Table of Contents
Common Running Injuries
These recommendations will assist you in recovering from prevalent injuries, enabling a return to your preferred activities.
Running provides numerous advantages for physical and mental health, yet it can impose significant strain on the body, increasing vulnerability to typical injuries. This occurs because each stride involves absorbing ground reaction forces equivalent to approximately two and a half times one’s body weight. Research from the Journal of Sport and Health Sciences in 2021 indicates that nearly 40 percent of runners encounter a running-related injury.
Furthermore, a 2023 study in the Journal of Morphology and Kinesiology, based on social media surveys, revealed that 84 percent of runners report a lifetime history of injuries, with 45 percent experiencing one in the past year.
Given these findings, it is reasonable to anticipate that most runners may face an injury at some stage; however, implementing preventive measures can mitigate this risk.
As an initial step, if pain registers at a level of 6 or 7 on a 10-point scale (where 10 represents severe agony), disrupts daily functioning, or persists beyond two weeks, consult a physician immediately, advises Cathlin Fitzgerald, D.P.T., C.S.C.S., a physical therapist at Custom Performance in New York City.
For addressing minor discomforts at home upon onset, consider these approaches from Fitzgerald, Jay Dicharry, M.P.T., a biomechanics expert and author of Running Rewired, and Jordan Metzl, M.D., a sports medicine specialist at the Hospital for Special Surgery in New York City.
PIRIFORMIS SYNDROME
What it feels like
A distinct discomfort in the buttocks, characterized by pain, spasms, or tingling in the gluteal region that may radiate along the posterior leg and into the foot. (Note that if buttock pain accompanies back discomfort, numbness, tingling, or weakness, seek medical evaluation to rule out a spinal nerve issue.)
Why it happens
Insufficient gluteal strength, often from prolonged sitting, or repetitive actions such as running can exhaust the piriformis muscle, which facilitates hip external rotation, leading to pressure on the adjacent sciatic nerve.
The fix
Alleviate sciatic nerve compression through nerve flossing exercises:
- Position yourself on the edge of a bench or chair with knees at 90-degree angles, allowing the left leg to extend forward and backward.
- Extend the head backward, straighten the left leg, and dorsiflex the foot. Maintain for 2-3 seconds.
- Flex the left leg, point the toes, and bring the chin toward the chest. Maintain for 2-3 seconds.
- Alternate between positions. Perform 2 sets of 10 repetitions.
Incorporate piriformis stretches into your regimen, such as the figure-4 pose:
- Lie supine.
- Place the right ankle across the left thigh and flex both feet.
- Grasp the posterior left thigh with both hands and draw it gently toward the body.
- Sustain for 15-30 seconds.
- Switch sides.
SHIN SPLINTS
a.k.a. medial tibial stress syndrome
What it feels like
Persistent discomfort along the anterior or lateral aspect of the lower leg near the tibia, typically emerging during or post-exercise and upon palpation of the region.
Why it happens
Excessive stress on the tibia and surrounding tissues results in minor muscle detachment from the bone, often due to rapid increases in training volume or biomechanical factors like excessive stride length.
The fix
Short-term use of arch-supporting shoe inserts may provide relief. Enhance protection by fortifying the feet, ankles, calves, and hips, which bolster the shins, through targeted routines. Practice controlled foot descent:
- Secure a mini resistance band around both feet and separate them to create tension.
- Elevate the toes of one foot off the floor, then gradually return them to the surface.
- Repeat. Complete 3 sets of 10 repetitions per foot.
LOWER BACK PAIN
What it feels like
Muscular discomfort on one or both sides of the lumbar spine, potentially with spasms, particularly during rotational movements. (If accompanied by numbness, tingling, or weakness, medical consultation is essential.)
Why it happens
Constricted hamstrings and anterior hip muscles, combined with deficiencies in the stabilizing musculature around the back—including the core, hips, glutes, and hamstrings—cause anterior pelvic tilt, impairing core engagement and overloading the lumbar area.
The fix
Utilize foam rolling to alleviate tension in key running muscles, thereby reducing lumbar strain:
- Employ a foam roller to target the lower back, glutes, quadriceps, iliotibial bands, hamstrings, and calves for 20 seconds per area.
- Cycle through the sequence three times, achieving 60 seconds total per muscle group.
ANKLE PAIN
What it feels like
Acute stabbing or persistent dull soreness along the medial or lateral ankle.
Why it happens
Instability from weaknesses in the kinetic chain, particularly above the hip such as in the gluteus medius, leads to excessive joint loading; inward ankle rolls can damage ligaments, while altered surfaces, footwear, or terrain amplify impact forces.
The fix
Allow rest, then enhance ankle stability via pass-back drills:
- Stand while holding a 5- to 15-pound weight or a filled water gallon, balancing primarily on one leg.
- Transfer the weight between hands, maintaining ankle equilibrium; increase speed for added challenge.
- Target 2 minutes per foot, pausing as necessary.
BLISTERS
What it feels like
A stinging sensation, possibly with associated soreness, erythema, or pruritus.
Why it happens
Skin friction from footwear or socks, exacerbated by accelerated speeds, ill-fitting shoes, or structural foot issues like bunions, calcaneal spurs, or hammertoes.
The fix
Puncture the blister with a sterile needle for drainage, then apply a secure, clean dressing; prevent recurrence with moisture-wicking synthetic socks and properly sized shoes.
IT BAND SYNDROME
What it feels like
Throbbing or incendiary discomfort on the lateral knee, occasionally extending to the thigh or hip, manifesting early in runs.
Why it happens
Repetitive strain, degraded footwear, pelvic asymmetries, or gluteal weakness cause inward leg rotation, aggravating the iliotibial band—a fibrous structure from hip to knee that aids joint stability.
The fix
Bolster the gluteus medius with hip elevation exercises to maintain pelvic alignment:
- Position sideways on a step, suspending one leg.
- Engage the core, keep the supporting leg extended, and lower the suspended leg by tilting the pelvis downward.
- Elevate the pelvis using the supporting hip muscles.
- Repeat. Execute 2-3 sets of 12 repetitions per side.
Post-exercise foam rolling and 15-second static stretches can mitigate discomfort, such as this standing variation:
- Stand with the right foot behind the left.
- Extend the torso upward and laterally toward the left.
- Sustain for 15 seconds.
- Switch sides.
PLANTAR FASCIITIS
What it feels like
Piercing or profound soreness in the heel or foot arch, notably upon waking, after prolonged sitting, or during gait propulsion.
Why it happens
Abrupt mileage escalations, foot architecture flaws like overpronation, calf tightness, frequent inclines, or unsuitable shoes overload the plantar fascia, inducing microtears and inflammation.
The fix
Arch-supportive orthotics and a Strassburg sock can address symptoms, particularly morning discomfort. Strengthen intrinsic foot muscles via toe exercises:
- Stand barefoot with even weight distribution and toes splayed.
- Elevate only the hallux while keeping digits two through five grounded.
- Hold for 2 seconds, ensuring smaller toes remain relaxed.
- Lower and perform 20 repetitions.
- Reverse: Anchor the hallux and lift digits two through five, avoiding inward foot roll.
- Hold for 2 seconds.
- Lower and perform 20 repetitions.
ACHILLES TENDINITIS
What it feels like
Mild persistent or acute discomfort along the tendon’s posterior aspect, often near the heel, with potential ankle stiffness.
Why it happens
Inadequate calf stretching, rapid mileage increases, hill training, speed sessions, or overexertion shift excessive load to the Achilles; minimalist shoe transitions may contribute.
The fix
Employ isometric heel raises for analgesia, followed by eccentric variants for resilience:
Position toes on an elevated surface with heels overhanging. Balance weight on one side, rise onto toes aligning the ankle crease with the second digit, and hold for 10 seconds. Repeat 5 times per side. Then, elevate both heels and descend one slowly below the surface. Repeat. Complete 3 sets of 10 repetitions per leg.
RUNNER’S KNEE
a.k.a. patellofemoral pain syndrome
What it feels like
Dull soreness around or beneath the patella, intensified by descending stairs or slopes.
Why it happens
Faulty biomechanics from proximal or distal issues, such as gluteus medius weakness, cause inward leg rotation, misaligning the patella within its groove; overuse aggravates this.
The fix
Target gluteus medius reinforcement with clamshell movements:
Lie on the left side with stacked hips, knees, and ankles bent at 90 degrees; loop a mini band above the knees. Externally rotate the right hip to separate the knees. Return to start. Perform 10 repetitions. Switch sides. Additionally, incorporate lateral walks for glute activation:
Secure a mini band at the ankles and widen stance for tension. Advance with the right foot, followed by the left. Proceed forward for at least 5 steps, then reverse. Complete 3 cycles.
BLACK TOENAILS
What it feels like
Minimal sensation or tenderness with swelling upon contact.
Why it happens
Repeated impact during gait toe-off, where extended toes contact the shoe’s toe box, accumulates subungual trauma and hematoma.
The fix
Typically, no intervention is required beyond ensuring ample shoe space; allow natural resolution. For persistent pain, seek professional drainage early. If detachment occurs, apply antimicrobial ointment and a bandage. Maintain short nails and verify a thumb’s width from the longest toe to the shoe’s end.
HAMSTRING STRAIN
What it feels like
Discomfort at the hamstring’s proximal attachment near the glutes, particularly during ascents or high-intensity efforts.
Why it happens
Quadriceps dominance tilts the pelvis anteriorly, elongating hamstrings, while hip and glute deficiencies overload them, causing microdamage and fibrosis.
The fix
Enhance hamstring capacity with bridging progressions:
Lie supine with bent knees, feet grounded, arms at sides. Elevate hips via heel pressure, avoiding lumbar hyperextension. Extend feet outward to near-straight knees, then retract. Descend gradually and repeat. Perform 3 sets of 8.
To counter glute fatigue, utilize the grasshopper pose:
Lie prone with chin on hands. Abduct knees maximally on the floor, uniting elevated toes. Elevate thighs slightly while maintaining torso contact. Descend. Complete 3 sets of 15 repetitions.
STRESS FRACTURE
What it feels like
Localized throbbing or burning along a bone, tender to palpation, worsening with activity; common sites include metatarsals, tibiae, and pelvis.
Why it happens
Excessive skeletal loading, frequently from training intensification without adequate progression.
The fix
Prioritize recovery, as healing spans four to eight weeks based on extent; avoid weight-bearing to prevent prolongation. With physician approval, engage in non-impact alternatives like aquatics or cycling. Medical assessment is crucial to identify etiologies, including nutritional shortfalls.
PAIN ON TOP OF FOOT
What it feels like
Surface irritation or lancinating pain extending into the toes.
Why it happens
Constrictive footwear compresses the forefoot, inflaming metatarsal nerves or causing neuromas.
The fix
Adjust laces for laxity or select shoes with expanded toe boxes; employ toe spacers to realign and decompress digits.
HIP BURSITIS
What it feels like
Acute or chronic soreness on the lateral upper thigh or hip, exacerbated by pressure such as during recumbency.
Why it happens
Frictional irritation inflames the trochanteric bursa, often from overuse, biomechanical imbalances, or gluteal insufficiency.
The fix
Decompress the region with sartorius elongation:
Sit with legs flexed ahead. Direct both knees leftward at 90 degrees, reclining on the left elbow. Contract glutes, thrust hips forward, and descend the right knee groundward. Sustain for 20-60 seconds. Repeat contralaterally.
SHOULDER PAIN
What it feels like
Dull aching or cramping in the shoulder musculature.
Why it happens
Excessive upper body tension or suboptimal posture from upper or lower back weaknesses—often sedentary-induced—overburdens the trapezius and scapular elevators; shallow breathing elevates shoulders rather than expanding laterally.
The fix
Improve scapular stability to retract shoulders via modified push-ups:
Assume a plank with hands beneath shoulders and feet aligned, body linear. Pinch scapulae together without elbow flexion or hip sag. Separate them actively. Repeat. Perform 3 sets of 5.
Fortify posterior upper body with Y-W-T sequences:
Lie prone with extended limbs. Form a Y with arms, elevate head, shoulders, and arms while gazing downward. Descend. Transition to W by drawing elbows, elevate again. Descend. Extend to T, elevate. Descend. Complete 3 sets of 8-10 repetitions.
FAQ
When should I seek professional medical advice for a running injury?
Consult a healthcare provider if pain exceeds a moderate level (6-7 on a 10-point scale), interferes with routine activities, or lasts longer than two weeks. Symptoms like numbness, tingling, or weakness warrant immediate evaluation.
How can I prevent common running injuries?
Gradually increase training volume, incorporate strength exercises for key muscle groups (e.g., glutes, core, and calves), ensure proper footwear fit, and include regular stretching and foam rolling in your routine.
Is it safe to continue running with mild pain?
Mild discomfort may be manageable with modifications, but persistent or worsening pain indicates the need for rest or cross-training to avoid aggravation.
What role does nutrition play in injury recovery?
Adequate intake of calcium, vitamin D, and protein supports bone and tissue repair; consult a specialist if deficiencies are suspected, particularly for stress fractures.
How often should I replace my running shoes?
Replace shoes every 300-500 miles, depending on usage and wear, to maintain cushioning and support, which helps prevent injuries like shin splints or plantar fasciitis.
Disclaimer: Quest Quip is not a doctor; please consult one. Don’t share information that can identify you.