The 5 most common running injuries, how to prevent them, and when you need help

Why do YOU run? Is it to regulate your weight? Do you want to compete in an ultra-marathon? Or maybe somewhere in-between? Maybe you like the solidarity, or the sense of belonging if you run in a group?

No matter what your reason, or how far along the journey you are; keep it up! It is well documented that consistent aerobic exercise decreases cardiac load (and risk of heart disease), and encourages lipolysis (yay, fat burning!). To add to the physiological benefit, there is also a long list of psychological changes that runners report stress relief, increased sleep quality and subsequently concentration, and decreases in symptoms of depression (just to name a few) and they wholly attribute it to running.

But today I’m writing about the dark side of running; injuries. No one likes to be injured, not only does it affect your sport, but it typically affects other aspects of you social and work life.

Each year, it is estimated that around 50% of the running population will develop an injury

Now, getting injured depends on a number of factors such as; age, gender, weight, muscle strength, flexibility, and running style (gait), and to elaborate on each of these factors for each of the following conditions would both take me too long to write, and most likely be too long for you to read!

So in an effort to keep this blog short(ish); please see below for the 5 most common injuries in runners!

Patella-Femoral Pain Syndrome (PFPS)


Accounts for 40% of running complaints. The condition is so common in running that along with ITB syndrome, it is colloquially known as “Runners Knee”. It is characterized by a pain in the front of the knee, typically beneath the patella (kneecap), and gets worse throughout physical activity. You may find it most painful when you run down-hill or climbing stairs. PFPS is a complex injury as it is not due to a single muscular imbalance or biomechanical (human movement) issue, but rather a combination, resulting in a mal-alignment of the patella in the knee joint. To complicate it further, it can be confused with a bursitis or tendonitis in the knee joint. Each PFPS case is as individual as the person who has it, so assessment by a qualified health professional is encouraged in order to accurately identify the issue, and cater treatment to them. Due to the nature of PFPS preventative measures differ between people; but maintaining good muscle tone and flexibility around the knee and hip joints is going to be your best bet.

Illiotibial Band (ITB) Syndrome

The less common cause of “Runners Knee” (accounting for up to 22% of running injuries). The ITB connects the iliac crest (top of the pelvic bone) down to the outside of the knee and is integral in stabilising the knee and hip during gait. Expect to feel a sharp pain in the outside of the knee, worse when descending hills. The predominant theory behind ITB syndrome is that the band “flicks” across one of the bony prominences at the knee causing it to become inflammed, resulting in sharp pain in the associated area. The reason the ITB rubs over the bony projection is varied as it comes down bone structure, muscle weaknesses and excessive tightness’. For this reason you are best off seeing a health professional in order to address the cause of the altered biomechanics, but applying ice to the painful area and using a foam roller on the ITB will help to relieve the tension.

Achilles Tendonitis (11%)

Coming in as the third most common of the running complaints, and accounting for 11% of injuries is Achilles tendonitis. The Achilles is the thick tendon at the back of your heel, and translates calve activity into ankle movement. If it is inflammed you will feel pain in the back of the heel or anywhere along the tendon, and may be aggravated when rising onto the balls of the foot. Achilles tendonitis can be due to irritation from the heel cup of footwear, habitual wearing of high heels or a sudden increase in exercise. More often than not, it is caused by excessive calve tightness and eversion of the heel bone (pushing out to the side). This changes the angle of pull of the calve muscles and results in irritation of the tendon. Important to know that if it isn’t addressed swiftly that potential ruptures can occur, and surgical intervention will be needed. Temporary relief may be experienced by raising heel height (and reducing load on the tendon), massage to the calves, ice to the painful site and cessation of activity.

Tibial Stress Syndrome

Another really common condition, known as “Shin splints”. There are two main types, medial (inside) and anterior (front), which denote the specific area in the leg that the condition affects. It typically feels like a strong ache in the leg somewhere along the length of the shin bone (tibia) and gets progressively worse throughout the run. A little bit simpler to explain than PFPS; tibial stress syndrome is due to the muscles inability to stop rapid foot and ankle movement. Its root cause is attributed foot mechanics and flexibility, as well as improper running technique. The simplest preventative action individuals can take is to ensure they have good quality running shoes, which will at least give the feet good shock absorption and offer some support where necessary. Footwear is a HUGE component of running, and will be addressed separately in another post.

Stress Fracture (Overuse)

Unlike a standard bone fracture, stress fractures are not due to a sudden impact or load. These fractures affect people who regularly run or report increased periods of physical activity. They are most common in the bones of the forefoot but can affect the midfoot, heel bone and shin bone. Overuse stress fractures are the result of a bones inability to bear the force going through them repetitively, resulting in micro-cracks which do not heel between training sessions. Less commonly, fatigued muscled can result in stress fractures (such as in the case of shin splints). They typically present during a seemingly normal run, occasionally with an audible ‘crack’ and immediate pain and swelling. Immediate cessation of activity is necessary and it is important to get checked by a health professional as soon as possible as further complications can develop if not addressed (bone and joint deformity).

Below are some honourable mentions, as in the world of sport a lot of conditions present similarly and simultaneously and it would be remiss of me to not mention them.

Plantar Fasciitis

If you experience pain in the heel and bottom of the foot during or in the days following a run then this may be your culprit. Inflammation of the big piece of connective tissue in the foot accounts for 15% of ALL lower limb medical consultations. I have already addressed Plantar Fasciitis in another post so it you wish to read more you will find it HERE.

Compartment Syndrome

Typically affecting the deep muscles of the lower leg, and felt in the back of the calve. It happens when muscles swell within the “compartments” in the lower leg, preventing blood from entering the muscles and resulting in muscle cramps and very firm musculature.

Ankle Sprains

Trauma to the outside (typically) of the ankle. Characterised by a sharp pain and immediate swelling. Inability to weight bear (depending on the level of damage) and bruising. Can be due to muscle tightness’, gait, foot mobility or misfortune! Important to seek medical advice to check for fractures, test ligament integrity and begin a rehabilitation program.


Painful collections of fluid that ‘bubble up’ underneath the skin. Common on the balls of the foot, the little toes, and the Achilles tendon, and are a result of rubbing. Easily prevented by correct footwear fitment. Do not burst the blister as you can introduce bacteria and cause skin infections. If they are causing excessive discomfort, seek out your Podiatrist for assistance.

So there you have it, the 5 most common running injuries in runners (and some extra). When exercising please be sure to wear the appropriate protective gear (jackets/sun cream/reflective clothing), and adequately warm up and cool down/stretch after exercise.

If you find yourself experiencing any of the symptoms mentioned, or simply want to make sure you’re in good working order, make an appointment at Podiatry First. We are experts in treatment and management of running injuries and we can work together to keep you running for years to come!

Thank you for reading!

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