Common Running Injuries

Research suggests roughly half of regular runners pick up an injury in any given year. Very few of them are freak accidents. Most are slow-building overload injuries that gave plenty of warning signs along the way.

That’s actually good news. If an injury builds gradually, it can usually be prevented, and almost all of them follow the same pattern – your training load increased faster than the body could adapt.

Here are the five injuries we see most often in runners at our Homebush and Seven Hills clinics, what causes them, and what you can do to stay ahead of them.

1. Runner’s Knee (Patellofemoral Pain Syndrome)

What it feels like: A dull ache around or behind the kneecap. It tends to flare up on downhill runs, walking up stairs, or after sitting with bent knees for a long stretch.

Why it happens: The kneecap sits in a groove at the end of your thigh bone and glides up and down as you run. When the muscles around the hip and thigh aren’t doing their job, the kneecap gets loaded unevenly and the tissue around it gets irritated. Weak glutes are a common culprit. So is a sudden jump in mileage.

How to avoid it:

• Strengthen your hips and quads. Single-leg exercises like step-downs, split squats, and side-lying hip work will build support to the knee.
• Increase weekly distance gradually. A common guideline is no more than a 10% increase per week.
• Shorten your stride slightly and lift your cadence. Overstriding increases load through the knee with every step.

2. Shin Splints (Medial Tibial Stress Syndrome)

What it feels like: An ache that spreads along the inside edge of your shin bone, usually over a span of 5cm or more. It often warms up during a run, then comes on afterwards or the next morning.

Why it happens: Shin splints are a bone-loading problem. The tibia adapts to running stress by getting stronger, but that adaptation takes time. Ramping up volume, adding speed work, or switching to harder surfaces faster than the bone can keep up, can cause the bone to become irritated. New runners and runners returning after a break are the highest-risk groups.

How to avoid it:

• Build volume slowly, especially in your first 12 weeks of running (or your first 12 weeks back from a break).
• Strengthen your calves. Aim for both straight-knee and bent-knee calf raises, loaded, two to three times a week.
• Mix up your surfaces. Grass, treadmill and trail sessions reduce the repetitive load of pavement-only running.

One warning: pain that becomes pinpoint (one spot you can cover with a fingertip) and hurts with hopping needs proper assessment. That pattern can indicate a stress fracture, which is a different problem with a different plan.

3. Achilles Tendinopathy

What it feels like: Stiffness and pain in the Achilles tendon, worst first thing in the morning or at the start of a run. It often eases as you warm up, which tempts runners to keep pushing through it. That’s usually how a niggle becomes a bigger problem.

Why it happens: Your Achilles absorbs and releases load with every stride, handling forces of several times your body weight. Tendons adapt slowly, much slower than muscles. Sudden increases in hill running, speed work, or total volume are the usual triggers. Calf weakness and years of low-load training also leave the tendon underprepared.

How to avoid it:

• Make heavy calf raises a permanent part of your week. Strong calves protect the tendon by sharing the load.
• Introduce hills and speed work gradually. One new stressor at a time.
• Don’t ignore morning stiffness. It’s the earliest and most reliable warning sign the tendon is being pushed past its current capacity.

4. ITB Syndrome (Outside-of-Knee Pain)

What it feels like: A sharp or burning pain on the outside of the knee that shows up at a predictable point in your run, often around the same distance every time, and gets worse on downhills.

Why it happens: The iliotibial band is a thick band of tissue running down the outside of your thigh. When hip control is poor, the knee drifts inward with each stride and the tissue under the band gets compressed thousands of times per run. It’s less a “tight band” problem and more a control and load problem, which is why foam rolling alone rarely fixes it.

How to avoid it:

• Train hip strength and control. Glute bridges, single-leg squats, and lateral band work all target the muscles that keep your knee tracking well.
• Avoid stacking risk factors. A long run, on a downhill course, on tired legs is the classic ITB recipe.
• If it flares up, cut the downhill runs first rather than stopping running altogether. Many runners can keep training on flat ground while it settles.

5. Plantar Fasciitis (Heel Pain)

What it feels like: Sharp pain under the heel with your first steps out of bed or not having moved for a while. It often eases up as you move, then returns after long periods on your feet or after a run.

Why it happens: The plantar fascia is the band of tissue supporting the arch of your foot. Like the Achilles, it’s a slow-adapting structure that gets angry when load jumps suddenly. Rapid mileage increases, a switch to flatter or worn-out shoes, lots of standing at work, and reduced calf flexibility all contribute.

How to avoid it:

• Strengthen your feet and calves. Calf raises with your toes elevated on a rolled towel load the fascia in a way that builds its capacity.
• Keep your calves loose – foam rolling and percussion therapy work well. Tight calves put added pressure on the Plantar and Achilles
• Rotate your footwear and replace shoes before they’re completely worn out (most running shoes are done somewhere between 500 and 800km).
• Manage total time on feet, not just running volume. A 10km run on top of an eight-hour standing shift is a can be sneaky additional load you hadn’t planned.

The Pattern Behind All Five

Notice the theme? Each one of these injuries often comes back to the same equation: load versus capacity.

When your training load exceeds your body’s current capacity to absorb it, something gives. The injury just tells you where your weakest link was.

Which means prevention is the same three things, whatever your weak link:

1. Progress gradually. Change one variable at a time: distance, speed, or hills. Not all three in the same week.
2. Strength train. Two sessions a week focusing on calves, glutes, and single-leg control raises your capacity across the board. In our experience, it’s the single highest-value habit a runner can build.
3. Respect the warning signs. Morning stiffness, pain that’s changing your stride, or a niggle that shows up earlier in each run. These are your body telling you somethings not right and maybe you need more recovery.

When to Get It Looked At

Plenty of niggles settle down with a few easy days. But it might be time to get a professional assessment if:

• Pain lasts more than two weeks despite reducing your load
• Pain is getting worse run-on-run, or showing up earlier each time
• It’s changing the way you run
• You have pinpoint bone pain, or there’s swelling that isn’t settling down quickly

A proper assessment identifies the actual cause (not just where it hurts), and a criteria-based rehab plan will get you back to running safely as soon as possible, whilst reducing the risk of re-injury.

If you’re dealing with a running niggle, our physios, chiros, and exercise physiologists work with runners at all levels, from first-time park runners to ultra-marathoners, across our Homebush and Seven Hills clinics. Book an assessment online or call 1800 4 VIBES.

FAQs

Should I keep running with an injury or rest completely?

It depends on the injury, but complete rest is rarely the answer. Most running injuries respond best to a temporary reduction in load (less distance, fewer hills, slower pace) combined with targeted strength work, rather than stopping entirely. If pain is above a 3/10 during a run, getting worse over time, or changing your stride, reduce the load and get assessed.

How long do running injuries take to heal?

Muscle strains can settle in 2 to 6 weeks, while tendon issues like Achilles tendinopathy or plantar fasciitis often take 3 to 6 months to fully resolve. The bigger factor is how early you act. An injury managed in week one almost always resolves faster than one pushed through for three months.

Can stretching prevent running injuries?

Stretching alone has limited evidence for preventing running injuries. Strength training is far more protective, particularly for the calves, glutes, and single-leg control. A dynamic warm-up before running is useful for preparing your body to run, but static stretching by itself won’t injury-proof you.

Do I need a referral to see a physio or chiro for a running injury?

No. You can book directly with a physiotherapist, chiropractor, or exercise physiologist without a GP referral. Private health insurance extras typically cover part of the cost, depending on your policy.

What’s the most common running injury?

Runner’s knee (patellofemoral pain syndrome) is generally considered the most common running injury, followed by shin splints, Achilles tendinopathy, ITB syndrome, and plantar fasciitis. All five are overload injuries, which means they’re largely preventable with gradual training progression and regular strength work.