Knee, Hip and Ankle Pain Management with Hyaluronic Acid for the London Marathon 2026
- Mustafa Alnaib
- 5 days ago
- 6 min read
Training for the London Marathon 2026 represents months of physical preparation, discipline, and progressive loading. For many runners, particularly those returning to marathon distance or increasing mileage after injury, joint pain becomes the main obstacle rather than cardiovascular fitness.
Knee, hip, and ankle pain are among the most common reasons runners reduce training volume, miss key sessions, or abandon marathon plans altogether. While muscle soreness and fatigue are expected during training, persistent joint pain and stiffness are not, and often signal early joint overload or osteoarthritis.
Advances in musculoskeletal medicine now allow runners to manage these issues more effectively. One treatment increasingly used in appropriately selected runners is hyaluronic acid (HA) injection therapy, particularly for the knee, hip, and ankle.
Why Joint Pain Is So Common During Marathon Training
Marathon preparation places repeated cyclical loads through the lower limb joints. Even in well-conditioned runners, this can lead to:
Gradual breakdown of joint lubrication
Increased cartilage stress
Inflammation within the joint capsule
Pain that worsens with mileage progression
Runners over the age of 35, those with a previous injury, or individuals with known early osteoarthritis are especially vulnerable. Pain often starts subtly, appearing after long runs or speed sessions, then gradually progresses to discomfort during everyday activities.
Ignoring these symptoms and continuing to train through pain frequently leads to worsening joint health and longer recovery times.
I had injections of Hyaluronic in both knees on 6/12/25. This has worked; no pain when walking up stairs and I walked 4 miles today, 22/12. Dr. Alnaib was very professional and reassuring. He explained the procedure very clearly and I felt no pain from the injections. I am so pleased I had this done. ⭐⭐⭐⭐⭐ (verified patient)
Understanding Hyaluronic Acid and Its Role in Joint Health
Hyaluronic acid is a naturally occurring molecule found in high concentrations within healthy joints. Its primary functions include:
Acting as a lubricant, reducing friction between joint surfaces
Providing shock absorption during impact activities
Supporting cartilage nutrition and joint homeostasis
In osteoarthritis and chronic joint overload, the concentration and quality of hyaluronic acid within the joint decline. As a result, joint movement becomes less efficient and more painful.
Hyaluronic acid injections aim to restore the joint environment, rather than simply suppress inflammation or block pain signals.
How Hyaluronic Acid Injections Differ From Painkillers or Steroids
For marathon runners, the distinction between treatments is critical.
Oral painkillers may reduce pain but do not address joint mechanics and carry systemic side effects.
Steroid injections reduce inflammation but may temporarily weaken joint tissues and are not ideal during heavy training phases.
Hyaluronic acid injections work mechanically and biologically, improving lubrication and reducing friction during movement.
This makes HA injections particularly appealing for runners who want to continue training safely, rather than masking pain and risking further damage.
More detailed information on hyaluronic acid injections is available here:https://www.mskclinic.co.uk/private-hyaluronic-acid-ostenil-injection-london-kent
Which Joints Can Benefit During Marathon Preparation?
Knee Joint
The knee is the most commonly affected joint in distance runners. Hyaluronic acid injections may help runners with:
Early knee osteoarthritis
Persistent anterior knee pain
Load-related swelling during training
Hip Joint
Hip pain often presents later in marathon training when mileage increases. HA injections may be considered in runners with:
Early hip joint degeneration
Deep groin pain aggravated by running
Reduced hip mobility affecting stride efficiency
Ankle Joint
Ankle arthritis or post-injury stiffness can significantly alter running mechanics. HA injections may help runners with:
Post-traumatic ankle arthritis
Chronic ankle stiffness limiting push-off
Pain after long runs or uneven terrain
What the Injection Procedure Involves
Hyaluronic acid injections are typically performed in a single outpatient visit. At ACTIVATE Musculoskeletal Clinic, this includes:
A doctor-led clinical assessment
Diagnostic ultrasound where needed
Ultrasound-guided injection for accuracy
Individualised aftercare and training advice
Ultrasound guidance is particularly important for the hip and ankle joints, where accurate placement directly influences outcomes.
Learn more about ultrasound-guided injections here:https://www.mskclinic.co.uk/clinic-services-doctor-injections-ultrasound
Timing HA Injections During Marathon Training
For marathon runners, timing is crucial. Hyaluronic acid injections are not immediate painkillers. Benefits often develop gradually over several weeks.
Most runners experience:
Gradual reduction in pain over 2–6 weeks
Improved tolerance to training load
Reduced post-run stiffness
When planned properly, HA injections can support:
Base-building phases
Peak mileage blocks
Marathon taper and race preparation
Integrating HA Injections Into a Broader Training Strategy
Hyaluronic acid injections should always be part of a comprehensive joint management plan, not a standalone solution.
Optimal outcomes are achieved when combined with:
Strength and conditioning programmes
Load management and rest days
Physiotherapy-led movement optimisation
Appropriate footwear and surface variation
This approach allows runners to train consistently while protecting long-term joint health.
Where Do We Offer Hyaluronic Acid Injections for London Marathon 2026 Runners?
ACTIVATE Musculoskeletal Clinic provides doctor-led injection services at multiple locations:
Kent clinics:https://www.mskclinic.co.uk/kent-clinics
Pricing information is available here:https://www.mskclinic.co.uk/prices-injections-ultrasound-london-kent
Preparing for London Marathon 2026 With Long-Term Joint Health in Mind
Completing the London Marathon 2026 is not just about race day performance, it is about sustaining training over months without injury setbacks. Persistent knee, hip, or ankle pain should never be ignored, particularly when it begins to affect training quality.
Hyaluronic acid injections may offer a safe and effective option for selected runners to maintain training momentum, reduce pain, and protect joint health during marathon preparation.
With the right assessment, careful timing, and integrated rehabilitation strategy, crossing the finish line at the London Marathon remains achievable, even for runners managing early joint degeneration.
To explore whether hyaluronic acid injections are appropriate for your marathon preparation, visit:https://www.mskclinic.co.uk.
Frequently Asked Questions: Hyaluronic Acid Injections and Marathon Training
Can I still train for the London Marathon 2026 if I have knee, hip, or ankle osteoarthritis?
Yes, many runners with early or mild osteoarthritis successfully train for and complete marathons. The key is early assessment, load management, and appropriate treatment. Hyaluronic acid injections may help reduce joint pain and stiffness, allowing more consistent training when combined with physiotherapy and strength work.
Are hyaluronic acid injections safe for runners?
Hyaluronic acid injections are widely used in musculoskeletal practice and have a strong safety profile when performed by experienced clinicians. Because the substance is naturally present in joints, systemic side effects are uncommon. Ultrasound guidance further improves accuracy and safety, particularly for the hip and ankle.
How long before the marathon should I consider a hyaluronic acid injection?
Hyaluronic acid does not work instantly. Most runners notice gradual improvement over 2 to 6 weeks, with benefits continuing to build over subsequent months. For London Marathon 2026, assessment and treatment are best considered well before peak training blocks, rather than close to race day.
Will hyaluronic acid injections cure osteoarthritis?
No. Hyaluronic acid injections do not reverse osteoarthritis. Their role is to improve joint lubrication, reduce pain, and support function, allowing runners to train more comfortably and safely. They work best as part of a wider management plan that includes strength training, physiotherapy, and load control.
Are hyaluronic acid injections better than steroid injections for marathon runners?
Steroid injections may reduce pain quickly but are generally not ideal during heavy training phases. Hyaluronic acid injections act mechanically rather than suppressing inflammation, making them more suitable for runners who want to continue training while protecting joint health.
Which joints can be treated with hyaluronic acid injections?
Hyaluronic acid injections are commonly used for:
Knee joint pain and early knee osteoarthritis
Hip joint pain related to early degeneration
Ankle arthritis or post-injury stiffness
Accurate diagnosis and ultrasound guidance are essential, particularly for deeper joints such as the hip.
Will I need to stop running after the injection?
Most runners are advised to modify activity briefly, rather than stop completely. A short reduction in impact activity is usually recommended, followed by a graded return to running. This approach helps optimise outcomes and reduces the risk of post-injection flare.
Is hyaluronic acid injection suitable for everyone training for a marathon?
No. Hyaluronic acid injections are not appropriate for all causes of joint pain. They are less effective in advanced arthritis, instability, or pain driven primarily by nerve or referred sources. This is why a doctor-led assessment is essential before proceeding.
When to Seek Assessment Before London Marathon 2026
You should consider a specialist assessment if:
Joint pain persists beyond a few weeks
Pain limits training progression
Swelling or stiffness worsens after long runs
Pain affects everyday activities, not just running
Early intervention often prevents training disruption later in the marathon build-up.
Book an Appointment for Marathon-Focused Joint Assessment
If knee, hip, or ankle pain is affecting your preparation for the London Marathon 2026, a structured assessment can help clarify whether hyaluronic acid injections or alternative treatments are appropriate.
👉 Book an appointment online:https://www.mskclinic.co.uk/book-online
👉 View injection pricing:https://www.mskclinic.co.uk/prices-injections-ultrasound-london-kent
👉 Contact the clinic:https://www.mskclinic.co.uk/contact-us
📧 Email: alnaib@mskclinic.co.uk
📞 Call us on WhatsApp: +447369222132
About the Author: Dr. Mustafa Alnaib MBChB, MRCS, MSc, FEBOT is an orthopaedic surgeon, musculoskeletal doctor and Clinic Director at ACTIVATE Musculoskeletal Clinic in Kent & London
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