Common Running Injuries

Running is one of the most popular and accessible forms of exercise, but due to its highly repetitive and high impact nature, runner’s may be at risk of a whole host of potential injuries. Whether you’re a seasoned marathoner or just starting out, knowing the common injuries runners face and why they happen can help you stay on track and injury-free.

1. Patellofemoral Pain Syndrome (PFPS) also known as “anterior knee pain”

Sometimes referred to as “runner’s knee”, PFPS is one of the most commonly experienced injuries in runners (and in most athletic populations). Pain may occur anywhere around the front aspect of the knee, usually but not always close to the kneecap. It may be associated with swelling, clicking, creaking, or a feeling of discomfort or locking about the kneecap. It is usually aggravated by loading the knee during running, stairs, hill running, squatting and even sitting or walking for long periods. The causes of PFPS are multifactorial and include external factors such as your training loads, footwear, terrain, recovery (or lack thereof) and internal factors such as your pelvic, hip and knee anatomy, muscle imbalances, and poor neuromuscular control.

2. Medial Tibial Stress Syndrome (MTSS) also known as “shin splints”

MTSS is pain experienced along the inside edge of your leg bone, close to the ankle. Pain can vary from mild to sharp, may start immediately or part-way into a run, and may even cause residual pain following a run for minutes to several hours, to the next morning. Progressed cases may cause constant daily pain. MTSS is a bone stress injury that will eventually progress to stress fracture if managed poorly (or not at all). The primary cause is an error in load management i.e. the training loads are too high, to the point the bone can no longer tolerate the load asked of it and recover adequately before the next session. Other factors such as muscle imbalance, poor biomechanics and footwear can also contribute.

3. Iliotibial Band Friction Syndrome (ITBFS) or “lateral knee pain”

ITBFS occurs when the ITB, a thick band of connective tissue on the outside of your thigh, rubs against the outside of the thigh bone at the knee (the lateral femoral condyle), causing friction and inflammation, and eventually pain. It is again an overuse injury that is highly aggravated by lots of downhill running and stairs. Other factors such as your anatomy and hip and knee control all play a part.

4. Lower Leg Tendinopathy: Achilles, Tibialis Posterior and the Plantar Fascia.

Tendons are structures that are highly susceptible to load. They are the “elastic bands” of our body that allow us to jump and run and spring off the ground. When tendons are exposed to highly repetitive forces (such as running), and compression and friction, they can become weak and painful, termed tendinopathy. The biggest factors in tendinopathy development are significant fluctuations in training loads, coupled with deficits in strength and control. The three most common tendinopathies of the lower leg are

(a) Achilles tendinopathy: Pain on the heel or bone or on the achilles tendon itself

(b) Tibialis Posterior Tendinopathy and Tenosynovitis: Pain on the inside of the ankle just behind the ankle bone. The tendon can become tendinopathic, or a tenosynovitis may occur where the sheath of the tendon becomes inflammed and swollen

(c) Plantar fasciopathy: pain on the bottom of the foot on and around the heel. It can be excruciatingly painful to walk, especially on your first few steps getting out of bed

5. Tendinopaties around the hip

The causes of tendinopathy about the hip are much the same as those in the lower leg.

(a) Proximal Hamstring tendinopathy: pain at the “sit bones” at the bottom and back of your pelvis where your hamstrings attach. This is particularly painful to sit on and during running, stairs, and running uphill.

(b) Greater Trochanteric Pain Syndrome (a.k.a hip bursitis/gluteal tendinopathy): pain on the side of your hip which is painful to sit, run and walk for long periods, and may be sore to lie on.

Interestingly, women are more susceptible than men to developing both these tendinopathies due to anatomical and physiological differences associated with pelvic structure and hormonal differences, muscle imbalances, and activity patterns.

6. Bone stress injuries

These injuries more commonly occur in weight-bearing bones of the shin, foot and thigh-bone and is caused by an imbalance and bone breakdown following activity and bone repair. When bone is exposed to high loads above what it can tolerate the breakdown exceeds repair, and stress reactions start to occur causing a deep ache during and after activity and at night. If left to progress, full-blown stress fractures occur, which are tiny breaks in the bone that will show up on x-ray. Once fractured, the bone will need to undergo a period of immobilisation and sometimes non-weight bearing to optimise healing. And unfortunately, this means extended periods (at least 3-6 months) of no running.

If you are experiencing any of these symptoms, we recommend you book an initial consultation to have your injury and potential causes assessed and addressed. Interested in learning how to prevent these injuries from occuring? You can book a Runner’s Strength and Conditioning session to discuss your training habits and receive recommendations on mobility and strength training to prevent injury. You can find out more here