Common running injuries and how to prevent them

profile picture of Brad Green
MSK Physiotherapist
17 August 2023
Next review due August 2026

Running is a popular way to keep fit and physically active. In England alone, nearly 6 million people say they run regularly. Although it can have many benefits, running also comes with the risk of injury if not done correctly.

Here, I’ll look at some common running injuries and ways you can prevent them happening.

A man running in the city

Risk factors for a running injury

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

  • Increasing the speed, intensity, or distance of your runs too quickly.
  • Muscle imbalance or weakness.
  • Improper technique – for example, when running on an uneven surface.
  • Having a low running cadence (the number of steps you take per minute). If you take fewer steps, you’re taking larger strides, which increases the impact.
  • Running in old or outworn shoes.
  • Not enough recovery time.

Some injuries may be caused by more than one risk factor. 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 – this means you’re training hard and not giving your body enough time to recover.
  • Trauma (falls and collisions).
  • Fractures and dislocations.
  • Sprains and strains (ligament and muscle injuries).

Most running injuries are due to overuse.

What are the most 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 injuries

Iliotibial band syndrome

This is most common cause of outer knee pain in runners. It develops when your iliotibial (IT) band rubs against the lower end of your thigh bone (femur) and becomes inflamed. You’re more likely to get Iliotibial band syndrome if you have weak hip muscles and are over-training.

Patellofemoral pain syndrome (runner’s knee)

The main symptom of patellofemoral pain syndrome is a dull, aching pain around and in front of your knee, or behind your kneecap (patella). This pain gets worse after activities that add stress to the kneecap, such as climbing stairs, squatting, or running. Patellofemoral pain syndrome is sometimes called ‘runner’s knee’ because it’s more common in people who run. The exact cause isn’t known but it’s thought that over-training, weak hip muscles, or weak thigh muscles could contribute.

Patellar tendinopathy

Tendinopathy is a general term that describes a loss of function in a tendon over time. The patellar tendon is in your knee, and it’s thought that repeated stress can lead to patellar tendinopathy. Symptoms of patellar tendinopathy are usually a combination of pain, swelling, and not being able to perform as well as before.

Foot and ankle injuries

Ankle sprain

If you twist or turn your foot beyond its normal range of movement, you might sprain it. A sprain can stretch or tear the ligaments that support your ankle joint. This can cause your ankle to be painful and swollen. A badly sprained ankle can also prevent you from being mobile and running 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. Achilles tendinopathy is one of the most common running-related injuries.

Plantar fasciitis (or plantar fasciopathy)

The most common cause of persistent heel pain. If you have plantar fasciitis, you might find that the pain is worse after rest, but gets better as you become active. Around one in 10 people who run regularly develop plantar fasciitis.

Hamstring injuries

Hamstring strains

These are 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
  • 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 and lower leg injuries

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 can be caused by overuse and repetitive activity. This overuse means that the bone doesn’t repair properly after it’s placed under increased load. The tibia is a common place for stress fractures in runners.

Calf strains

Your calf is made of three muscles (gastrocnemius, soleus, and plantaris). If you strain one of these muscles, you might feel pain and tightness in your calf that’s made worse by walking or jogging.

How to prevent running injuries

1. Invest in some good trainers

The best thing about running is that you only need a good pair of trainers to do it. You don’t need a gym membership or expensive equipment to run. But make sure you get a pair of shoes 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 advisor can check how they have been worn down.

2. 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. If you’d like to increase your distance, why not try one of our long-distance training plans ? These are designed to gradually build up your fitness over several weeks.

3. 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.

4. Warm up and cool down

Spend five to 15 minutes warming up before a run. Do some light aerobic activity, such as jogging on the spot or walking quickly, to warm up. Although there’s no conclusive evidence to suggest that stretching before a run can lower your risk of injury, it may help you to mentally prepare.

After your run, try spending 5 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. You might find it’s more effective to stretch after a run because your muscles have warmed up.

5. Have recovery days

Running too much can increase your risk of injury through overuse. Have recovery days where you don’t run. This gives your body a chance to rest. And try to alternate easy runs with longer or more intense runs. This helps your body to adapt, and to repair muscle.

6. Combine your running with strength training

Regular strength training, such as using weights and doing body weight exercises, can reduce your risk of injury. You should aim to do two strength training sessions a week. You could also try our 15-minute bodyweight workout if you’re not sure where to start. Cross-training – which involves doing another form of exercise to running – can help you build strength and flexibility, too.

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.

profile picture of Brad Green
Brad Green
MSK Physiotherapist



Sheila Pinion, Health Content Editor at Bupa UK

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