Running injuries can be painful, stubborn, and depressing.
If you’re reading this, even if you have been injury free throughout your running career (please show us your secret), chances are, if you keep training, you’re going to pick up more than one injury sooner or later.
A Few Stats
According to surveys, at any time, roughly 1 in 4 runners will have an injury. Polls also show that approximately 80 percent of runners get injured every year. These are not good odds.
The majority of running injuries is caused by overuse—meaning that they happen over time through applying repeated force rather than because of a single traumatic event. Other common causes include drastic changes in training volume, biomechanical deficiencies, running in the wrong shoes, poor form, etc.
The bulk of injuries tends to afflict the knees, feet, calves, shin, and ankles. Other weight-bearing limbs and regions, such as the thighs, hips, and the back are also prone to injury.
Here is the good news. Today, dear reader, I will delve a little deeper into some of the most common running injuries, along with the best ways for treating and preventing them for good.
By learning more about the causes and preventative measures for these common inflictions, it might save you a lot of pain while help keep you going strong throughout the season.
So, are you excited? Then here we go.
1. Achilles Tendinitis
Achilles Tendinitis is an inflammation of the Achilles tendon, the largest tendon in the body that attaches the two major calf muscles to the back of the heel bone.
Under repetitive stress, this tendon gets inflamed and irritated, resulting in tendinopathy—micro partial tears to the tendon.
Survey shows that this condition makes up 11 percent of running injuries.
Main symptoms include stiffness and pain in the region of the heel, just above the heel at the Achilles tendon, especially while pushing off with your toes (walking, running, etc.) and in the morning upon taking the first few steps.
The pain is sharp and can be severe enough to keep you from running at all.
Besides the pain, Achilles tendinitis may also manifest as visible swelling or a knot in the tendon.
The primary cause is repetitive stress to the tendon. During a foot strike, the Achilles tendon absorbs several times your body weight. The longer and faster you run, the more stress you put on this tendon.
But other factors can make it worse. Here are a few
- Increasing your weekly training load too fast, especially in those who have increased their mileage more than 10 percent per week.
- Weakness in the muscles of the posterior chain—the glutes, hamstrings, and calves.
- Tight calf muscles. More specifically, the gastrocnemius muscle, which is a muscle that crosses these three joints: the subtalar, the ankle, and the knee joint.
These measures can help reduce the risks of the condition:
- Strengthen your posterior muscles. One powerful exercise, according to research, is eccentric heel drops. Other exercises to try include calf raises, lunges, squats, deadlifts, and burpees.
- Stretch your calves. Lift your toes back toward your shin while keeping your heel on the ground the entire time.
- Proper form. Work on improving your footstrike and cadence efficiency and speed.
- Consider wearing orthotics or running in shoes with more support. Steer clear of flip-flops, high heels, or any footwear that may irritate the Achilles tendon.
The best treatment is to reduce training volume or take a break from running and do plenty of cross-training with low-impact activity, think swimming, biking, and aqua jogging, for a few weeks.
With severe cases of the condition, you might need clinical treatment. Some options consist of physical therapy methods of electrical stimulation, such as high-voltage galvanic stimulation (HVGS), and ultrasound.
Further, run in the proper footwear and replacing them often every 400 to 500 miles—that’s about 6 months of regular training.
2. Ankle Sprains
Ankle sprains are the most common acute injury that strikes runners. This one-time traumatic injury that occurs when the foot twists or rolls inward, forcing the ligament surrounding the ankle to stretch beyond their healthy range of motion.
The most common ankle sprain is an inversion ankle sprain resulting from a partial tear of the anterior talon-fibular ligament—the ligament in the front and outside of the ankle.
Immediate pain at the onset of the injury, typically accompanied by ankle swelling. You might not be able to put weight on the injured limb.
In severe cases, this ligament may also tear completely.
Ankle sprains are widespread among trail and cross country runners. Anything that forces the foot to roll inward or outward, straining the ligament, can result in injury.
- Running on uneven surfaces
- Missing the curb
- Tripping over a rock
- Stepping in a pothole
- Landing awkwardly upon footstrike.
Treating ankle sprains depends, mostly, on the severity of the injury.
In general, the R.I.C.E method is the way to go. At least, ice the injured ankle for 15 to 20 minutes three to four times a day for up to 72 hours.
The majority of ankle sprains heal on their own, but you can expect it take 2 to 8, or longer, to fully recover.
As a cardinal rule, return to running once you can do it pain-free, have a full range of motion in the injured joint, and the strength of the injured limb is equal to that of the healthy side.
If symptoms do not improve after two or three weeks of rest, then medical intervention is required for a more intensive treatment approach. An air cast or ankle brace, and taping it up might be needed for full recovery.
The only two measures you need to take to reduce the risks include:
- Running on proper surfaces, especially if you’re new to trails and challenging terrains.
- Balance exercises to strengthen the musculature structure surrounding the ankle, according to research.
3. Runner’s Knee
Also known as Patellofemoral Pain Syndrome, or PFPS for short, runners knee is irritation of the cartilage on the underside of the patella (the kneecap), which is located in the patellar tendon and connects to the quads muscle group, the most powerful group in the body.
Runners’ knee occurs when the kneecap tracks out of alignment due to several reasons. Over time, this cartilage can wear down, resulting in debilitating pain.
This notorious knee injury is the most common affliction among runners—from all training backgrounds. Surveys show that about 40 percent of running injuries are knee injuries—and runners knee makes up a large percentage.
In fact, according to a runnersworld.com poll, about 13 percent of runners reported suffering from knee pain in the past year.
The main symptom is a tender and constant pain behind or around the kneecap, typically on the front of the knee, just under the bottom edge of the kneecap.
The pain gets particularly worse when:
- Running downhill
- Descending the stairs
- After prolonged sitting
The leading causes of runners knee tend to be different from one runner to the next. Some of these include:
- Weak glute, hip, or quad muscles
- Overpronation, which is the excessive inward foot rolling during a foot strike.
- Muscle imbalances
- Too much downhill running
- Faulty biomechanics,
- Improper footwear,
First, decrease your running volume by half, avoid running on consecutive days, or take a break from the sport altogether.
Next, ice the affected knee for 10 to 15 minutes post-run, or three to four times a day.
For more aggressive treatment options, use a knee brace, knee tape, take anti-inflammatory medications.
See your physician in case the pain gets worse. Left untreated, runners knee can progress into a more serious ailment that may require surgical intervention, such as fracturing or fissuring of the kneecap. That’s going to take you a long time to recover from.
The following precautions can help:
- Strengthen your knee’s support muscles like the glutes and the quads to help keep your knee tracking correctly over the femoral groove. This can provide more balance to your kinetic chain. Some of the best exercises include lunges, bridges, lateral side steps, wall sits, squats, side-Lying leg left, and clamshells.
- Stretch your hip flexors, and keep your hamstrings flexible and loose.
- Consider shortening your stride length while landing with the knee slightly bent. This might help reduce the load on your knee joint.
4. Shin Splints
Also known as medial tibial stress syndrome, this term is typically used to refer to pain in the front or inside of the lower leg as a result of small tears occurring in the muscles around the tibia—shin bone.
Research shows that shin splints are more common among beginners and those returning to the sport after an extended layoff, making up roughly 15 percent of all running injuries.
For most runners, shin splints manifest as throbbing pain in both the front, outer portion of the shin, or in the medial region of the inner side of the leg.
Known culprits include:
- Drastic changes in training volume. Doing too much too soon before your body is well adapted to handle the new workload.
- Having high arches or flat feet. Research suggests that runners with flat feet are more prone.
- Running in the wrong shoes.
- Running on hard and/or cambered—slightly arched—surfaces and roads.
Cut back on your training volume. To ease the pain, try icing the affected shin for 15-20 minute three times a day, and keeping them elevated at night to lessen swelling and pain.
Regular stretching, and running with neoprene sleeves might also help. Or consider taking over-the-counter anti-inflammatory drugs.
Taping the shin, using Kinesio Tex tape, can also soothe the pain and speed healing.
Just whatever you do, do not run through pain as doing might eventually lead to a stress fracture, a more severe and painful condition.
To ward off the condition, do the following:
- Increase training volume gradually and slowly. This means that you should not increase distance by any more than 10 percent each week.
- At first sight of pain, back off your running to a pain-free level, or stop exercising altogether for a few days to a week.
- Feel free to pool run, bike, swim, or do any other form of exercise, as long as it’s pain-free.
- Strengthen the anterior tibialis muscle on the front of your shin. Good exercises include heel walks and toe taps.
- Increase your intake of vitamin D and calcium.
- Consider taping the injured shin using Kinesio Tex tape or other products to alleviate pain and speed healing. Wearing an air cast ankle brace can also help.
5. Plantar Fasciitis
Running is high impact, and with every foot strike, your feet absorb a force many times your body weight.
So, it’s not surprising that roughly 15 percent of all running injuries strike the foot. One of the most common foot injuries is Plantar Fasciitis.
As the name implies, plantar fasciitis is an inflammation of the plantar fascia, which is the thick band of ligaments and tendons in the bottom of the foot that runs from the heel to the toes, joining the heel and forefoot and providing arch support.
In short, it’s pain in the bottom of the foot.
Another poll run by runnersworld.com revealed that up to 10 percent of its readers suffered from this injury this past year. So it’s quite common.
The common symptom of plantar fasciitis is a tight, tender sensation at the base of the heel that can range anywhere from irritating to excruciating.
Most runners describe the pain as if they were stepping heel first onto a nail or walking on glass.
The pain is worse when exercising or first thing in the morning.
Known causes include:
- Weakness and/or tightness in the muscles of the foot. This forces the heel to take on and withstand excessive load.
- Runners with abnormal feet—those with very high or very low
- Overpronation—the excessive inward roll of the foot during a foot strike, and supination—the excessive outward roll
- Ramping up mileage too quickly.
- Prolonged periods of standing, typically on hard surfaces without supportive footwear.
- Running in the wrong shoes
To speed up healing, roll your injured limb over a frozen water bottle or a tennis ball for five minutes at a time, five times a day. You can also use a foam roller to loosen your plantar fascia.
Try stretching. This simple stretch can help.
Recovery time depends on the severity of the injury. It can range from one month to a year, but three to six months is relatively common.
Stability shoes and orthotics can also be effective at reducing symptoms and speeding up recovery, but they are not a permanent fix.
In severe cases, taking a long layoff from running is required. Swimming, biking, aqua running and other low-impact cross-training exercises are recommended.
Do the following:
- Run in the right shoes. Make sure they fit your foot type and running gait. Go to a specialty running store or a certified podiatrist to ensure you’re making the right shoe decision.
- Stick to the 10 percent rule.
- Do foot strength exercises. Check this post.
- Improve your running form
6. Iliotibial Band Syndrome
Also known as ITBS, this injury is an inflammation of the iliotibial band, a thick piece of connective tissue that stretches from the pelvic bone all the way down your thighs.
When you run, or perform any knee bending movement, your IT band rubs on the side of the femur in order to help your knee flex and extend.
Do this for an extended period of time, then the action can lead to irritation, particularly if you’re doing a lot of intense training, think interval work or downhill running. This is especially the case when hip motion is not well controlled.
Surveys show that ITBS makes up about 12 percent of all running injuries.
This condition manifests as pain around the outside of the knee.
The feeling has been described as comparable to getting stabbed in the side of the knee while running, especially when going downhill.
Key factors include:
- Doing too much too soon
- Weakness in the hip abductor and gluteal—butt—muscles
- Runners with leg-length discrepancies
- Faulty running biomechanics
Reduce your training volume by half or take a few weeks off entirely. Instead, opt for low-impact cross-training exercises, like swimming, aqua jogging, or cycling.
Applying ice to the affected area can also help.
Use a foam roller on the affected limb to break up tissue adhesions and loosen things up.
Reduce the risks of the injury by doing the following:
- Add hip abductor strength exercises to your resistance training. These include side leg lifts, lateral side steps, and one-legged squats.
- Perform a proper warm-up before every run.
- Shorten your stride and increase your cadence turnover
- Stick to the 10 percent rule.
- Use the foam roller before and after your runs.
7. Stress Fractures
Stress fractures are a tiny crack in a bone caused by sub-maximal cumulative stress on the bone resulted from excessive pounding of the pavement on a regular basis, forcing the bone to take on greater amounts of force than it can handle.
The injury can occur anywhere, but in runners, the most commonly afflicted areas include the main weight-bearing bones, such as the metatarsals – especially the fifth metatarsal, your pinky toe, the tibia—the lower leg bone, and sometimes, but not as often, the femur—anywhere in the upper leg, even the pelvis or sacrum.
Polls show that stress fractures are behind 6 percent of all running injuries.
Pain ranges from mild to debilitating enough to sideline any committed runner from training for weeks, sometimes months.
Pain is relieved with rest but gets worse with high impact activity.
Any of the following increases the risks of injury:
- Running low on certain nutrients
- Running in improper shoes
- Running on hard surfaces
- Being a woman. Female runners are more prone to stress fractures, usually due to inadequate caloric intake, nutritional deficits, and low estrogen levels.
Your first line of defense is the RICE method.
At the onset of pain, allow for no high impact exercise, and let your affected bones heal completely. That said, feel free to cross train. Recommended exercises include aqua jogging, cycling, anytime gravity treadmill running, or yoga
Next, use ice therapy to reduce symptoms and speed up recovery.
If the pain gets worse, then you HAVE to see a certified physician. There is no way around it.
Preventative measures include:
- Wearing proper and supportive footwear
- Steady mileage increase
- Strength training
- Doing plenty of non-weight-bearing cross-training exercises like swimming, cycling or yoga.
- Getting plenty of calcium and vitamin D.