5 Common Running Injuries and How to Prevent Them

Many runners struggle with injuries. From hips and knees to ankles and feet, studies show that anywhere from 37 to 56 percent of regular runners sustain a running-related injury—the majority of those are from overuse.

There could be many causes of running injuries: muscle imbalances, impact forces, altered biomechanics and aggressive training programs are all contributing factors to pain. Even where you land on your foot—forefoot, midfoot or heel—might have an effect on whether you get injured.

Seasoned athletes and novice runners alike are susceptible to the consequences of overuse and overload. Understanding the ins and outs of some of the more common ailments can help runners adapt their programming and avoid season-ending injuries.

Here are some of the most common injuries that hinder runners, how you can help prevent the pain and how to treat each injury if it’s already crept in.

This article has been updated with treatment recommendations from John Dewey, PT, ATC.

What it is: Plantar fasciitis presents as pain and stiffness in the arch or heel of the foot, caused by the inflammation of the plantar fascia (the tissue that connects your heel to your toes). Symptoms tend to be worse in the morning but get better with activity.

How you get it: The plantar fascia acts as a "shock absorber" for the foot, becoming inflamed under repetitive bouts of high stress. Wearing ill-fitting shoes, walking on hard surfaces, obesity, high impact sports and increased pronation are all contributing factors to plantar fasciitis pain.

Preventative Exercise Suggestions:

• Arch Roll
• Calf stretch
• Towel Curls

How to treat it:

• Ice
• Arch support through use of an insert for the shoe
• Proper footwear
• Rest / cross training to allow time for the inflammation to decrease
• Stretching of the plantar fascia
• Stretching of the calf muscle and Achilles tendon
• Use of Strassburg sock
• Use of kinesiology tape
• In severe cases, a cortisone injection may be a treatment option (consult your physician).

What it is: Commonly felt by new runners, shin splints develop due to altered biomechanics and increase stress placed on the lower limbs. Shin splint pain, located below the knee and above the ankle, can be felt toward the front (called anterior tibial stress syndrome - ATSS) portion of the shin bone or the back (called medial tibial stress syndrome - MTSS).

How you get it: According to the Brigham and Woman's Hospital, shin splints account for "60 percent of all overuse injuries of the lower limb.” Running on deconditioned legs is a chief cause, making novice runners prime candidates for shin splints. Runners who abruptly increase the intensity of their training, or have low muscular strength and endurance, may also experience lower limb pain.

As mentioned above, shin splint pain can be felt towards the front (ATSS) of the shin bone or toward the back (MTSS). ATSS stems from excessive pronation of the foot and is common among beginner-level runners. MTSS, on the other hand, is often diagnosed as a chronic condition and is a result of excessive pronation of the foot and rearfoot varus.

Preventative Exercise Suggestions:

• Calf Raises
• Resisted Ankle Dorsiflexion
• Ankle ABCs

How to Treat it:

• Arch support through use of an insert for the shoe
• Calf and hamstring stretches
• Proper progression of running
• Proper footwear
• Rest / cross training to allow time for the inflammation to decrease
• Strengthening of the lower leg muscles
• Use of ice pack
• Use of a compression sleeve during activity
• Use of kinesiology tape

What it is: Patellofemoral pain syndrome, otherwise known and runner's knee, is more common among the athletic population. Runner's knee is thought to be a consequence of overuse, alignment and tracking issues of the knee cap and musculature imbalance. Presenting with anterior knee pain felt in the front or underneath the kneecap, the pain worsens with repetitive bending, downhill slopes or stairs, and prolonged sitting. Many runner's knee patients report a popping sound at the knee joint and increased sensitivity when walking on harder surfaces.

How you get it: Pain located at and around the kneecap stems from inflammation and irritation of tendons and soft tissues. Many variables contribute to runner's knee: poor running technique, muscle imbalance, patellar malalignment or cartilage changes. If patellar malalignment is present, the kneecap will have abnormal movement patterns, increasing the chance of dislocation. Runner's knee can also be an early sign of chondromalacia patella, a condition indicating cartilage breakdown.

Often experienced by runners or high-impact-sport athletes, there is high controversy in the orthopedic medical community regarding the exact cause. Many suspect weak quadriceps and hamstring muscles, as well as the inflexibility of the IT band, contribute to runner's knee. Biomechanical compensations due to pronation, high-arch foot and increased Q-angle have also been proposed. Still, currently, no single variable has been determined.

Preventative Exercise Suggestions:

• Side Leg Lifts
• Clam Shells
• Ball Squat

How to Treat it:

• Arch support through use of an insert for the shoe
• Proper footwear
• Stretching of the hamstrings and quadriceps muscles
• Strengthening of quadriceps, hamstrings, hips, and core muscles
• Stretching of the IT Band with a foam roller
• Use either of a patellar tendon strap or of an IT Band strap during activity
• Use of kinesiology tape

What it is: Long-distance runners are a prime population to experience IT band syndrome. Thought to be caused by increased friction of the iliotibial band, pain from ITBS runs along the outside of the thigh and knee. The IT band is a thick band of fibrous connective tissue that helps stabilize the hip and knee. Athletes with ITBS report pain with knee flexion or downhill running, a feeling of instability at the knee, and tenderness with touch.

How you get it: ITBS is prevalent among long-distance runners due to the combination of an increased rate of flexion and extension, excessive stress and substantial weekly mileage. Structural variables, biomechanics and muscular strength can all be factors for the onset of ITBS. Also, steep inclines or a sudden increase in mileage have shown to affect the tension of the iliotibial band resulting in higher reports of pain.

Preventative Exercise Suggestions:

• IT stretch
• Lateral band walk
• Single-Leg Squat

How to Treat it:

• Check in with your orthopedist or Physical Therapist. They typically check leg length, strength, and sacroiliac joint dysfunction.
• If caused by excessive pronation, consider a stability shoe with an insert.
• Stretching, icing, and massage of ITB may be helpful. Consider foam rollers for self-massage.

What it is: Similar to runner's knee, patellar tendonitis (also called jumper’s knee) presents with pain in the anterior portion of the knee joint. Athletes experience discomfort and swelling between the base of the kneecap (patella) and the top of the shinbone (tibia). The patellar tendon connects the tibia to the patella, which helps stabilize the patella and assist in the straightening of the leg. High-impact exercises, such as running or plyometrics, or a sudden change in activity can cause small tears of the patellar tendon leading to inflammation and pain.

How you get it: Patellar tendonitis starts with inflammation of the patellar tendon. Appropriately nicknamed jumper's knee, inflammation is caused by repetitive stress at the knee through actions such as jumping, kicking and running. Repetitive trauma or inflammation can lead to a weakened patellar tendon, increasing the chance of a tear.

Preventative Exercise Suggestions:

• Single-Leg Bridges
• Straight Leg deadlifts
• Leg curl with ball

How to Treat it:

• Hot/Cold Therapy Wrap
• Ice
• Foam rollers
• Roller massagers

Proactively implementing injury prevention methods during your training is key to keeping overuse injuries at bay. A few of my favorite preventative techniques include:

1. Cross-Training
2. Strength Training
3. Proper Footwear
4. Quality Warm-Up Routine
5. Daily Stretching