Six weeks out from the BYD Singapore International Marathon on 6 December 2026, and the training logs are filling up. Long runs are getting longer, the legs are accumulating fatigue, and for a significant number of runners, something that was not there three months ago has begun to hurt.
This is the highest-risk window of marathon preparation. You have done the hard work — the base building, the tempo runs, the back-to-back weekends. What you have not done yet is make it to the start line healthy. That last part is harder than it sounds.
This guide covers the five injuries most likely to derail your December race, what the warning signs are, and what you can do about them in the weeks remaining — written by chiropractors who have seen runners through this exact window many times, including at the Singapore Marathon itself.
Why the Final 6 Weeks Are the Riskiest Part of Marathon Training
Most runners assume the danger zone is early in training, when the body is adapting to new load. In reality, peak injury risk arrives late — at the 16–20 week mark of a standard marathon plan, when cumulative fatigue is highest and the immune system is suppressed from sustained aerobic stress. At this point, even a well-trained body is running on limited recovery capacity, and structures that held up well for months can fail under relatively minor additional stress.
The other factor is psychology. With race day visible on the horizon, runners are reluctant to cut volume or take rest days. Missing a long run at week 14 feels catastrophic. This resistance to backing off is exactly what turns a minor irritation into a full injury that forces a DNS.
The 5 Running Injuries We See Most in the 6 Weeks Before Race Day
1. Plantar Fasciitis
Pain in the heel or arch, worst first thing in the morning and after periods of rest. The plantar fascia — a thick band of connective tissue running along the sole of the foot — becomes inflamed under sustained running load, particularly when weekly mileage increases rapidly. Left unmanaged, it alters gait mechanics, which compounds the problem further up the kinetic chain.
2. Runner’s Knee (Patellofemoral Pain)
A broad ache around or behind the kneecap, worsening on downhill sections, descending stairs, or after sitting for long periods. Common in runners who increase their long-run distance quickly or who have hip abductor weakness that allows the knee to track inward under load.
3. IT Band Syndrome
Sharp or burning pain on the outer knee, typically appearing at a predictable point in a long run — often around the 10–15 km mark — and fading shortly after stopping. We have written a detailed guide on IT band syndrome and chiropractic care in Singapore for runners dealing specifically with this injury.
4. Piriformis Syndrome
Deep buttock pain that may radiate down the back of the thigh, sometimes mimicking sciatic nerve pain. The piriformis — a small external hip rotator — tightens significantly under sustained running load, particularly in runners with anterior pelvic tilt or weak glutes. Sitting aggravates it, making this a common complaint among runners who also spend long hours at a desk. See our page on back pain for more on how pelvic mechanics affect the lower back and hips.
5. Shin Splints (Medial Tibial Stress Syndrome)
A dull ache along the inner shin during or after runs, reflecting overload of the tibial bone and surrounding connective tissue. Common when mileage jumps quickly, when running surface changes suddenly, or when shoe cushioning is overdue for replacement.
What These Injuries Have in Common
Each of the five above is a load-management problem — the structure involved has been asked to absorb more stress than it can currently tolerate. But each is also influenced by mechanical factors: how load is distributed through the kinetic chain, how the pelvis is oriented during the running stride, whether one hip extends fully at push-off, and whether the lumbar spine and sacroiliac joints are moving symmetrically.
A runner with restricted left hip extension, for example, will compensate by rotating the pelvis more than necessary on that side at push-off. Over thousands of strides, that compensation loads the IT band, the piriformis, and the lumbar facets asymmetrically. Addressing the hip restriction changes the load pattern — which is why runners sometimes find that a long-standing knee problem responds after attention is directed at the hip or lumbar spine.
This is where chiropractic assessment adds something that rest and stretching alone do not: an evaluation of the joints and movement patterns that govern how running load is distributed through your body.
How Chiropractic Care Helps Marathon Runners
At Family Health Chiropractic, Founder and Clinic Director Dr Kelvin Ng and Senior Associate Chiropractor Dr Ashley Liew use the ArthroStim instrument — a low-force, high-frequency adjusting instrument — to assess and restore joint movement in the spine, pelvis, hip, and lower limb. There is no cracking, no twisting, and no high-velocity thrust.
For runners, this is relevant in two ways. First, joint restriction reduces the range of motion available in the running stride. When a hip joint, sacroiliac joint, or ankle cannot move through its full range, adjacent structures compensate — and compensation under load is the mechanism behind most overuse injuries.
Second, joint restriction affects proprioception — the body’s sense of joint position in space. Running is a high-repetition movement performed largely on autopilot; poor proprioceptive input means subtle gait compensations go uncorrected stride after stride, accumulating over a 42.2 km race.
Assessment typically covers the lumbar spine, sacroiliac joints, hips, knees, and ankles — the full kinetic chain involved in running.
Why See Dr Kelvin Ng and Dr Ashley Liew for Your Marathon Preparation?
Not many chiropractic clinics can say that one of their chiropractors was a national marathoner — and that the other was his chiropractor throughout his competitive career.
Dr Kelvin Ng (Founder and Clinic Director) has been caring for elite and competitive sportsmen since 2009. Among his long-term patients during those years was Dr Ashley Liew, then a national marathon representative for Singapore. Dr Ng has looked after the spines and joints of national athletes across multiple sports, and brings that same understanding of athletic load to every runner who walks through the door.
Dr Ashley Liew (Senior Associate Chiropractor) competed as a national marathoner and understands the specific demands of marathon preparation from the inside — the fatigue, the long-run niggles, the mental calculation of whether to push through or hold back. He now works with competitive and recreational runners alike, including national athletes, and his clinical approach to running injuries is informed by his own experience of getting to start lines healthy.
When you come in for a pre-marathon assessment at Family Health Chiropractic, you are not explaining what a long run feels like or why missing one matters. We know.
Should I Get a Chiropractic Check-Up Before Race Day?
If you are running the full marathon and you are currently pain-free, a pre-race assessment in the next two to three weeks is worthwhile. It identifies restrictions you may not feel during a training run but that surface under the cumulative load of 42 km — the hip that rotates a little less than the other, the ankle that loses dorsiflexion under fatigue.
If you have an existing niggle — something you have been managing, ignoring, or running through — come in sooner rather than later. Six weeks is enough time to make meaningful improvements to a mechanical problem. It is not enough time to be casual about it.
If you are injured now and unsure whether to pull out, an assessment will give you a clearer picture of whether the injury is structural, how much it is likely to respond to chiropractic care, and whether race day on 6 December is still realistic. That information is worth having before you make a decision.
Race Week Protocol
Race week is not the time for new interventions. The final week before a marathon should be treated as consolidation — maintaining movement without adding new load. If you have been receiving chiropractic care during your training block, a light session early in race week (Monday or Tuesday for a Sunday race) can help ensure your joints are moving well without leaving you feeling different in a way that takes days to settle.
Avoid deep tissue massage in the 72 hours before the race. It can temporarily increase local inflammation and leave muscles feeling heavier than usual. Light movement, walking, and short easy runs are the appropriate stimulus for race week.
Book Your Pre-Marathon Assessment
6 December is six weeks away. If you have a niggle, do not wait to see whether it clears on its own — it rarely does at this stage of training. Book a pre-marathon assessment at Family Health Chiropractic — Somerset MRT, no referral needed, no cracking.
Frequently Asked Questions
Can a chiropractor help with marathon training injuries?
Yes. Chiropractic care addresses the joint restrictions and movement compensations that contribute to most running overuse injuries — plantar fasciitis, IT band syndrome, runner’s knee, piriformis syndrome, and shin splints among them. The ArthroStim instrument used at Family Health Chiropractic delivers precise, low-force adjusting without the downtime sometimes associated with manual techniques.
How many chiropractic sessions will I need before the Singapore Marathon?
This depends on what is found at assessment. A runner with a single mechanical restriction and no active injury may need one to two sessions. Someone managing an existing condition with six weeks to race day typically attends two to three times over that period. Sessions are planned around your training schedule and taper requirements.
Is it safe to run the marathon with IT band syndrome or plantar fasciitis?
It depends on severity. Mild symptoms that are not worsening with training and do not alter your gait are different from symptoms that arrive earlier in each successive run. The latter pattern suggests the structure is being progressively overloaded — racing on it risks converting a manageable problem into one that sidelines you for months after the race.
Are Dr Kelvin Ng and Dr Ashley Liew experienced with marathon runners?
Yes. Dr Kelvin Ng has been caring for elite and competitive athletes since 2009 — including Dr Ashley Liew, who was then a national marathon representative for Singapore. Dr Ashley Liew competed as a national marathoner and now sees runners in clinical practice, including national athletes. Between them, they bring both clinical expertise in athletic injury management and direct competitive running experience to every consultation.
Where is Family Health Chiropractic, and is it convenient for the marathon route?
Family Health Chiropractic is at 111 Somerset Road, #08-03 TripleOne Somerset — a short walk from Somerset MRT, which sits between the Marina Bay start area and Orchard Road. Convenient for runners training on the Orchard Road corridor or the Marina Bay loop.
Do I need a referral to see a chiropractor in Singapore?
No referral is needed to see a chiropractor in Singapore. You can book directly via our website. Initial consultations for runners include a full postural and movement assessment alongside any specific complaint you bring in.
Dr Kelvin Ng (Founder and Clinic Director) and Dr Ashley Liew (Senior Associate Chiropractor) see runners at Family Health Chiropractic, 111 Somerset Road #08-03, Singapore 238164. Nearest MRT: Somerset (EW13).