Most Common Running Injuries: How to Diagnose, Prevent and Treat

Most Common Running Injuries: How to Diagnose, Prevent and Treat

Diagnose, Prevent and Treat Common Running Injuries

Running is not an easy exercise; it puts a lot of pressure on your bones, joints and muscles. Ideally, every step of the way would be pain-free, but injuries are bound to happen. The good news is that they can be prevented – you have to eat, train and run “smart.”

Your smartest move will be to listen to your body, Jesse Thomas, pro-triathlete, an Ironman champion and a 5x Wildflower Champ, says. You can’t stop runners from running. “But one of the biggest differences between elite athletes and recreational runners is body awareness,” he adds. You may be one run away from a serious injury.

As you get more experienced, you will undoubtedly get more sensible. The recovery process will change, as was the case for Meb Keflezighi, a long distance runner, the first American man to win the 2014 Boston Marathon, and winner of the 2009 New York City Marathon and the 2012 Olympic Marathon Trials. “I am getting wiser, not faster. I take more recovery days now than I used too,” he adds.

There is no reason why professional or amateur runners should get into a cycle of running, getting injured and recovering. You just have to be aware of what you may be doing wrong.

1. Knee Pain/Runner’s knee

Runner’s knee is  damage to the cartilage under the kneecap. It’s one of the most common overuse injuries. Check with your doctor if you feel discomfort around the knee bone when you run or climb stairs. Knee pain can be caused by strength imbalances, weak hip muscles or over-pronation. Make sure you perform exercises to increase strength in the quadriceps, hips and hamstrings. Ice packs, physical therapy and anti-inflammatory pills are used for treatment. 

2. IT Band syndrome

Iliotibial band syndrome is one overuse injury Josh Cox, U.S. 50k Record Holder, has sustained the most in his career. It’s a painful condition in which the ligament gets too tight and rubs against the thighbone. If you have it, you’ll feel pain between the hip and knees and it will get worse as you are physically active. Rest, pain relievers, anti-inflammatory pills and sometimes steroids are usually prescribed to treat the injury. 

3. Stress fractures


“In the 2007 [Olympic marathon] trials I could not walk or stand because of a stress fracture,” Keflezighi says. Stress fractures, small cracks in a weight-bearing bone of the body, are tricky because runners usually have high tolerance for pain due to the release of endorphins. However, if you feel more pain as a run progresses and a sore type of pain after a run,, you may have the injury. Swelling is also a sign. Surgery may be required. Other treatments are suing a walking boot, brace, or crutches.

4. Plantar fasciitis


Plantar fasciitis is another very common injury Cox has sustained several times. The inflammation of a thick band of tissue connecting the heel bone and the toes will cause pain in the heel or arch of the foot. This injury can be self-diagnosed – it usually hurts the worst in the morning after you wake up and make a few steps. Depending on how serious the injury is, you may need physical therapy, shoe inserts, steroid injections, or even surgery.

5. Shin splints


The pain is usually caused by overuse along the shinbone. The inflammation of the front part of the tibia is also a common injury for basketball and tennis players. Shin splints, which can be treated in days, are common among new runners because the body, and bones, are not used to the new strenuous activity they are subjected to on regular basis now. Shin splints are usually self-treatable – rest, apply ice, and maybe consider taking pain relievers.

6. Hamstring strain

“Hamstring strains are pretty common,” Thomas says. The hamstring muscles run down the back of the thigh. A strain can be a pull or a (partial) tear. Because the hamstring helps you extend your legs and bend your knee, a strain, which is caused by overloading the muscles, will affect your ability to do either. Muscle tightness, imbalance and fatigue are common risk factors. Rest, ice, compress, elevate, stretch and take anti-inflammatory painkillers.

7. Ankle sprain

“Those are the worst,” Thomas says. This injury usually occurs when the ankle twists or turns in an unnatural way. That can happen when you lose your balance, Thomas adds. While the pain may subside after a few minute, the ankle may still swell. If left untreated, it can lead to long-term problems. The treatment includes rest, ice and pain relievers.

8. Achilles tendonitis/inflammation

Inflammation in the Achilles tendon, which connects the calf muscle to the heel bone, usually occurs when you’re suddenly overloading the muscle. Examples are running a lot more miles than the previous day or week or excessive amount of interval training. Lack of flexibility and rest can are also risk factors. Treatment includes rest, slowing down with your training, not putting much pressure on the Achilles, and no hill running. Icing the area will always help.

9. Warm up

“I’m a believer in easy activity to warm the muscles up before engaging in any activity,” Cox says. “After that, having a dynamic warm-up routine is beneficial as it activates the muscles you will use during the workout, thus preventing injuries.” Stay on soft surfaces and wear a good pair of running shoes, he adds.

10. Forget about “no pain, no gain”

“Early on, this is a recipe for disaster,” Cox adds.  The “good pain” in running is the burning of the legs and lungs while you push yourself, he adds.  The “bad pain” is joint or ligament pain that should be addressed and not pushed through.

Don’t let the pain level go beyond seven out of 10, Thomas adds. “Before you know it, you’re passed an injury.”

11. Eat right


Nutrition and fueling the body is really important,” Thomas says. “Under-fueled muscles will give out.”

Cox recommends fueling with carbohydrates and protein post-workout (he uses PowerBar protein bars and the ready to drink protein mix), eating a variety of vegetables and consuming plenty of water daily.

Keflezighi eats eat vegetables, salad, protein and carbs. His cheat foods are sweets. “I love cheesecake and tiramisu.” He also eats a PowerBar a couple hours after a workout.

12. Recover right


Recovering right is a crucial element contributing to a bigger goal, Keflezighi says. “When I have aches and pains I take a day off; when I am sick I take a day off.” It’s better to skip your workout than to risk injury. When you think you’re ready to go back, take another day. “One day longer than you think you should, so you don’t relapse,” he adds.

13. Change your sneakers

“I change my sneakers every month or month and a half,” Keflezighi says. “The dirt and grass wear them out.” Cox recommends changing your running shoes at least every 400-500 miles.

14. Get better running shoes

Running shoes are a growing business. There are new materials and new shoe manufacturing techniques created all the time. They all can affect your running performance. Forget about the barefoot/minimalism craze, Thomas says. Don’t run on super low profile, he adds. Make sure your sneakers fit well, provide enough support, and are comfortable.

15. Don’t make drastic changes in your training

“Don’t do too much too soon,” Cox says. “Be patient with the process.”

“Massive changes in training load in general can definitely hurt you,” Thomas adds. The extra fatigue that is going to the body is not doing your muscles any favors.  Follow the 10-percent standard – don’t increase your weekly mileage by more.

16. Run in proper form

New runners often shift back on their heels and look like they are sitting, Thomas says. “A good runner has a forward leaning posture,” he adds. “Amateurs do the opposite and injuries follow.” Your shoulders should be low and loose. Look ahead when running, not down at your feet. Keep your hands in and relax your fists.

17. Stretch before and after

This is very important if you want to achieve bigger goals, Keflezighi says. But make sure you know the proper stretches before and after you run or work out. Dynamic stretching (you stretch as you move) is what you should be doing before the strenuous activity to warm the muscles; then cool down with static stretches (you stretch as the body is at rest).

18. Balance exercises

Balance exercises are “super important” in preventing ankle injuries, Thomas says. Stand on a controlled but unstable surface, like a bosu ball, and maintain your balance for a minute or two. Other exercises include scissor hops, jumping squats, bounding and calf raises.

19. Get regular massages

Regular massages, whether self-massages or deep tissue, are  good preventive measures, Thomas says. They help with stiffness and soreness and with healing wear-and-tear. Blood circulation is improved and the muscles are relaxed, allowing you to recover faster and maintain optimal running performance.