Preventing and managing running injuries

Laura McCrystal
Laura McCrystal Monday, 18 November 2019

Preventing and managing running injuries

Key tips for preventing and managing the 6 most common running injuries.

Preventing and managing running injuries

Do you dream of being that runner where every mile is 100% pain free? No aches, no twinges or niggles, no lingering soreness  Well, you are not alone; evidence  shows that as up to 79% of runners get injured at least once a year.  Think about that number for a moment; nearly 8 out of every 10 runners you see at your next race have been or will be injured sometime that year.

Think of running niggles and pains on a scale. At one end you have severe, full-blown injuries, otherwise known as  the  red zone,  that require time off. The other end, where you're in top form, is the green zone. Mild, dull aches that bug you one day and reduce the next falling closer to the green end. Unfortunately, many runners get stuck in the middle, in the not-quite-injured but not-quite-healthy or the  yellow zone.  Staying  in the green zone depends largely on how you react to that first experience of pain. Often a little rest , or reduction in , with some treatment, can prevent a lot of time off later. Developing a proactive  injury-prevention strategy, such as strength training, stretching, regular massage and foam-rolling, can help keep you in the ‘green.’ Physiotherapy is a lot like homework, not all of us like having to do it, but if you don't do it, you’re sure to get in trouble at some stage! There is no one size fits all to this program as it depends on many factors and the way you body adapts.

So, what causes running injuries?  

There are a many of theories as to what causes running injuries, however the most obvious one is running! Evidence has stated that “running practice is a necessary cause for RRI (running-related injury) and, in fact, the only necessary cause.” With running being the key risk factor for running injuries, what other factors influence risk? Historically a lot of emphasis was placed on intrinsic factors such as  leg length discrepancy, pronation (flat foot), high arches, genu valgus/varum (knock knee or bow legged) and extrinsic factors like ‘special’ running shoes being stability shoes or anti-pronation shoes, lack of stretching. However, recent studies have shown there is no one specific risk factor that has a direct cause-effect relationship with injury rate or injury prevention.

There is however one specific factor that has been proven, and that is training error. Estimates suggest that anywhere from 60% to as much as 80% of running injuries are due to training errors. I touched on this topic in my previous blog (

Runners become injured when they exceed their tissues' capacity to tolerate load. A combination of overloading with inadequate recovery time. Poorly perfused tissues, such as ligaments, tendons and cartilage, are particularly at risk because they adapt more slowly than muscles to increased mechanical load. 

Factors that affect how much training load a runner can tolerate before injury will also have a role. There are 2 key factors that appear to play a part in this – body mass index (BMI >25) and history of previous injury. While high BMI and previous injury may reduce the amount of running your body can manage, strength and conditioning is likely to increase it.

There is a growing body of evidence supporting the use of strength training to reduce injury risk and improve performance. Training error and injury risk share a complex relationship - it may not be that total running mileage on its own is key but how quickly this increases and also the intensity of hill and speed training. The old saying of “too much, too soon” is probably quite accurate.  You can find out more on injury prevention, with recommended exercise leaflets, at the link below.

What are The Most Common Injuries to be Aware of?

Body tissues such as muscles and tendons are continuously stressed and repaired daily, as a result of both 'normal' functional activities and sport. An overuse injury often occurs when a specific tissue fails to repair in the time available, begins to breakdown initially at cellular level and then over time develops into a true injury. So, the first time you feel a soreness, a stiffness or a pain is not necessarily when it all began.

The most common injury is ‘runners knee’ or patellofemoral pain syndrome and accounts for over 40% of running injuries. This is followed closely by plantar fasciitis, achilles tendinopathy and then ITB (iliotibial band syndrome), shin splints and hamstring strain. These injuries generally need a period of  rest or at least a reduction in training volume and intensity. Followed by physiotherapy . Although these are overuse injuries there is frequently an underlying muscle weakness and/or flexibility issue that needs to be addressed with specific rehabilitation exercises. Follow this link to find more specific information about each of the most common running injuries with specific rehabilitation leaflets for you to use.

You can find our prevention and treatment guides for the following running injuries at this link:


  • Medial tibial stress syndrome (shin splints)
  • Patellofemoral pain (runner’s knee)
  • Achilles tendinopathy
  • Plantar fasciitis
  • Hamstring strains
  • Iliotibial band syndrome


While guidance can be given, it is general in its nature, whereas individual complaints may need individual attention. If you do pick up an injury (including 'tightness' 'irritation' or 'niggle') that you are worried about then we can help, the sooner it’s treated the better.

If you need any more advice or have one of these injuries and need some treatment then get in touch with us at LMC Physiotherapy and we will work with you to get you back in the running green zone.


Thanks for reading


Related articles