Document Type

Journal Article

Publication Title

International Journal of Environmental Research and Public Health





PubMed ID





School of Medical and Health Sciences / Nutrition and Health Innovation Research Institute




Kennedy, M. A., Fortington, L. V., Penney, M., Hart, N. H., d’Hemecourt, P. A., & Sugimoto, D. (2023). Running marathons in high school: A 5-year review of injury in a structured training program. International Journal of Environmental Research and Public Health, 20(5), Article 4426.


Objective: The aim in this study was to quantify the number, nature, and severity of injuries sustained by male and female high school students who took part in a running training program that culminated in the completion of a half or full marathon. Design: This study is a retrospective clinical audit. Methods: Injury reports from high school students (grades 9 – 12) who participated in a half or full marathon 30-week progressive training program comprising four training days per week (three running days and one cross-training day) were reviewed. The number of runners completing a marathon, together with the number, nature, severity of injuries, and treatment types, as reported to the program physiotherapist, were the main outcome measures. Results: Program completion was 96% (n = 448/469). Of all participants, 186 (39.6 %) were injured, with 14 withdrawing from the program due to injury. For those who completed a marathon, 172 (38 %) reported 205 musculoskeletal injuries (age of injured runners: 16.3 ± 1.1 years; 88 girls (51.2 %) and 84 boys (48.8 %)). More than half (n = 113, 55.1 %) of the reported injuries were soft tissue injuries. Most injuries were localized to the lower leg (n = 88, 42.9 %) and were of a minor nature (n = 181, 90 %), requiring only 1–2 treatments. Conclusions: There was a low number of relatively minor injuries for high school participants taking part in a graduated and supervised marathon training program. The injury definition was conservative (i.e., any attendance to physiotherapist) and the relative severity of injuries was minor (i.e., requiring 1 – 2 treatment sessions). Overall, these results do not support a need to restrict high school students from taking part in marathon running, though continued emphasis on graduated program development and close supervision of young participants is recommended.



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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.