Most Common Running Injuries
Welcome to our detailed guide on running injuries and their treatment. Running is a fantastic way to stay fit and healthy, but it can also lead to various injuries due to repetitive impact and strain. From common issues like shin splints and plantar fasciitis to more severe conditions such as stress fractures, understanding these injuries is essential for runners of all levels.
This page provides insights into the most frequent running injuries, their symptoms, and effective treatment options, along with prevention tips to keep you moving safely and efficiently. Whether you’re training for a race or enjoying casual jogs, being informed can help you maintain your running routine and avoid setbacks.
Most Common Foot & Ankle Running Injuries
Ankle Stress Fracture
Microscopic cracks in the bone(s) of the ankle caused by overuse and repetitive stress on the bones. Most commonly involves the fibula bone (lateral malleolus) at the outer side of the ankle, but can also include the medial malleolus, distal tibia and talus bones. Typically seen in physical activities that involve a lot of running, jumping or walking.
Symptoms Include:
Pain and swelling, and difficulty weight-bearing. Treatment typically requires a period of immobilization in a boot-cast, followed by physiotherapy, massage therapy and chiropractic to address any biomechanical problems. Treatment also requires correcting running and jumping technique issues, better footwear, ankle brace, training adjustments and optimizing nutrition and bone health.
Achilles Tendonitis
Inflammation at the back of the heel and ankle where the Achilles tendon attaches to the heel bone. Typically caused by overuse in athletes that do a lot of running, jumping or walking, in combination with biomechanical issues (muscle tightness and weakness), techniques problems and improper footwear.
Symptoms Include:
Pain at the back of the heel, swelling and tightness. Besides acute injury management, treatment typically includes physiotherapy, chiropractic, massage therapy, better footwear, technique changes. Injections are NOT typically done for this injury.
Morton's Neuroma (Interdigital Neuritis)
Inflammation or mechanical irritation of a nerve between the toes, most commonly involving the third and fourth toes. Caused by compression and irritation of the nerve often caused by foot biomechanics, improper footwear (e.g. shoes too tight) and overuse (e.g., running, walking, jumping).
Symptoms Include:
Forefoot and toe pain, burning sensation, numbness and tingling in the toes. Treatment includes physiotherapy, better footwear, orthotics, forefoot pads, anti-inflammatory creams, toe flexor retraining exercises, and sometimes requires special injections or surgery.
Peroneal Tendonitis
Inflammation of the peroneal tendons which are located at the outer (lateral) side of the ankle. Typically caused by abnormal foot biomechanics, improper footwear, ankle instability, ankle sprains, repetitive overuse (e.g., running, jumping, walking), and soft or uneven playing surfaces (e.g., sand).
Symptoms Include:
Pain and swelling at the outside (lateral) part of the ankle. Besides acute injury management, treatment includes physiotherapy, chiropractic and massage therapy to address any biomechanical issues, adjustments in training and technique, proper footwear, orthotics, bracing and sometimes specialized injections.
Metatarsalgia
Mechanical irritation, and sometimes inflammation, at the ball of the foot, a part of the foot known as the metatarsal heads. Caused by abnormal foot biomechanics, improper footwear and overuse (e.g., running, walking, jumping).
Symptoms Include:
Pain in the ball of your foot, often feeling like you are stepping on a small stone. Treatment includes physiotherapy, better footwear, orthotics, forefoot pads, anti-inflammatory creams, toe flexor retraining exercises.
Plantar Fasciitis
Inflammation at the base of the heel where the plantar fascia attaches. The plantar fascia is a band of tissue that extends from the heel, into the arch of your foot to the base of your toes; its function is to help keep the shape or your arch. Plantar fasciitis typically occurs from a combination of overuse (running, walking, jumping, etc.), biomechanical issues (e.g., flat feet, weak ankle and foot muscles, tightness), running gait technique abnormalities, and improper shoes.
Symptoms Include:
Pain at the bottom of your heel especially the first few steps upon rising in the morning and with weight-bearing exercise, and sometimes local swelling. Besides acute injury management, treatment includes physiotherapy, chiropractic, massage therapy, home strengthening and stretching exercises, orthotics (custom arch supports), night splints, better footwear, improving running technique, and sometimes requires specialized injections.
Foot Stress Fracture
Microscopic cracks in the femur bone of the hip joint caused by overuse and repetitive stress on the bone. Typically seen in physical activities that involve a lot of running and jumping.
Symptoms Include:
Pain (typically felt in the groin area), stiffness, and difficulty weight-bearing. People with nutritional disorders and/or who have low bone density are pre-disposed to getting stress fractures. Hip stress fractures are especially serious and may have severe complications. Treatment often requires a period of non-weightbearing and may require surgery to stabilize the stress fracture. Treatment after the stress fracture heals, typically involves physiotherapy any biomechanical problems to prevent recurrences. Treatment also requires correcting running and jumping technique issues, training adjustments and optimizing nutrition and bone health.
Tibialis Posterior Tendonitis
Inflammation of the tibialis posterior which is located at the inner (medial) side of the ankle. Typically caused by abnormal foot biomechanics, improper footwear, ankle instability, ankle sprains, repetitive overuse (e.g., running, jumping, walking), and soft or uneven playing surfaces (e.g., sand).
Symptoms Include:
Pain and swelling at the outside (lateral) part of the ankle. Besides acute injury management, treatment includes physiotherapy, chiropractic and massage therapy to address any biomechanical issues, adjustments in training and technique, proper footwear, orthotics, bracing and sometimes specialized injections.
Most Common Knee Running Injuries
ITB (Iliotibial Band) Syndrome
Overuse injury that results in inflammation of the ITB which is a thick tight band that passes from the hip to the (lateral) part of the knee. Common in runners, especially when starting a running program or increasing the intensity, during or frequency of running.
Symptoms Include:
Lateral knee pain that is especially sharp and stabbing, and that often stops you from running. Besides acute injury management, treatment includes physiotherapy, gluteal muscle strengthening, stretching, massage therapy, chiropractic and other manual therapy. As with other overuse injuries, ITB syndrome requires addressing any contributing factors such as training techniques, body biomechanical issues and footwear. If especially troublesome, then specialized injections may be needed.
Patellofemoral Pain Syndrome (Runner's Knee)
Overuse injury that results in at the front part (anterior) of the knee, that is often felt as “around” or “beneath” the knee cap. Common in sports and exercise that involve running, jumping, squatting or repetitive knee bending.
Symptoms Include:
Pain and sometimes grinding sensations. Besides acute injury management, treatment includes physiotherapy, gluteal muscle strengthening, massage therapy, chiropractic and other manual therapy. Bracing, strapping and taping can also be used. As with other overuse injuries, patellofemoral syndrome requires addressing any contributing factors such as training techniques, body biomechanical issues and footwear.
Knee Osteoarthritis
Degeneration of the knee cartilage layer which acts like a shock absorber. Contributing factors include older age, previous serious injuries (e.g. ACL tears, tibial plateau fractures, large meniscal tears), heredity/genetics, and certain professions or activities that put abnormal straining on the knee.
Symptoms Include:
Pain, swelling, mechanical symptoms (e.g., grinding, catching, clicking), stiffness, and decreased range of motion. Treatment is multi-factorial and includes losing excessive weight, strengthening, appropriate exercise, pain medication and creams, anti-inflammatories, physiotherapy, bracing, supplements, injections and may eventually require knee replacement surgery if severe.
Most Common Hip Running Injuries
Hip Stress Fracture
Microscopic cracks in the femur bone of the hip joint caused by overuse and repetitive stress on the bone. Typically seen in physical activities that involve a lot of running and jumping.
Symptoms Include:
Pain (typically felt in the groin area), stiffness, and difficulty weight-bearing. People with nutritional disorders and/or who have low bone density are pre-disposed to getting stress fractures. Hip stress fractures are especially serious and may have severe complications. Treatment often requires a period of non-weightbearing and may require surgery to stabilize the stress fracture. Treatment after the stress fracture heals, typically involves physiotherapy any biomechanical problems to prevent recurrences. Treatment also requires correcting running and jumping technique issues, training adjustments and optimizing nutrition and bone health.
Hip Osteoarthritis
Degeneration of the knee cartilage layer which acts like a shock absorber. Contributing factors include older age, previous serious injuries, heredity/genetics, and certain professions or activities that put abnormal straining on the hip.
Symptoms Include:
Pain (often in the groin area), mechanical symptoms (e.g., grinding, catching, clicking), stiffness, and decreased range of motion. Treatment is multi-factorial and includes losing excessive weight, gluteal and core strengthening, appropriate low impact exercise, pain medication and creams, anti-inflammatories, physiotherapy, bracing, supplements, injections and may eventually require hip replacement surgery if severe.
Gluteal Tendonitis or Tear
Inflammation or tearing of the tendons at the outside (lateral) part of the hip. Typically caused by overuse with weight-bearing exercise, other repetitive motions or activities, and often related to gluteal muscle and core weaknesses. May be exacerbated by sudden twists or trauma. Often associated with trochanteric bursitis.
Symptoms Include:
Pain at the lateral side of the hip, pain with weight-bearing activities, sometimes pain with direct contact. Besides acute injury management, treatment includes physiotherapy, core and gluteal strengthening, massage therapy, chiropractic, topical anti-inflammatories, and specialized injections.
Most Common Lower Leg Running Injuries
Shin Splints (Medial Tibial Stress Syndrome or Tibialis Posterior Periostitis)
Straining and inflammation at the inner (medial) edge of the shin bone (tibia). Overuse injury caused when too much stress occurs at the medial tibia which is where the tibialis posterior muscle attaches and is an important running muscle. Caused by overtraining, biomechanical issues, running gait abnormalities, improper or worn-out running shoes, and running on surfaces that are too soft, too hard or too irregular.
Symptoms Include:
Pain along the inner shin bone, especially at the star of a run. Besides acute injury management, treatment includes physiotherapy to address biomechanical issues (e.g., muscle weakness, tightness, imbalances, alignment problems), other types of therapy such as massage therapy and chiropractic, new or proper running shoes, more gradual training regimen, and running gait analysis.
Calf Strain
Overstretching or tearing of the calf muscles which are important running muscles especially in the push-off phase of the running gait. When chronic, typically caused by overtraining, biomechanical issues, and running gait abnormalities. When acute, often caused by sudden running stops and starts.
Symptoms Include:
Pain (especially with the pushing off phase of the running gait), swelling, and stiffness. Beside acute injury management, treatment includes physiotherapy to address biomechanical problems, other types of therapy such as massage and chiropractic, stretches and strengthening exercises, running gait analysis, and more gradual increases in running.
It’s important to listen to your body, gradually increase training intensity, wear appropriate footwear, and seek professional advice if you experience persistent or severe symptoms. A sports medicine professional or physical therapist can provide a tailored treatment plan based on your specific situation.
Most Common Thigh Running Injuries
Hamstring Strain
Overstretching or tearing of the hamstring muscles which are important running muscles at the back of the thigh and function to bend the knee and extend the hip. In runners, often caused by muscle imbalances such as weak buttock (gluteal) muscles that put too much strain on the hamstrings when running. May be caused by a sudden running start or stop, overuse, inadequate warm-up, and muscle tightness.
Symptoms Include:
Pain at the back of the thigh. Besides acute injury management, treatment includes physiotherapy to address biomechanical problems, other types of therapy such as massage and chiropractic, stretches and strengthening exercises, running gait analysis, and more gradual increases in running.
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