Running Injuries

Running Injuries

Did you know?

According to University of South Carolina researchers, running up to 20 miles (32 km) once a week can prolong your lifespan.

Running is becoming increasingly popular, which suggests that the frequency of injuries associated with running would likely also rise not only among athletes but also in the general population.

In this blog, we’ll look at some commonly encountered running injuries and how to deal with them.

Running injuries

A research study revealed the incidence of running injuries in novice and recreational runners to be 17.8 and 7.7, respectively. (Videbæk et al., 2015).  Repetitive stress causes nearly 80% of running injuries, but abrupt accidents such as a sprained ankle or a torn muscle can also occur due to trauma or faulty mechanics.

Let’s discuss some of the most common running injuries.

Achilles Tendinitis

The Achilles tendon is present at the backside of your ankle and connects your calf muscles to the heel. Repetitive movements of your ankle can result in inflammation of this tendon and this condition is known as Achilles Tendinitis. (McCRORY et al., 1999) It may occur after increasing your mileage or running intensity.

This condition is associated with the following symptoms:

Dull pain in your heel or calf

Swelling along the tendon

Restricted range of motion of your ankle

Ankle Sprain

An injury or tear of a ligament is called a sprain. An ankle sprain is an injury caused by overstretching of your ankle ligaments. This commonly occurs when you suddenly twist your ankle (inward or outward) or when you land from a jump with a twisted ankle. (Tenforde et al., 2016)

The symptoms of an ankle sprain are as follows.

Pain in ankle

Swelling around the ankle joint

Difficulty in weight-bearing

Hamstrings Strain

Injury or tear of a muscle is called strain. Hamstring strain may occur if you suddenly stop while running (rapid deceleration). This injury is more common if your hamstrings are weak or inefficient. Repetitive stress over the hamstrings in distant runners also causes this type of strain. (Erickson and Sherry, 2017)

It results in the following symptoms.

Dull or boring pain in the back of your thigh

Tenderness of hamstrings

Stiff or tight hamstrings

Runner’s Knee

Runner’s knee or patellofemoral syndrome causes pain in the knee due to faulty mechanics at the knee joint. The main cause of this condition is weakness in your hips or the muscles around your knee. (Petersen et al., 2014)

Dull and achy pain in one or both knees

Pain worsens with prolonged running

Knee Ligaments’ Tear

There are four important ligaments in the knee joint i.e. Anterior Cruciate Ligament (ACL), Posterior Cruciate Ligament (PCL), Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL). ACL and MCL injuries are much more common among runners as compared to PCL and LCL injuries.

Knee ligaments’ injuries in runners result in the following symptoms.

Pain and swelling around the knee joint

Instability of the knee joint

Wobbling sensations in the knee joint

Difficulty running and jumping

IT Band syndrome

IT band syndrome is the most common condition among runners. The iliotibial band, also known as the IT band, is a type of connective tissue that runs from your outer hip to the knee. When you walk or run, this band of tissue helps to stabilize your knee. (Fredericson and Wolf, 2005)

IT band syndrome is caused by the IT band rubbing against your leg bone repeatedly. Due to tight IT bands, it is very common in runners. This condition may also be caused by weak gluteal muscles, abdominals, or hips.

IT band syndrome is characterized by the following symptoms.

Sharp pain on the outer side of your knee and leg

IT band tenderness

Pain that worsens with knee bending movement

Plantar Fasciitis

PF is one of the most common injuries to the foot. Due to repetitive loading on your foot, a layer of tissue present underneath your sole (plantar fascia) gets inflamed and causes pain and irritation. (Warren, 1990) Footwear is a significant risk factor in developing plantar fasciitis.

Common symptoms of plantar fasciitis include the following

Pain in your heel and sole

Burning sensation in your sole

Pain that is worse in the morning or after prolonged activity

Other conditions

Other common conditions among runners are osteoarthritis, shin splints, stress fractures, bursitis, meniscal injuries etc.


The treatment of the injuries associated with running depends upon the nature of the injury. Fractures and grade 3 ligaments’ tears may require surgery followed by physiotherapy. Other conditions such as minor strains, sprains, tendinitis, bursitis etc. can be managed conservatively using individualised physiotherapy treatment.

Role of Physiotherapy in Running Injuries

Physiotherapy plays a crucial role in managing injuries associated with running. Physiotherapy not only reduces the healing time of the injury but also enables the athlete to return to the running routine effectively. A specialist running physiotherapist can also perform a biomechanical assessment.

Acute Management of Running Injuries

The acute management of the running or sports injury follows POLICE protocol.

Protection: Protect the injured area by fixation or bracing.

Optimal Loading: Completed rest is no longer the default recommendation. Matching the loading exposure to the injury is essential.

Icing: Intermittent icing of the injured area helps to decrease swelling and pain relief.

Compression: Wear compression bandages to minimise the swelling.

Elevation: Elevate the injured area above the heart level to improve venous return and minimize swelling.

Chronic Management of Running Injuries

Once the acute phase of the injury is over, other physiotherapy treatment approaches are used to boost the healing process and return to the sport. Physiotherapy treatment for running injuries may include the following.

Modalities: Manual therapy, hot pack/icepack, ultrasound, dry needling, shockwave therapy and most important of all, a graded loading program.

Stretching: Stretching exercises of tight or spastic muscles to relieve muscular tension.

Strengthening: Strengthening exercises of weakened muscles such as calves, quadriceps, calf muscles etc.

Balance Training: Exercises targeted at improving balance by providing proprioceptive input.

Plyometric Training: Exposing an injured joint to more bounding is required for a return to running

If you have recently suffered from a running injury, click the link below to schedule a one-to-one consultation with one of our top experts for individualised assessment by our running assessments. Our physiotherapists are all athletes and runners, having competed in many marathons and Ironman triathlons and coached many runners and triathletes to achieve their goals.


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PETERSEN, W., ELLERMANN, A., GÖSELE-KOPPENBURG, A., BEST, R., REMBITZKI, I. V., BRÜGGEMANN, G.-P. & LIEBAU, C. 2014. Patellofemoral pain syndrome. Knee surgery, sports traumatology, arthroscopy, 22, 2264-2274.

TENFORDE, A. S., YIN, A. & HUNT, K. J. 2016. Foot and ankle injuries in runners. Physical Medicine and Rehabilitation Clinics, 27, 121-137.

VIDEBÆK, S., BUENO, A. M., NIELSEN, R. O. & RASMUSSEN, S. 2015. Incidence of running-related injuries per 1000 h of running in different types of runners: a systematic review and meta-analysis. Sports medicine, 45, 1017-1026.

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