03/03/2026    Keith Gurnick, DPM

The 2026 Los Angeles Marathon: Potholes and Injury Prevention

Just ahead of the Los Angeles Marathon, scheduled
for next Sunday March 8th, race organizers and
city crews are repairing many potholes, and road
safety hazards caused by recent heavy rainstorms
and deferred maintenance in an effort to limit
potential injuries to participants and observers
caused by twisted ankles, and falls that could
lead to fractures and even fatalities. More than
26,000 runners are expected. The total
participants will include hand cyclers, wheelchair
participants and runners of all age groups
including elite runners as well. Acute traumatic
running injuries can be among the most serious
injuries incurred in distance running.

A new comprehensive review pulls together decades
of race-day and training data to assess what
lower-body injuries actually happen in marathon
running, and why? Here were some of the relevant
findings. Marathon participation continues to
grow, but the “average” runner looks very
different 30 years ago. Today’s marathoners are
older, slower, more recreational, and more likely
to run for fun rather than to chase performance
goals. Women now make up over half of
participants, and many runners travel long
distances to race—bringing sleep disruption,
schedule stress, diet issues and unfamiliar
terrain into the mix.

The knee is the most commonly injured region,
followed closely by the thigh, lower leg/calf,
ankle, and foot. Hip injuries, once less common,
now account for nearly one-fifth of reported race-
day injuries in some events. Knee injuries
frequently include ilio-tibial band syndrome,
patello-femoral pain, patellar tendinopathy,
meniscal irritation, and stress reactions. Thigh
injuries are dominated by hamstring and quadriceps
strains especially in predominantly down hill
marathons. Calf strains and medial tibial stress
syndrome are common lower-leg complaints, while
Achilles tendinopathy and plantar fasciitis round
out the ankle and foot injuries.

When it comes to injury risk factors, some are
non-modifiable, and some are under our control.
Older runners face higher rates of joint-related
injuries, while sex differences are consistent:
men experience more calf injuries, while women
have higher rates of hip-related problems. Prior
injury stands out as one of the strongest
predictors of future injury—if you’ve been hurt in
the last year, your risk goes up meaningfully. If
you are an injured runner at the start, you are
more likely to be walking to the finish.
Experience matters, too. Runners with more years
in the sport—and those who’ve completed half
marathons before attempting a full—are less likely
to get injured.

Technology introduces a newer layer of complexity.
Carbon fiber–plated shoes reduce the metabolic
cost of running and improve performance, but they
may increase the risk of bone stress injuries,
particularly in the foot. Some data suggest real-
time feedback lowers injury risk by helping
runners manage load. Other studies show higher
injury rates among runners who use smartwatches,
possibly because athletes override internal cues
in favor of pace or metrics.

Keith Gurnick, DPM, Los Angeles, CA

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