Ultrarunning, running beyond marathon distances, has grown significantly in popularity over the past decade. Given the high prevalence of running-related injuries and the multifactorial nature of these injuries, the process whereby ultrarunners seek to achieve consistent and injury-free training and to complete running events greater than 42.2 km (26.2 miles) is not well understood. The purpose of this study was to describe the prevention and management strategies used by ultrarunners for running-related injuries. A qualitative, grounded theory approach, involving 37 semi-structured in-depth interviews with 28 ultrarunners and field observation at two different ultramarathon events, resulted in three themes, “listen to your body”, “back on track”, and “mental toughness.” Study participants were at least 18 years of age and had completed at least one ultramarathon within the last three years. Rigid adherence to high-volume training programs and over-scheduling ultramarathon events were considered to be contributory to overuse running-related injuries, whereas training activity guided by perceived exertion and focusing on a particular goal race for the calendar year were described as effective injury prevention strategies. Management strategies included problem-solving to determine appropriate levels of running activity as well as engaging in fitness alternatives perceived to boost the physical and mental health of ultrarunners during time off running. Study participants utilized a “me against me” strategy for challenges associated with obligatory training tendencies and pressures associated with online performance tracking tools. Positive thinking strategies were deemed useful for ultrarunning participation; however, these strategies led to mixed results for the management of running-related injuries.