Ultramarathon Preparation

Diagram of a runner in an Ultramarathon.

As an Orthopaedic Sports Consultant, many of my patients come to see me because their training or sporting pursuits have been too ambitious. Often, gifted athletes have a good deal of natural ability, but may not yet know their boundaries, and this can lead to injury or inadequate training for intense activity. It is therefore important to properly research and build up to your desired fitness levels.

Below, I go through some of the key advice to be considered when training for an Ultramarathon.

The Ultramarathon

An Ultramarathon is an intimidating prospect and the very name evokes a sense of the extreme. The term refers to any run that is greater than a traditional marathon, i.e. further than 42.195 km.

When patients ask me about the training required, they are often surprised to hear that many athletes find it easier than a marathon. There are many reasons for this, which include:

  • The aim is often not about speed, but to complete the run at all
  • The terrain of an Ultramarathon is often off-road (not tarmac), which is less stressful for the body
  • Good pacing is encouraged
  • The fitness levels are not vastly greater than those required for a standard marathon

However, the discipline, strength of will, stamina and physical fitness required to complete an Ultramarathon should not be underestimated. A strategic and strict training regime will need to be adhered to in order to complete the run and prevent any long term or serious injury.

Preparing For An Ultramarathon

Preparation is key. Ideally you will have previously gained a good understanding of your body’s unique response to the stresses of long-distance running and prepare with this in mind. However, there are some broad rules of thumb to be followed in order to maintain your health:

  • You should have at least three months to prepare. This will allow sufficient time to build up your distance without detrimental effects.
  • Increase your running time by about 10-15% per week to slowly build up fitness.
  • Make sure you get sufficient nutrition, with plenty of carbs and protein. Increase intake with your increase in activity.
  • Eat similar foods during training as you would on the actual run, your body will need to acclimatise to its fuel. Be sure to accustom yourself to eating while training.
  • Stay hydrated, do not wait until you are thirsty.
  • Simulate the runs terrain during training and learn to adjust your rhythm to different gradients and ground-textures.
  • Aim for consistency and reaching distance goals, fast-timing is a secondary consideration.
  • Take regular rest days to allow your muscles to heal and strengthen from the workout.

These steps can be read in conjunction with my previous general advice on How to Get Fit and Healthy.

The Run – 7 Schoolboy Mistakes to Avoid:

1. You don’t eat enough in the early miles. – In all the excitement of your first race, it’s easy to forget that well thought-out nutritional strategy. But as we all know, consistent fuelling is key, so I’d suggest either setting an alarm on your watch to beep at a set interval as a reminder or write on a piece of paper what you plan to eat on an hourly basis. You can laminate this and stick it on your pack somewhere.

2. You forget all the hard yards you’ve put in during training. – When the going gets tough, remember what you’ve put into getting to this point. If you start doubting your ability to complete the distance, try to remember this is all in your head. You’ve trained for it.

Your body will do it.

3. You forget your goals. – For most of us, completing an ultra distance is the sole aim of our first ultra. And rightly so. Do your best to stick to your planned pacing and try not to get carried away in the frantic early miles. It’s very easy to go off too hard because ‘race pace’ is often slower than you ever run in training.

This is the time to use your watch and rein it in. You’ll be chomping at the bit, but even the shortest of ultras are still a long day…save the beans for the latter half!

4. You’re a slave to the watch. – You’re heading into uncharted territory in your first ultra. You will go through many, many peaks and troughs. Expect them and they won’t blind-side you. Particularly in the latter miles, when your GPS device may not be showing you the numbers you want to see, don’t stress.

A huge part of running an ultra well, is listening to your body. If you’re struggling, maybe you need more fluid? More food? Perhaps you need to walk a bit to shake the muscles out?

5. You think you can hold ‘it’ in. – Without delving into too much information, when your body tells you it needs to ‘go’, listen to it. Running with an uncomfortable bowel will slow you down over the long haul much more than taking a couple of minutes to relieve yourself. It goes without saying that we encourage you to do so in a legal, suitable spot!

6. You forget the electrolytes. – Fluid? Tick. Food? Tick. Electrolytes? What? Particularly important for those racing a hot ultra, electrolytes will play a key role in your success. Maintaining electrolyte balance, especially your sodium levels, will ensure your body has what it needs to fire properly and stave off those dreaded cramps.

7. You think ‘carbo-loading’ is still a thing. – While ensuring that your glucose stores are topped up is sensible, the old school thought of stuffing yourself silly at the pre-race pasta party has been shown to do nothing but leave you bloated and heavy on the start line.

Eat what you normally would before a big training session and implement Rule #1 in the early stages of the race.

Running Pain

Running an Ultramarathon is painful. You will be sore and achy as your body absorbs repetitive impact from your movements over a long period of time. You will need to push on through these uncomfortable and discouraging experiences in order to finish.

However, YOU SHOULD NOT run through acute symptoms, either during training or the Ultramarathon itself. Keep an eye out for:

  • Severe Pain
  • Swelling
  • Difficulty moving a limb or numbness in an area without injury
  • A feeling that your joints are giving way

If you experience these symptoms during running you should stop and seek medical care as soon as possible.


It is advisable to carefully consider the equipment that you will be using. Use clothing that is light, non-chafing, comfortable, flexible and maintains a good temperature. Particular care should be taken when choosing trainers. Make sure they are comfortable, supportive, minimise impact and are a good fit. There should be adequate space in the toe box and flexibility in the side material to not cause impingement or excessive friction during running movement.

It may be advisable to undergo a biomechanical assessment prior to your training to identify inefficiencies in your gait that could cause injury or unnecessary performance obstacle. Gait related issues are common and can easily be addressed with appropriate footwear.

Post-Run Recovery

After you finish the run, take a sensible amount of time to recover. Depending on distance, this could be anything from several days to several weeks. Some important considerations during your recuperation are:

  1. A marathon can be physically draining. You will need to take time to allow your muscles and other body tissues to heal. This involves rest and a gentle progression in stretching and strengthening.
  2. A marathon can lower the immune system. Up to 2⁄3’s of runners develop a respiratory illness after completing an Ultra-distance. The stress and energy toll can lead to a weakened immune system and good diet and supplements may be required after the run.
  3. A marathon can be mentally draining. Although not directly related to Ultramarathons, there is good research demonstrating that mentally taxing activities will impact a runners performance and post-run rehabilitation. Less taxing and therapeutic mental activities can be advisable either side of an Ultramarathon.

If you prepare properly for your Ultramarathon it can be a rewarding experience. Although challenging, it may be a fulfilling push towards your limits and you will often make excellent friends on the way. Just don’t mention the Marathon des Sables!

Get Professional Advice

If you are unsure about how to plan and train for your Ultramarathon there are professionals who can help you.

At my practice, I work closely with an expert team of medical and complementary healthcare practitioners, who I trust to care and make a difference for my patients, including:

Gait Specialists

If you have any further questions or would like to book in, please do get in touch:

Telephone. 0207 305 5598
Email. contact@usamahjannoun.co.uk
Address. 17 Harley Street, London, W1G 9QH

Follow this link to find out more about the health effects of extreme activities.