First aid for marathon runners

St John Ambulance FIT team members carrying and injured runner at the Flora London Marathon

St John Ambulance has issued crucial first aid advice to marathon competitors for dealing with the injuries or accidents they can expect.

St John Ambulance is in its 28th consecutive year of providing essential first aid cover to the Flora London Marathon. Each year over 1,400 St John Ambulance volunteers from around the country devote their time and expertise to help and encourage runners over the 26 mile course - that’s one volunteer for every 35 metres. Last year the charity treated over 4,000 participants, from celebrities to fun-runners.

Ann Cable, Commissioner of St John Ambulance in London, who is in charge of the first aid operations at this year’s marathon, said: ‘A marathon is a massive challenge even for elite athletes, let alone for people running one for the first time.

‘We want to make the process of that final element of training for the marathon more comfortable by making people aware of how to combat some of the frequent injuries our volunteers treat each year during the marathon itself.’

Here are our tips...


  • If you get a blister, leave well alone if it’s unbroken
  • If it’s broken or likely to be damaged, cover with a dry, non-adhesive dressing that extends well beyond the edges of the blister
  • Do not break or cover a blister with any creams or lotions
  • To avoid blisters, make sure your running shoes are a good fit and don’t use the Marathon as an opportunity to break-in new shoes!

Heat exhaustion

  • If you start getting a headache, feel nauseous, have pale clammy skin, cramps or a rapid, weakening pulse – you may be suffering from heat exhaustion
  • This is a serious condition, so seek help straight away
  • If you are training and no help is available, find a shady spot in which to lie down with raised legs
  • Even if you recover quickly, see a doctor as soon as you can.


  • Wash your hands
  • Try to wash or pick out small pieces of grit, but don’t attempt to remove anything embedded in the wound
  • Rinse with water or use an antiseptic wipe to clean the wound
  • Apply adhesive dressing
  • Ensure you are up to date with tetanus jabs.

Knee joint injuries

  • If you injure your knee, lie down and support your knee in a raised position.
  • Put an ice pack on it or a cold compress
  • Put soft padding around it and bandage it in place
    these actions will minimise swelling
  • Go to Accident and Emergency
  • Don’t try to walk on the leg or straighten the knee
  • Don’t eat or drink anything in case you need an anaesthetic.

Nipple bleeding

  • This is caused by friction damaging the skin
  • You can prevent this by covering nipples with plasters or petroleum jelly
  • If they bleed, wash and dry carefully and cover with a plaster, but do not use waterproof plasters
  • Sometimes, nipple bleeding may be due to more serious problems. If in doubt, consult your doctor.

Regarding drinking water

  • Drink sensible amounts of fluid to keep hydrated, but avoid drinking too much too quickly, or in short amounts of time.

And finally in all cases of injury on marathon day seek out our St John Ambulance volunteers at any stop along the course - just look out for the first aid signs.

Good luck – run well.