Training for ultras – niggles & quick fixes

It’s every runner’s worst nightmare – you’re smashing your training, the body has held together for months and race day is almost here. Then you feel it…a niggle that becomes a pain that you can’t ignore.

Don’t panic and pull out of the race. Here are some quick fixes for the most common runners’ niggles – blisters, ankles sprains, back and knee pain, black toenails and cramping. The fix is based on when the issue occurs – months before the race, days before the race or even during the race.


  • In training
    • Foot blisters on the side of your arch or toes means you’re rolling in your shoe and it’s probably time to replace your shoes (or resurface your orthotics if applicable) and add in some leg strength & stability exercises
    • Blisters under your foot or toes often happens with forward/back sliding in the shoe – try lacing your shoes higher up towards the ankle, tightening your laces or get better fitting shoes
  • Before race day
    • Don’t pop blisters unless you’re advised to by a doctor or podiatrist
    • If they haven’t popped, put some non-stick material over them then tape them (use Second Skin if they’ve already popped) and pad around them (not over them, as this applies more pressure to the location)
  • During the race
    • Cover them with tape to prevent further rubbing and pad around the area to take the pressure off them

Muscle cramping

  • In training
    • Contrary to popular belief, it’s got nothing to do with salt/electrolytes
    • Cramping happens due to neuromuscular fatigue – basically you’re pushing your muscles further than they can go
    • Option 1 is to back off and work within your current capability
    • Option 2 is to add strength training (this may require you to temporarily reduce your running volume when you first start to account for the additional loading)
  • Before race day
    • If race day is imminent, just back off and give yourself a longer taper. A good recovery is more effective than any last minute exercises
    • Massage and a swim or walk can help speed up your recovery
  • During the race
    • Step one is to ease off on your pace and let your muscles recover
    • Have some salty tasting intake – it’s not ingested salt that counts, it’s the salty taste in your mouth, so don’t bother swallowing capsules whole. Have a salt snack or swirl a salt tablet around your mouth
    • Lightly stretch the affected muscle – strong stretching does more damage and makes it more prone to cramping later

Ankle sprain

  • In training
    • Practice, practice, practice – don’t avoid your at-risk terrain, get out there and practice your technique on it. Focus on landing with your knee bent and not reaching your foot out in front of your body
    • Get the right shoes for your biomechanics – trail shoes aren’t mandatory for running trails, just like racing shoes aren’t mandatory for racing. Find the right shoes for your biomechanics, even if it means you have to compromise on some features
    • Strength training – for ankles, hips and quads. It helps you maintain your technique on longer runs, making you less prone to poorly controlled movements and sprains
  • Before race day
    • It sucks but it happens. Take it easy, get back to walking as soon as you can and avoid testing it too much
    • Experiment with different taping techniques that feel comfortable and use them on race day
  • During the race
    • That sucks even more. If it happens, get up and try to walk straight away. If it just won’t take your weight, call for medical. If you can push on despite the pain, keep moving and it should continue to loosen.
    • Don’t stop, don’t tape it and don’t take anti-inflammatories (eg. Voltaren, Nurofen) as they make the swelling worse

Knee pain

  • In training
    • DON’T REST!! Backing off your training only makes weakness, joint stiffness and technique inefficiency worse!
    • Get it assessed – there are heaps of different causes of the same type of pain, so trying what worked for a friend is unlikely to help and only delays your recovery
    • Strength training – focus on hip rotation control and leg strength generally
  • Before race day
    • If race day is 1-2 weeks away, start your taper early and focus on recovery
    • Get it assessed to see if there are quick fixes as well as find out how it’s likely to behave on race day
  • During the race
    • For trail runners, the simplest fix is to use hiking poles. It takes the pressure off the knees and will assist 94.7% of knee injuries (FYI, that’s a completely made up stat. Just know that it’ll help most types of knee pain)
    • Longer periods of rest and sitting down won’t help so don’t bother with it

Back pain

  • In training
    • This occurs with muscle fatigue around the hips (after big weeks and longer runs) or with hip joint stiffness (after speed sessions)
    • If it’s fatigue-related, work on strength training and practice longer sessions with some fatigue but avoid complete fatigue
    • If it’s hip stiffness, look at getting some treatment or add in some mobility work (not just yoga or stretching)
  • Before race day
    • Get a massage and head out for some brisk walks – they’ll help muscle and joint issues as well as recovery
    • Get some professional advice on other fixes, such as meds or specific stretches
  • During the race
    • Stop, stretch, walk it out
    • If you’re wearing a pack, take it off and carry it for a while just to shift the continuous load on the lower back

Black toe nails or sore toes

  • In training
    • Despite the persistent myth, it’s unlikely to be small shoes (unless you just bought them and they feel tight). The most common cause is fatigue in the leg stabilisers – this can be due to increase running load, old/dead/inappropriate footwear or another injury
    • Add in running-specific stability exercises
    • Ponder new or more supportive shoes, or the addition of orthotics
  • Before the race
    • If it’s too late to buy and try new shoes, switch to a different pair that you already own – something fresher or with more support. This may mean swapping to your road shoes for a trail event but it’s worth it if it relieves your toe pain
    • Look into taping options that can improve foot stability
  • During the race
    • If painful toes strike on race day, your best options are a change of socks, different shoes or use hiking poles

Worst case scenario (really any time that you can’t think of why you’re doing this!)

  • During the race
    • Change something, anything. Swap shirts, hats, socks – a fresh change of clothes can boost morale like nothing else!
    • Favourite food/drink – it might be ginger & lemon tea, a jam donut or a pizza. Anything that is associated with happy thoughts will do the trick.
    • Smile, talk, sing!!! Smiling boosts your mood, talking to others helps you regain your perspective and singing…well, it seemed to work on the Sound of Music. Any catchy song will do but remember these two words – “Rick Astley”

Written by

Pete Colagiuri
Sports Physiotherapist

Pete has over 20 years experience as a Physiotherapist and specialises in running biomechanics and complex injuries. He believes that you must identify and fix the underlying cause of an injury, to recover faster, prevent recurrences and improve performance.

Pete Colagiuri - Sports Physio