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Common running injuries and how to prevent them

Physiotherapist at Bupa UK
30 September 2020

During 2020, there has been a shift in how we exercise. As lockdown came into force in late March, people had to rethink their routines, habits and ways to keep active. With people craving the outdoors more, or perhaps lacking space or gym equipment at home, there has been an increase in people running.

A study from Bupa UK has revealed that two in three UK adults have been taking advantage of time in lockdown to exercise. Although an increase in exercise is a positive, it can come with the risk of injury if not performed correctly. Running especially puts strain on your knees, ankles and feet.

Here I’ll look at some common running injuries and ways you can prevent them happening in the first place.

Risk factors for a running injury

There are some things that put you at greater risk of injury.

  • Being overweight.
  • Running a high distance each week.
  • Having a low running cadence (the number of steps you take per minute).
  • Running in old or outworn shoes.

The most common risk factor, however, is having a previous injury, so preventing a first injury should be a key focus.

Sport injuries, in general, can be divided into four categories.

  • Overuse.
  • Trauma (falls and collisions).
  • Fractures and dislocations.
  • Sprains and strains (muscle and ligament injuries).

Most running injuries are due to overuse.

Common running injuries

The most common running injuries affect the knee, foot and ankle, hamstrings (the muscles at the back of your thigh) and tibia (bone in the lower leg).

Knee

Iliotibial band syndrome. The most common cause of pain on the outside of the knee in runners and other sports people. It develops when your iliotibial (IT) band becomes inflamed because of excessive friction with the lower end of your thigh bone (femur). You’re more likely to get Iliotibial band syndrome if you have weak hip muscles or poor flexibility through your quadriceps (thigh muscles).

Patellofemoral pain syndrome (runner’s knee). A general term for pain in the front of your knee, behind, or around your kneecap (patella). It’s thought to be a result of excessive stress on the joint between your kneecap and your thigh bone (femur). Patellofemoral pain syndrome is sometimes called ‘runner’s knee’ because it’s particularly common in people who run.

Patellar tendinopathy. An overuse injury where the tendon that joins your kneecap (patella) to your shin bone (tibia) becomes painful, especially when exercising. Tendinopathy is a general term that describes tendon degeneration (deteriorates over time and loses function). Symptoms are usually a combination of pain, swelling and the inability to perform as well as before.

Foot and ankle

Ankle sprain. A very common running injury that can happen when you twist or turn your foot beyond its normal range of movement. This can stretch or tear the ligaments that support your joint. Your ankle may be painful and swollen, and a badly sprained ankle can put you out of action for several weeks.

Achilles tendinopathy. An overuse injury to the tendon that runs down the back of your lower leg to your heel. You may get pain, stiffness and sometimes swelling that makes it hard for you to move freely.

Plantar fasciitis (or plantar fasciopathy). The most common cause of persistent heel pain, although you can also have pain in the arch of your foot. Around one in 10 people who regularly run develop plantar fasciitis.

Hamstring Injuries

Hamstring strains. These are very common among runners. You’re more at risk of a hamstring strain if you:

  • have poor flexibility of your hamstring muscles
  • don’t warm-up before running
  • are fatigued
  • have a previous injury

You will feel pain at the back of your thigh and may have some bruising and swelling.

Chronic hamstring tendinopathy. Hamstring pain can become chronic when a damaged tendon doesn’t heal properly and becomes degenerative. This is when the tendon deteriorates over time and loses function. You may feel pain at the back of your thigh or deep in your buttock. It usually gets worse when you try to run or sit for long periods of time.

Tibia

Shin splints. This is the name for pain in your lower leg between your knee and ankle. It’s caused by repetitive impact, especially if you run on hard surfaces such as a road.

Tibial stress fracture. A stress fracture is a small crack in a bone, or severe bruising within a bone. Stress fractures are caused by overuse and repetitive activity. The tibia is a common place for stress fractures in runners.

Preventing running injuries

Invest in some good trainers

The best thing about running is that you only need a good pair of trainers to do it. No gym memberships and no expensive equipment. But make sure you get a pair that matches the shape of your feet and lets you run naturally.

Some specialist sports shops can watch you run and advise you on the best trainers for you. If possible, take an old pair of trainers with you so the adviser can check how they have been worn down.

Know your limits

When you’re running, notice how your body feels. If you’ve started to notice a twinge or some tightness, don’t ignore it and push on. If you’re new to running, start slowly and gradually increase how much you do. Our 5km walk to run training programme is a great place to start. Going in too hard or too quickly can cause an injury.

Fuel your body

What you eat before, during and after you exercise can affect how well you perform. The right diet will support any training programmes you do and help you to recover more efficiently, reducing your risk of injury.

Warm up and cool down

Spend five to 15 minutes warming up before a run. Do some dynamic stretches (stretches that work your muscles and joints through their full range of motion) and light aerobic activity. Start your run with a fast walk or jog to warm up.

After your run, try spending five to 15 minutes cooling down. This involves light activity, such as walking and stretching your leg muscles. Some people think that stretching after running reduces muscle soreness the next day, but there's little evidence to support this. However, stretching does maintain and improve flexibility, which can help prevent injury.

Have recovery days

Running too much can increase your risk of injury through overuse. Have recovery days where you don’t run to let your body rest, and alternate easy runs with longer runs.

Combine your running with strength training

Strength training, such as using weights and doing body weight exercises, can significantly reduce your risk of injury. In fact, regular strength training (also known as resistance training) can half your risk of an overuse injury. Aim to do two strength training sessions a week. See our strength training home workouts for some inspiration.

Need a running plan? Visit Bupa’s running hub to find a plan suitable for your ability and the distance you want to run.


If you have a muscle, bone or joint problem, our direct access service aims to provide you with the advice, support and treatment you need as quickly as possible. If you’re covered by your health insurance, you’ll be able to get advice from a physiotherapist usually without the need for a GP referral. Learn more today.

Declan Leonard
Physiotherapist at Bupa UK

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