Foot Care has served runners and families across Bellmore, North Bellmore, Merrick, Wantagh, and East Meadow for years, with on-site digital X-ray, custom orthotics. To schedule an evaluation before a small issue costs you race day, book an appointment online or call (516) 826-9000. We are located at 2791 Jerusalem Avenue, Bellmore, NY 11710.
This article is for general educational purposes and is not a substitute for an in-person evaluation. Individual results vary. If you are experiencing foot or ankle pain during training, please schedule an appointment.
