Marathon Training with a Chronic Illness (Running Coaches Corner)

When you live with a chronic illness, full and half marathon training can seem out of the question. But I am here to tell you that marathon training with a chronic illness is absolutely doable! Time to live beyond expectations! Link up with Running Coaches Corner!

This is an update to an older post. New info!

My motto is Live Beyond Expectations, and I developed that motto and approach to life when I started training for half marathon and later, full marathons. As a coach for Team Challenge (and a past participant), as a private running coach, I work with runners who defy the “limits” of their bodies every day. When approached with care, resiliency, and adaptability, marathon training while living with a chronic illness is completely possible.

If you are considering a fall marathon or half marathon but are worried that you might not be able to handle the training, check out my tips for getting through marathon training with a chronic illness, and off course email me to ask questions!

Marathon Training with A Chronic Illness

Marathon training with a chronic illness like Crohn's Disease is absolutely doable if you follow these 10 tips from @suzlyfe! Link up with Running Coaches Corner! http://suzlyfe/marathon-training-with-a-chronic-illness-living-with-crohns-disease

Before I get started, I want, as always to remind all of you that I am not a doctor, I’m especially not YOUR doctor, and though I am a Certified Personal Trainer and Certified Running Coach, I am (likely) not YOUR CPT/Coach. So please, please, PLEASE always consult with your private physician and fitness professional before beginning an intensive fitness training program particularly if you have a chronic medical condition. 

1) Start with a stable condition and your specialist’s blessing

As lovely as it would be to say that you pushed through a flare and conquered your training…. it just isn’t worth it. Intense physical activity affects not only the muscles that you are actively working–it places stress across your entire body. Crohn’s Disease is, by definition, an inflammatory condition, and also one that reacts/can be triggered by stress, hormones, and dietary changes, all of which are likely to change/increase during training. So why start a lap behind and try to win the race? Marathon training, in particular, is difficult enough for a perfectly healthy body. Imagine what it can do with one prone to issue. 

2) Gradually work up to your big goals

Though I have worked up to the big race rather quickly in the big scheme of things, I didn’t start with marathons. In fact, when I was in 9th grade, I had a doctor’s note to keep me FROM running because of the stress that it might cause. It wasn’t until I was stable later on that I started my running routine, and then it was largely for fitness.

I started running more seriously in my final year of undergraduate (I worked up to about 5 miles then), and I took on my first half marathon two years later during my last semester of grad school. I tried my first marathon 18 months later, and my second a full year later. Incremental increases in distances, and numerous set backs and injuries as I had to make up for my lack of running knowledge and physical issues helped me improve.

3) Conservative Training Plans

For my first two marathons, I trained extremely conservatively, and even the training for my Boston Qualifying marathons were conservative by the majority of marathon training standards. During marathon training, I run 3 times a week–2 mid-week runs and one long run for the first two marathons and with the addition of another run (for coaching) in my later marathons.. My midweek runs are generally about 8 miles and consistent with regards to pace. I try to throw in speed work when I can, but my goal is a happy, injury and pain free marathon, not elite status.

suz pose victory phoenix marathon

I’m elite in my mind

Every thing that I accomplish is gravy beyond the finish itself. It isn’t that you need to do the minimum or “get by,” it is that you have to know that you are already playing with fire. I think that most of your all know by now that I don’t really use any of the popular ones. My training plan is to get my 3 runs, do yoga at least 2 times a week, PT exercises 2-3 times a week, and strength training of some variety 1-2 times a week. And, of course, rest.  

4) Flexibility and Patience

Flexibility and patience are not just keys to successful training, they are keys to living with chronic conditions, PERIOD. So is a sense of humor. Sometimes? Your body is just going to give you the middle finger.

invincibilitySometimes? You are going to wake up and not be able to hit your miles or your speed work goal. Set yourself up for success respecting that–pick an objective that you can hit, and move things around a bit. Don’t ruin your chances at your long term by going after what you want in the short term.

5) Learn to Listen to Your Body

One of the most frequent comments that I receive is that I know and listen to my body so well. First of all, I have had a few years with it to do so, but, to be honest, yes, I am one of the most in-tune-with-their-body-people I know myself. Sometimes my body cries wolf, and I have worked hard to figure out what that feels like. Don’t force yourself to fit into some other expectation or mold of what training looks like. Keep notes, figure out what is working, what isn’t. 

Do you know the difference between pain and discomfort?

6) Hydration/Fueling Strategies

This can get tricky. Many people with Crohn’s Disease and Ulcerative Colitis have had resections or colostomies that have removed critical parts of their digestive system and thereby makes it very difficult for them to absorb proper nutrients, especially to keep them hydrated.

and i want a puppy #thingsicanthave

and i want a puppy #thingsicanthave

Absolutely consult with your doctor about the best strategies for dealing with this. I make sure to hydrate the day before, of, and after my big runs. Same with nutrition. I spread out my refueling over 48 hours. Check out other Running Coaches Corner posts for more info on hydration and fueling.

7) Supplement Use

Again, consult your doctors. I take a selection of vitamins throughout the year (Folic Acid, Vitamin D, Probiotic, Women’s One-a-Day, a few others) throughout the year, but during training, I have also taken iron and stool softeners (Iron makes you constipated, as well as being rough on your stomach. CONSULT A PHYSICIAN BEFORE TAKING). I have a proven history of anemia (thanks to the ulcers and inflammation), thus an iron regimen, but I take a more powerful one when I am menstruating or training. Runners tend toward anemia often, so that + Crohn’s = likely the need to take iron. I did not this past time after my illness in November (and the constipation associated with it), but I have been advised to start again.

I do not take herbal remedies of any sort–you MUST consult with a physician before starting any of those, as they can have adverse effects on your medication or condition.

8) Carry the right equipment

Ok, full disclosure here. I run with a few sheets of TP, a little bit of money (in case I have to purchase drinks or the rights to use a bathroom), and ginger with me during my long runs. And I always run in a pantyliner. Let’s just say that I’ve had more than just the “trots,” mkay? I also have Uber on my phone.

9) Rest/Recovery are non-negotiable

You may be taking some powerful medications or downing a green smoothie every day, but that doesn’t mean that you are invincible. Some bodies need rest the day before the heavier days, some like rest after, some need both days. Figure out what works for you, but know that you might need more of it than the average person. That. is. OK.

alex massage team challenge

He is my minion. Like Despicable Me but less prone to wearing overalls.

Also, request more foot and leg rubs. Because, you know, chronic condition and all….

Here is a great post on Optimal Muscle Recovery

10) Have the right support team

Surround yourself by people who believe in you and want to help you achieve your goals. Support System for the Win!

What the Suzlyfe does best--obnoxious and loud and making people laugh by yelling ridiculous things at them as they ran by. We all have our skillz. Don't be jealous of mine.

What the Suzlyfe does best–obnoxious and loud and making people laugh by yelling ridiculous things at them as they ran by.
We all have our skillz. Don’t be jealous of mine.

Many people scoff at the idea of running a marathon for healthy people, many scoff at leading a “normal” life with a chronic illness. Try putting those two seemingly inconceivable notions together and see what reactions you get! But also? DON’T surround yourself with people who will just blow smoke up your ass. Ask them to be critical, but not critics, if that makes sense. You will be going through the same mental and physical battles as everyone else, after all! Sometimes, you will need that kick out the door, or someone to keep you from taking it. 

A chronic illness won't keep me from #marathon training with these tips! #runchat #running Click To Tweet

If you’ve never run a marathon before, or are worried about doing so with little experience, hire a running coach with experience with chronic illness such as myself (I can work with you and personalize your schedule) or look into joining a charity team. I ran with Team Challenge, and though I did not train with them, they were amazing for many of the runners who were running with chronic illnesses. At races, they have doctors just for TC use, in fact. Many of the mentors have the diseases themselves, or close family members, and they have all done this before–they will help you through. And, the sad truth is, you might not be “successful.” But regardless of what happens on race day, know that you are a complete, unerring success in taking your life to the next level and living beyond expectation. 

You are living Your life on Your terms. Know that the terms might change, but they are still yours. 

Chronic illness or not, what is your biggest challenge when it comes to training?

Join the link up and Running Coaches Corner for more great running advice and content!

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I am linking up with myself, Rachel, Lora, and Debbie for Running Coaches CornerPatty, Erika, and Marcia for Tuesdays on the Run, Nicole, Annmarie, Michelle, and Jen for Wild Workout Wednesday, and Ilka and Angela for Food and Fitness Sunday. 

  1. This is good advice even if you don’t have a chronic illness! I think you set a great example of living with a difficult disease. I see so many patients ( and I work in peds) who let their health issues rule their lives. Can you come to my clinic and give motivational speeches please?
    Wendy@Taking the Long Way Home recently posted…RewardingMy Profile

    • Well, I always liked algebra! seriously! But yes, lots of trial, error, and regrouping!

  2. So when I was going through all my things and trying to get a diagnosis, all the doctors kept saying was to just stop running. I mean, no big deal, just stop doing what you love. Thankfully I didn’t listen to them and found a doctor who knew what I wanted to do and didn’t stop until he found something. It’s tricky to have flares and look fine but be feeling terrible inside and know you can’t do anything. It’s a tough call between running too much and knowing when your body feels its best. I know running 3 days a week works for me, too, and more than that I tend to get sick. Definitely a tricky one but I love all of your tips!!
    Heather @Fit n Cookies recently posted…My changing schedule, again + Half marathon training week 5My Profile

    • It’s all about finding the right balance. It isn’t “don’t” but “let’s find a way.”

    • I think it just goes to show that you can have balance and still end up where you want to be–you don’t have to balls to the walls at all times!

    • It is so hard to train alone–and you would know the incredible impact of the support system on athletes!

  3. There’s really valuable info in this post, both for people without chronic diseases and people with them. It’s so inspiring how you found what worked for you and have become such a speedy marathoner!
    A strong support team is so so so important! Running is not as much of a solo sport as it appears.
    Laura @ This Runner’s Recipes recently posted…Apple Cinnamon Chia Seed OatmealMy Profile

    • DEFINITELY not. One of my favorite things about running is that I can be running and alone and still feel connected to the larger community!

  4. Definitely important and great advice for everyone. Since marathon training is so hard on even a very healthy body, any chronic conditions make it that much more challenging! Support all around is so important I think. For me the biggest challenge is listening to my body for signals, since I often initially ignore/deny although I think just with experience it’s harder to ignore things.
    Michele recently posted…Feeling Inspired to RUNMy Profile

    • My biggest issue is that my body just doesn’t heal the way I would like it to. Sometimes I over listen, sometimes, I under-listen. The trouble is listening to the right voice.

    • I will say that being conservative in my running has kept me from getting burnt out! I truly look forward to each of my runs!

    • Thank you, love. It definitely isn’t easy, it definitely takes some planning, but it has given me so much that I would never give it back.

  5. I love that you write these types of posts based on your personal experience and that in doing so, you’re helping so many other people. Stomach issues are definitely my biggest problem when running.
    Kate @ Baking in Yoga Pants recently posted…NYC TreatsMy Profile

    • I really hope so–that’s all I’m really looking to do! It took me a while to figure out my stomach, and sometimes? It still revolts. But I’ve learned what I can and can’t help.

    • Ah, Mar, you are always so sweet. And the confidence is there a decent amount of the time, but don’t get it twisted–I still freak out a lot!

  6. I think a lot of the advice you’ve laid out is definitely applicable to anyone, regardless of chronic health conditions. My biggest challenge has been and always will be fueling appropriately. I just don’t eat as well as I should, and I always “run to eat” versus “eat to run.” I’m trying to get better, but it’s just not second nature to choose veggies over fries.
    Rae recently posted…Manic Monday – 04/20/15My Profile

  7. Nutrition is prob my biggest challenge when training. When I started running more and for longer during my half training, my stomach would revolt unexpectedly and I had to make surprise trips to the woods (good thing there were woods). Then I started running with TP too and ate super bland food since I wasn’t sure what exactly was causing it. Good times.
    Erin @ Erin’s Inside Job recently posted…Spring Menu Tasting at Weber GrillMy Profile

    • Well, you know where to find me if you need to discuss. Hopefully you won’t have the same issues in a few weeks!

  8. Great advice. I think it’s great for people with Crohns or other chronic conditions to see it is possible to run and even run a marathon. It takes patience and practice but totally worth it. You’re awesome!
    Jen @ Pretty Little Grub recently posted…I Confess…My Profile

    • Thank you Jen! And that is the key–patience. You just have to keep chipping away at it, and develop a practiced hand.

  9. I love how you wrote about how our bodies can cry wolf. It’s so true! Often when I have a niggly feeling in a quad or whatnot, if I run on it, it seems to work itself out. But if it’s a real injury then I will know within the first minute.
    Suzy recently posted…Break it DownMy Profile

    • But you know what I mean–any time we go after something, we need to have the support system, have our heads in the right place… or as much as my head can ever be in the right place.

  10. Such great advice! I had been told my issues in the beginning were because of running and I immediately hated that doctor (and obvi he was wrong). It was music to my ears when my new, current doctor told me he signed up for NYCM – and promotes my lifestyle!
    Now realizing I ran all my marathons through flares I cannot wait to spend some time in remission and then train for real once again. It has been a very long time coming and I will definitely be looking to you for some advice when that time comes!
    Gianna @ Run, Lift, Repeat recently posted…Weight Watchers Week 12My Profile

    • You got it–you know where to find me! And just think of how different it will be this time around!

  11. This is good advice for everyone. I’ve been running three days a week and wondering if it was enough. Since I’m only training for a couple of half marathons this summer, you’ve convinced me that I’m on the right track. Thanks!

    • So happy to hear that! There is no reason to do more than that unless you feel secure in your running!

    • Girl you would be so bored, you’d never make it. Unless we dangled wine in front of you.

  12. It’s so great that you have found the right “formula” that allows you to train safely! For me, my biggest challenge other than time right now is that my calves hate me when I do much more than 16 or so miles. It means a few days a week with my PT, doing a lot of graston treatments, etc. While I love longer distances, I am going to be fousing more on shorter distances with some speed in the near future. I think recognizing what we are capable of doing safely (but always having a bigger goal) and then executing it well are the keys to long term success in not only running but life.

    • I will say that after my first marathon, I thought that there was no chance at another, much less more. But I think that you have to just figure out the right way to set yourself up. For me? Adding regular yoga throughout the week and making a few changes to my diet, getting my glutes to fire, made all the difference.
      But at the same time? Respecting your body and not putting it in a position that you can’t get out of (especially with a kiddo) is most important.

    • We definitely have some gems, don’t we! It takes a village, yes, but ultimately?? You need the right person to be that voice in your head, checking and pushing you forward.

  13. Love your honesty here, Suz. And your willingness to be so open about your journey. And you. 🙂 I’m sure that others with Crohn’s or related diseases will find your tips really helpful, so thanks for being a great resource, too. I think my biggest struggle when training is staying motivated. Sometimes I just want to sleep in!
    Beth @ Running with the Sunrise recently posted…Cross Training for RunnersMy Profile

    • I love your face 😀 Training is usually the one thing that gets me going in the morning–otherwise I blarg around. Training has been incredibly valuable for me by giving me and my body some structure.

  14. This is all wonderful advice, with or without a chronic illness! I’m still not entirely sure what sports medicine entails, but if I do decide to pursue that, I hope I get to learn more about how to counsel my patients on nutrition, what I would and wouldn’t recommend them doing, and how to best work with them so they can keep doing the things they love without aggravating whatever condition they may have!
    Farrah recently posted…Recharging With My Other LifeMy Profile

  15. I really respect and look up to the runners who have struggled through and overcome physical challenges to keep running and conquering goals despite the difficulty. You also seem to have a really good balance on the rest/training.
    Emily recently posted…Tuesday Runner Confessions.My Profile

    • Thank you, Emily! It hasn’t been easy. I get hurt like everyone else, and I don’t heal very well. But I think and hope that, if anything, what I have been able to overcome can be a source of hope for anyone, regardless of what they are facing.

    • Thank you so much Debbie. Sometimes, I wonder if I am doing the right thing–and believe me, I make mistakes! But then I look at the overall picture, and I realize what incredible things my body has been able to accomplish. I just hope that others can use some of this advice to do the same!

    • I really hope that it will help others, Sam, thank you! Whether to get through a tough time or to dream big!

  16. I am loving the entire series of Crohns posts! I think many of these points are applicable to ‘healthy’ runners as well. Most important is listening to your body. I think many of us try to push past pain which at times is necessary and helpful but others times can be dangerous. Running 3x week always worked for me too! Running seems to exacerbate my bowels so on long runs it def helps if I have a looped planned where I can circle back to the potty! Love these posts Suze!
    Jill recently posted…A Few Things Friday…My Profile

    • It is definitely critical to have an “emergency” plan–sometimes that is just having TP and a good friend on the look out. Or no pride. But you have to know when your body is crying uncle, and sometimes it can do that in multiple ways!

    • You are too sweet! I try as hard as I can, and I think that I just have had to learn to respect my body because it won’t have it any other way. I would love to push through, but it isn’t going to happen!

    • As I always say–I couldn’t do it without any of them. They push me forward, keep me in check, and help me when I hit road bumps.

  17. Alright, this is my third attempt to post a comment on this–my laptop is fighting me in Mexican cyberspace!
    I just wanted to add that being part of your “personal support team,” at a number of these long races, is as important to me as my being there is for you.
    I know what you go through to train, and prepare for these races. You need someone on the sidelines who can cheer you on, have your extra “whatevers” and be there as close to the finish line as possible.
    But, as an athlete with a chronic illness, you might need someone who knows what to do if the unthinkable happens.
    I have been on the sidelines and watched someone who needed help right then. As a “Crohns Mom” I know the physical signs to look for and I know what to do for Crohn’s or UC runner if he or she becomes ill.
    Whatever we may or may not have, having people who support our efforts and share in our victories and our defeats is an important part of participating in our passions.

    I am there to support you, first and foremost, but I love to cheer for all of the athletes–whatever the event. That is a passion, too!

    • And a passion that I will neverneverneveevevevevevevevevever take for granted. I love you so much!

  18. It is a relief to see more people like myself training for these events. I’ve had a range of responses from my doctors (neutral, positive and negative). I posted a link to more details on my adventure so far, I haven’t made it as far as you yet, but I’d love to give it a shot one of these days. My disease (TRAPS) is much more joint/muscle/nerve focused, but sometimes I can get similar swelling around my digestive system (Sunday was an interesting run, running to get home to my bathroom). My brother, father, and mother all have crohn’s and I’m sure they can’t possibly imagine running during a flare. Never stop fighting!

    • Eric, thank you so much for your comment! I know of TRAPS, but not nearly enough. And to think that your whole family has Crohn’s–you all are certainly incredible! I have had too many runs where the goal is just to get home in one piece and not have to hide behind a tree. And yet we somehow still do it. I can’t wait to read your story!

      • Actually, funny story. After reading about your journey, discussing it with friends and family, and thinking on a few good long runs I have an update. I want to run my first Marathon, and I’m going to write down my journey this time. My goal is currently to run one in April or June of next year (Vermont or Boston). I’ll be running at least 2 more Half’s before then. Several of my friends blog, of course there’s this blog, and I thought “what a good way to remember all the steps”. I’ve contacted 2 charities so far to try to get myself a bib, but my backup plan is Vermont.

        • Eric, that is fantastic! I am so excited for you to start the journey, both for the blog and for the marathon! Please please keep in touch, and I look forward to keeping tabs on your progress!
          Truly awesome, and so much good energy being sent your way right now.

  19. This is so inspiring. I don’t have a chronic illness, but I have a long term foot injury that’s kept me from running races for the past couple of years. It’s starting to feel a bit better lately, so I’m *hoping* I may be able to get back into at least shorter races. These are great tips!
    Christina @ recently posted…April GoalsMy Profile

  20. Such good tips Susie! As someone who runs with another chronic illness… severe asthma… I do a lot of this too. I’ve found running conservatively three days a week works for me and I’d rather do that than run too much and not be able to run at all! I also know to avoid certain weather and triggers.
    Julie @ Running in a Skirt recently posted…Balsamic Glazed SalmonMy Profile

  21. I’m so curious to know where the term “blowing smoke up your ass” came from. I’m a visual person and it just seems uncomfortable. On a serious note, I just think you’re such a champion for running frigging marathons while dealing with a chronic illness. Wait… does your ass feel a little warm right now?
    Suzy recently posted…Pregnant and Running: 18 Week UpdateMy Profile

  22. Great post, Suse!
    Sometimes we need a swift kick in the rear to get moving….but, sometimes we need an iron fist to hold us back from moving too fast.
    You are an excellent trainer–you know how to listen to your body and what it is telling you.
    You may not like what you hear, but you know how to listen, and that is the greatest advice a coach can give!!

  23. I’ve always admired your drive to push past your illness and not let it control you! While I don’t have a chronic illness I do have issues that force me to find work arounds. I think listening to your body is so important regardless of who you are. I love that my doctor and naturopath work with me to adjust my supplementation routine during peak months of training and I think everyone could benefit from that. I don’t take iron supplements, but I do increase my intake of red meat during peak months because I feel better. Great post Susie!
    Alaina @ The Simple Peach recently posted…Meal Prep: Inspirational BlogsMy Profile

    • We all have our issues! We all have things that we have to fight against. I respect anyone who demands the best for themselves and their family!