How often have you heard about someone quitting running because they kept getting injured? It could even be you.
Unfortunately, running is not an injury-free sport. Studies have shown that 40-70% of runners will get injured in a given year. According to these studies, these injuries are bad enough to force an extended break from running. That’s not good!
Running is one of the best exercises in the world and one of the worst. It is easy to slip on a pair of shoes and run out the door. Yet it is so easy to run out of breath in two minutes, cramp in the first half-mile, or develop a knee injury in just a few days.
This post will cover the eight most common running injuries and how to avoid them. We’ll discuss each injury in detail, why it happens, and how to prevent it.
At the end of this article, we’ll help you develop a training program that will help you make the most fitness gains while staying injury-free.
You can start from the top or skip to another part of this guide at any time. Here’s what we will cover in the rest of this blog:
Injury Risk Factors in Running
Before we get into each of the most common running injuries, we must mention injury risk factors for running. These are the traits and practices that more often lead to running injuries.
You can avoid some of these higher risk factors altogether, while others are a necessary part of the sport.
This study identified the injury risk factors for running and included a meta-review of more than 400 articles. Here is what they identified as major risk factors for runners:
- Previous use of orthotics
- Running on concrete
- Running only once per week
- Running too much too soon (i.e., overtraining)
- Primarily participation in non-axial (uni-directional) sports
- Running 50km or more per week
- Wearing the same running shoes for longer than four months
Let’s run through each risk factor with a few bullet points on how to manage them.
Previous Use of Orthotics
Running shoes with neutral support is best for beginner runners – and most runners – because they allow you to run using your unique physiology. Orthotics are like a crutch or a band-aid. They may relieve pain temporarily, but they are not addressing the root of the problem.
If you experience pain or injury while running, that is a sign that something is wrong with your form or technique. Orthotics can change your run because they constrict you from using your natural technique.
Check out this post to find the Best Running Shoes for Beginners.
Running on Concrete
Humans are not meant to run exclusively on concrete, especially in padded running shoes. Concrete is not bouncy or forgiving like a hiking trail, dirt, or grass. Running is a high-impact sport, and running on concrete can exacerbate those forces.
Try to avoid running exclusively on concrete. Run on trails, paths, sidewalks, or anywhere in nature. We recommend running on soft-surface trails or hiking at least once per week to build up your stabilizer muscles which help prevent injury.
Running Only Once per Week
Running is not a natural movement for modern humans, especially since most of us spend the majority of each day sitting in a chair. This leads to tight hip flexors and a rounded lower back, which are not traits you want to carry into a run.
With each run, your body reinforces the proper running form with neuromuscular connections – these are mind-to-muscle connections that allow your muscles to fire in a specific way. These connections don’t last forever, so you should reactivate them more than once per week. If too much time goes by, your mind and body will have to relearn proper running form with each run, putting you at greater injury risk.
Running Too Much Too Soon
Overtraining is one of the major causes of injury in running, especially for beginners. Taking things slow and gradually building up your training over time is essential.
Start with two runs per week and focus on perfecting your running form. Once you feel ready for the next step, add high-intensity intervals to your training once per week. Don’t increase your weekly training miles by more than 10% in a week. Take things slowly, and you will avoid injury.
Primarily Participating in Non-Axial Sports
Non-axial sports are also known as unidirectional sports, or sports where you only move in one direction. This includes cycling, swimming, and running (sorry, triathletes), which only require one direction of movement.
Multi-axial sports like basketball or soccer can help strengthen your stabilizer muscles and lower body joints.
Running 50k or More per Week
Heavy run training is something you need to build up to, not something you can accomplish in a few weeks. The average runner takes hundreds or thousands of strides during each run, and with each stride comes the impact of their foot on the ground.
You can quickly develop a running injury if a tiny detail is out of balance. Take your time when building up your training, and focus on quality over quantity.
Wearing the Same Running Shoes for Longer than Four Months
Unfortunately, running shoes can wear out fairly quickly. It is crucial to stay on top of your gear and notice the wear and tear before it is too late. Once your running shoes are worn out, all the injury-protection qualities of the shoe are gone.
We recommend replacing your running shoes after 3-4 months or earlier if you run more than three times per week.
You can learn more about running for beginners on our YouTube channel here.
8 Most Common Running Injuries
It is extremely common to get injured when you first start running – as we’ve discussed, 40-70% of runners get injured within a given year.
Many injuries are more common than others, and almost every runner will experience some. Most running injuries are overuse injuries or related injuries to overtraining or inadequate rest. Here are the eight most common running injuries and how to treat them.
Note: rest is the most common prescription for running injuries. If possible, take a break from running, and the injury may heal.
Iliotibial Band Syndrome
The iliotibial band, a band of tissue more commonly known as the IT Band, runs from your hip to your knee outside your thigh. It helps stabilize your knee during walking or running, but it is not a muscle, so it cannot be stretched or strengthened.
IT Band syndrome is when the band of tissue starts rubbing up against your leg bone, possibly creating severe damage. The symptoms that appear are knee pain or pain along the outside of the knee. You may also experience pain outside your thigh, worsening when you bend your knee.
Because the IT Band isn’t a muscle, there isn’t much you can do to the actual band itself. Instead, you should stretch and strengthen the muscles around your knee, hip, and thigh to help relieve pressure on the IT Band. Specifically, target your quads, hamstrings, glutes, hips, and core with strength training exercises. Foam rolling your glute medius (side bum) and IT Band itself (along the side of the leg) also helps with IT band issues.
Achilles Tendonitis is inflammation of the Achilles tendon, which connects your calf muscle to your heel bone. Symptoms include pain, soreness, and swelling around the Achilles or heel. You may feel aching around your Achilles tendon or a warm sensation near the ankle joint.
Fun fact: tendonitis can be spelled with the "o," or alternatively as "Achilles tendinitis." The latter spelling is more common outside of the United States.
Leg strengthening is the best treatment for Achilles Tendonitis after short-term rest. Focus on strengthening your calves and ankle joints, and rest and recover between runs. You also may have tight calf muscles which can be loosened up with a few simple stretches.
It is crucial to get ahead of Achilles pain before it worsens. If left untreated, Achilles Tendonitis could lead to an Achilles rupture requiring surgery and months of recovery.
One of the first injuries that runners will experience is shin splints. The proper name for shin splints is medial tibial stress syndrome or MTSS.
Symptoms of shin splints include pains and aches on the front of your lower leg, also known as the shin or shin bone.
With medial tibial stress syndrome, there may also be swelling or tenderness to your shin. This pain is a normal response to running, especially for beginner runners or those restarting a running program after a long break.
Like most running injuries, shin splints are best-treated with adequate rest. Once you can return to training, focus on strengthening your lower leg muscles, specifically your calf muscles.
To avoid shin splints, you need to loosen up your calves. You can do calf stretches and mobility movements for your lower leg. Strengthening your shin and calf muscles can be done with a few simple band exercises.
One of the most common injuries for runners is sore legs – depending on the severity, some wouldn’t even call this an injury. Sore legs occur from the repetitive pounding of your feet with every stride during a run.
Soreness, often referred to as DOMS (delayed onset muscle soreness), occurs when your muscles flex or are stressed in a new way. Perhaps you just started running, or you recently increased your training load. Either way, you are probably going to end up with sore legs.
It can be difficult to distinguish between soreness and pain. The best way to tell the difference is by paying attention to your recovery. Soreness will dissipate after 24-48 hours and can be more quickly relieved with stretching, foam rolling, and massage practices.
Pain, on the other hand, will not go away after 24-48 hours. It will probably worsen with exercise, and you won’t feel any better after stretching or foam rolling. Pay close attention to these symptoms, and you’ll be able to distinguish between sore legs and painful injury.
Lower Back Pain
Lower back pain occurs because of the twisting and pounding forces of running. Most of us sit at a desk all day, so our back is not accustomed to these forces – or any forces, to be honest. The symptoms of back pain are self-explanatory. However, you should watch for the difference between back pain and back soreness. Pain will persist. Remember that soreness will dissipate after 24-48 hours and may relieve even faster with proper recovery techniques.
To help treat and prevent lower back pain, we recommend strength training for beginner runners, specifically kettlebell exercises, which help stretch and strengthen your lower back. Crucially, these exercises will strengthen your side stabilizers and glutes, which help keep you strong and balanced while running.
Runner’s Knee or Patellofemoral Pain Syndrome
Runner’s knee is a sharp pain that occurs on the side of the knee while running, and it can be excruciating. However, there is a surprisingly simple solution – runner’s knee is most often caused by tight IT bands, which are the ligaments that run down the side of your thigh from your hip to your knee.
Runner’s knee is sometimes called patellofemoral pain syndrome since it refers to pain around your knee or your kneecap (i.e., your patella).
Symptoms of Runner’s Knee include pain in the knee or kneecap or just in front of or under the kneecap. This pain may worsen with running, activity, or knee bending.
Rest and strength training is the best way to prevent Runner’s Knee. Specifically, focus on the hip joint and muscles around your knee. A tight IT Band may also be contributing to your symptoms.
Tight IT bands can be loosened with stretching, foam rolling, and massage. Don’t clench or tense up while performing these stretches – try and relax, releasing the muscle and reducing the tension on the IT bands. Sometimes one session of a few minutes of stretching can completely relieve the pressure on your IT bands.
Plantar Fasciitis is inflammation of the tissue on the bottom of your foot, known as the plantar fascia. This is the tissue that you push off of every time your foot strikes the ground.
Of course, it is easy to irritate the plantar fascia through running. But Plantar Fasciitis occurs when the repetitive stress is too great, and you’re not allowing your body enough time to recover.
Symptoms of Plantar Fascia include persistent pain on the bottom of your foot, a burning sensation, or pain that worsens after a run or flares up first thing in the morning. It can be challenging to distinguish Plantar Fasciitis from normal foot soreness, so pay attention to if and when your symptoms worsen over time.
The best way to treat Plantar Fasciitis is short-term rest. Once you’re ready to return to exercise, focus on strengthening your leg muscles, calves, and the foot itself. You can also use stretching, massage, and trigger point balls to help relieve foot tension.
A stress fracture is a small, hairline crack in a bone often caused by repetitive stress. Most stress fractures in running occur in the foot, ankle, or lower leg.
It is easy to first mistake a stress fracture for normal pain and soreness. But over time, the pain will worsen as the fracture becomes more and more severe. Other symptoms include swelling or bruising in the area around the stress fracture.
A structured training plan should prevent most stress fractures because of the built-in rest and recovery periods. However, stress fractures can happen to anyone. In most cases, rest is the ultimate cure.
If you suspect a stress fracture, take a week or two off of running. If the pain persists, we recommend following the medical advice of a doctor or running-specific physiotherapist.
How to Prevent Injuries
There are three main things that you can do to prevent running injuries:
- Take it slow
- Focus on technique
- Get the right gear
By saying “take it slow,” we mean both running slowly and progressing slowly. No matter how motivated you are at the start of your running journey, it’s important to pace yourself.
In the short term, you can use the RICE method (rest ice compression) to alleviate some pain and swelling in the affected area.
Below, we're going to cover a number of ways to prevent injuries in running. First, we'll discuss pacing and structured training, and then we'll talk about strength training and cross training for injury prevention.
Pace Yourself in More Ways Than One
Don’t run until you collapse on every single run. Instead, develop a consistent training program that includes one short workout and one long per week. Stick to your plan and make the most fitness gains while avoiding injury.
In each run, monitor your technique and focus on maintaining perfect form. If you are running with perfect form, you should not feel any pain (besides the cardiovascular challenge of running).
Learn the perfect running form in our Beginners Guide to Getting Started Running.
Lastly, you need the right gear to avoid overuse injury. The right pair of running shoes should be comfortable and supportive, helping you avoid injury as you ramp up your training. Get yourself a pair of dedicated running shoes, and don’t be afraid to try out a few before you get the perfect fit.
Sticking to a structured training program is the best way to avoid running injuries. Having a plan (and sticking to it) will give your body adequate rest between each run.
It can be easy to overdo without a structured training plan, especially when your motivation is high.
We recommend sticking to 2-3 runs per week for beginner runners. Two of these runs should be structured workouts: one short run and one long run.
Short Run Workouts
Your weekly short run should consist of short, high-intensity intervals such as 10-second sprints. You should fully recover between each interval – allow your heart rate to come down, whether walking for 10 minutes or jogging for five minutes.
Long Run Workouts
Each week's long run should be done at an endurance pace, or Zone 2 if you are training by heart rate. These workouts should never feel hard and should be done at a conversational pace. The challenge of these long runs is the duration, not the intensity.
Once you’re ready to progress, you can start adding runs to your weekly plan, one workout at a time. Remember to take it slowly and focus on steady progression. Allow yourself to rest and recover between each run, and you will simultaneously get stronger and avoid injury.
If you’re not sure where to start, we have a number of training programs available in our app. You can find more information and find or create your own training plan in the MOTTIV training app.
We highly recommend cross-training for runners, especially strength training and hiking. Running is very hard on the body, but it is also one-dimensional. There is typically just one direction of movement that is extremely repetitive.
By adding cross training to your program, you will be strengthening your muscles and improving your balance and range of motion – all of this makes you stronger and more resilient to an overuse injury in running.
The Importance of Strength Training
Strength training is one of the best medicines for running injuries, and that’s why it comes up so often in our list of common running injuries. Strengthening your calves, shins, quads, hamstrings, and hips can significantly reduce your injury risk, and you’ll probably get faster, too.
Hiking as Cross Training
Hiking is one of the best modes of cross training for running because it uses many of the same muscles while also activating many more. On steep, rugged, or technical terrain, you will be activating your stabilizer muscles which are dormant when running in a straight line. Hiking is also a fun and enjoyable way to do a few hours of Zone 2 training without pushing yourself too hard.
Post-Injury Return to Running Program
As we’ve seen in the statistics, injuries are nearly inevitable in running. It’s happened to me and if it hasn’t already happened to you, it probably will. But do not fear – a running injury is not the end of your running career. Given proper rest, recovery, and treatment, you can return to running in no time. Here’s how to return to running after an injury.
At the outset of an injury, you have two options: one is to keep moving, and the other is to completely rest.
We’ve covered this topic in video format which you can find on YouTube: Post-Injury Return to Running Program
Option 1: Keep Moving After an Injury
After an injury, you can keep “training,” at a very easy rate. We recommend keeping your body and mind moving – not only will this help maintain some level of fitness, but it will also improve your mental health during a tough period.
Post-injury, all of your training should be done at a 4 out of 10 on the pain scale. If your pain level crosses that threshold, it’s time to stop and rest.
4/10 Training to Return to Training
Brodie Sharpe of the Run Smarter Physiotherapy Clinic & Podcast recommends this option for runners returning from injury. If you can’t run, then walk, he says. The longer that you spend not running, the longer it takes for you to get back to your previous running speed and fitness.
Over time, you can gradually return to running using the 4/10 pain scale. As your injury heals, you will be able to do a little bit more walking or running each week. Remember to monitor your symptoms and take it slow – soon you’ll be back up to full speed.
Option 2: Complete Break From Running After an Injury
Sometimes there is no option but to rest after an injury. If your pain persists or you’ve seen a doctor or physical therapist, sometimes the best prescription is to take a break from running. But don’t worry, there are still many different forms of physical therapy that you can do before you get back to running.
Number 1 on the list is strength training – one of the best ways to prevent running injuries is also one of the best ways to return to running. Strength training will help balance out your muscles from your hip to your heel, as well as your core and upper body.
Cross Training to Return From Injury
Many injured runners are still able to complete other forms of cardiovascular training such as cycling or swimming. If you have the means, you can even do some water running to help heal your injury and maintain running fitness.
Cycling, for example, is a non-weight bearing activity, which means that you can ride without the repetitive pounding of each and every foot strike in running. If you’re coming back from a serious or chronic running injury, make sure to check with your doctor or physical therapist to see if you have the green light for other forms of cardiovascular training.
Run Walk Method to Return to Running
Once you are ready to return to running, use the run-walk method to ease back into training. Don’t push yourself in your first few weeks of running, and take all the running breaks you need. We recommend starting out with 30 seconds of running followed by three minutes of walking. Each week, add 30 more seconds of running and 30 fewer seconds of walking in between run intervals – pretty soon, you will be able to run continuously again.
One study followed a group of participants as they recovered from major hip surgery. At the beginning of the study, each participant performed three-run walk sessions, three non-impact cardio sessions such as swimming or cycling, and one rest day.
Each week, the participants ran a little more and walked a little less. By the end of the study – after just four week – they were able to run continuously for one mile.
This shows that after major surgery, you can return to running in just a few weeks. You can also use the 4/10 pain scale to keep progressing and push past the 1-mile session that was the focus of this study. Follow the 4/10 scale and you will be back to full fitness soon.
In this post, we’ve covered everything you need to know about the 8 most common running injuries and how to avoid them.
First, we looked at the injury risk factors in running, and then we went through each of the most common running injuries. With each injury, we discussed their symptoms and how to prevent them. The theme throughout all of them? Strength training and proper recovery will prevent almost every running injury.
We covered a number of topics to help you avoid running injuries including running form, beginner’s running gear, structured training, and cross training.
Lastly, we gave you the specific protocol for returning to running post-injury. You’ll have a few options, and we went through each in detail including the run walk program for beginner runners.
It’s a lot to remember, but many of the principles are the same: stick to a structured training program, keep up with strength training to train each of your running muscles, and give yourself adequate rest if and when issues pop up.