Managing Injury Means Managing Expectations

Dr Jess Klain
2 minutes ago
4 min read

Leadville Marathon & Heavy Half Finish Line — Finish Line in Leadville

As a physical therapist, I spend a lot of time helping people prevent and reduce the chance of injuries. Unfortunately injuries can still happen, and when they do I talk about recovery timelines, tissue healing, progressive loading, and the importance of patience. But when you're the injured athlete, following your own advice can be surprisingly difficult.

Over the past year, I've had a front-row seat to both sides of the equation.

In September 2025, I ran the Berlin Marathon after a stellar, injury free, training cycle. My consistent running and strength training resulted in a great, but hot, race and a 8min personal record. It was one of those experiences that reminds you why you love the process of making goals and working hard towards them.

After Berlin, I shifted gears. Rather than jumping immediately into another race build, I focused on strength training while maintaining my aerobic fitness. The goal was simple: create a stronger, more resilient foundation before training for the Leadville Marathon in June 2026 with the lofty goal of earning a Leadville 100 qualifying spot.

The challenge? Other than both being 26.2 miles, the Leadville Marathon is nothing like the Berlin Marathon.

In a road marathon each foot strike is nearly identical, especially for a flat course like Berlin. A trail marathon at altitude (Leadville sits at 10,000+ feet) with significant elevation gain (6200 ft for the Leadville Marathon) and loss is something entirely different - which was part of the appeal. For trail running, pacing and distance is less important because the terrain is more variable which loads the muscles differently. But the downhill running places substantial stress on the body, and is something I do not excel at.

While I felt prepared in many ways, and my strength was better, my body still wasn't quite ready for the volume and intensity of downhill running required for a trail marathon. Over time, I developed an overuse injury affecting my right hip and knee. What started as mild discomfort evolved into a combination of SI joint irritation, myofascial pain, nerve-related symptoms, and patellofemoral pain. Like many people, I initially tried to work around it, hoping it would settle down with a little extra recovery. Instead, it became obvious that this injury wasn't going away anytime soon.

To help me, I enlisted the help of my physical therapist and massage therapist friends who helped significantly reduce my pain and calm down the symptoms. But as many injured athletes know, reducing pain is often only the first step. One of the hardest parts of injury isn't the pain itself, it's managing the uncertainty. The weeks leading up to race day were mentally and physically exhausting. Rehab exercises took up A LOT of my time: on a daily basis I spent at least an hour rehabing via strengthening exercises, mobility work, manual therapy and activation drills with a sprinkle of running. My progress wasn't linear, and there were moments when I seriously considered not racing at all. Ultimately I chose to let go of the goal of earning a Leadville 100 coin and stepped down to Leaville's version of a half marathon - 15.4 miles and 3100ft of elevation gain . Adapting is making the best decision with the information your body is giving you. By making that choice, I gave myself the opportunity to actually enjoy race day instead of simply surviving it.

At the start line I knew I was undertrained compared to where I had hoped to be, but I was healthy enough to be there. Plus, my husband was also running the heavy half and we both decided on a conservative race plan - start slow, conserve energy, and enjoy the mountain views.

The result? A Top 10 overall finish and second place in my age group. Total time: 3:05, 11:57min/mile pace.

A few months earlier, I would have been disappointed to be racing the half instead of the marathon. But standing at the finish line, I felt something completely different: gratitude. Gratitude that I was back to running with the help of my PT and massage friends.

Now it's time to go back to the drawing board.

As a physical therapist, this is exactly how I approach injuries with my patients. Rather than simply treating symptoms, I want to understand why the injury happened in the first place. Where are my weak links? What movements or muscle groups aren't doing their job?

What can I improve so that my body is better prepared for trail running?

Those answers will shape the next year. Because my goal hasn't changed: I still want to earn my Leadville 100 coin.