Running injuries - and how to avoid them

Running is one of the most popular forms of exercise, valued for its benefits to cardiovascular health, mental well-being, and overall fitness. However, the repetitive nature of running places ongoing stress on the joints, muscles, and tendons. As a result, most running-related injuries develop gradually through overuse rather than from a single traumatic event.

Many runners tend to ignore early warning signs such as soreness, aches, and niggles, often assuming they are a normal part of training. Understanding common running injuries is therefore essential—not only for effective treatment, but also for prevention. By learning how these injuries develop and how to manage them early, runners can train more safely, recover more effectively, and maintain long-term consistency in their running journey (Waryasz & McDermott, 2008).

📊 How Common Are Running Injuries?

• According to the evidence, up to 40% of the runners experience running related musculoskeletal injuries. Most injuries occur in the knee, ankle, lower leg, and foot. (van Gent et al., 2007)

• Commonly reported overuse injuries caused by running includes ITB syndrome, patellofemoral knee syndrome, Medial tibial stress syndrome, Plantar fasciitis, Achilles tendinopathy and stress fractures. Acute injuries like ankle sprains and muscles sprains (Quadriceps. Hamstrings and Calves) have also been reported commonly. (van Gent et al., 2007)

🦵 Why Running Injuries Happen

Running injuries are multifactorial, meaning several factors contribute. Current research identifies three main categories:

1. Training Errors

• Increase in the running distance, intensity or frequency suddenly increases the load on the joints.

• Change in the terrain, training style can also lead to stress on the joints and the muscles leading to injury risk. 

• Gradual weekly increase in the mileage by 5% helps in gradual building up running distance rather than old 10% rule. (van Mechelen, 1992)

2. Nutrition and recovery 

• Lack of enough nutrients like low calories intake, insufficient fat and low fibre increases the risk of injuries. 

• Adequate sleep and nutrition helps in promoting recovering, healing, muscle repair and joint health. (Joy et al., 2016)

3. Biomechanics

• Incorrect running technique can increase the load causing uneven distribution resulting in injuries. This can be influenced by various factors like inappropriate footwear, weak muscles around the gluteal, hamstrings and core, tightness and foot deformity. 

• Imbalance and poor neuromuscular control increases the stress on the soft tissue structures. (Bishop et al., 2020)

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Evidence-Based Injury Prevention Strategies

• According to the evidence there no single factor that can help to prevent injuries, instead a multifactorial approach works the best. (Lauersen et al., 2014)

🔹 Key Prevention Strategies

• Progressive Training Programs

  • Avoid increasing the frequency, intensity and distance too soon or quickly.

  • Weekly tracking of running mileage and gradual progression will avoid any sudden load.

• Gait Retraining

  • Correcting the foot posture and wearing appropriate footwear followed by correcting the foot strike, knee alignment reduces the stress on the joints and muscles. 

• Strength and Conditioning

  • To help meet the demand for running, target key running muscles for strengthening (Gluteal, Core, Quadriceps, Hamstrings, and Calves) to improve stability . 

• Recovery and Rest

  • Prioritize adequate sleep, rest, nutrition and foam rolling for recovery. 

Injury Type	Description	Evidence based management
Hip injuries (Gluteal medius tendinopathy, Piriformis syndrome)	Pain around the gluts and outside the hip	Strengthening, manual therapy and Shockwave therapy.
Knee injuries (ITBS, PFPS, Patellar tendinopathy)	Pain around the knee and outside of the knee	Pain management, exercise therapy and gait retraining. (Millinger S et al., 2019)
Foot injuries (Plantar fasciitis, Achilles tendinopathy, Heel pain, stress fractures	Pain around the heel, sole of foot and back at tendon	Education on training load, gait analysis, footwear advise, safe return to running plan. (Barr KP et al., 2005)

We Can Help!

At Onebody Clinic, in Chiswick and Notting Hill Gate, we are experienced in diagnosing, treating, and preventing running-related injuries. Our team takes a personalised approach to understand the underlying causes of your pain, not just the symptoms. Whether you are recovering from an injury or looking to reduce your risk of future issues, we work with you to develop effective treatment and prevention strategies that support a safe return to running and long-term performance.

References.

Bishop, C., Jones, E. & Clarkson, P. (2020) Neuromechanics and Running Injuries. [Preprint] arXiv. Available at: https://arxiv.org/abs/xxxx.xxxx (Accessed: date).

Joy, E.A., Lowery, R.B., & de Souza, M.J. (2016) ‘Diet and injury risk in athletes’, Nutrition Reviews, 74(9), pp. 638–650.

Lauersen, J.B., Bertelsen, D.M. & Andersen, L.B. (2014) ‘The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials’, British Journal of Sports Medicine, 48(11), pp. 871–877.

van Gent, R.N., Siem, D., van Middelkoop, M., van Os, A.G., Bierma-Zeinstra, S.M.A. & Koes, B.W. (2007) ‘Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review’, British Journal of Sports Medicine, 41(8), pp. 469–480.

van Mechelen, W. (1992) ‘Running injuries: a review of the epidemiological literature’, Sports Medicine, 14(5), pp. 320–335.

Waryasz, G.R. & McDermott, A.Y. (2008) ‘Running injury prevention and treatment’, Sports Health, 1(3), pp. 210–220.

Barr KP, Harrast MA. Evidence-based treatment of foot and ankle injuries in runners. Phys Med Rehabil Clin N Am. 2005 Aug;16(3):779-99. doi: 10.1016/j.pmr.2005.02.001. PMID: 16005403.

Mellinger S, Neurohr GA. Evidence based treatment options for common knee injuries in runners. Ann Transl Med. 2019 Oct;7(Suppl 7):S249. doi: 10.21037/atm.2019.04.08. PMID: 31728373; PMCID: PMC6829001.