The Big 6 Common Running Related Injuries
Opinion Advocates for ideas and draws conclusions based on the author/producer’s interpretation of facts and data.
By Gabriela Rodriguez, PT, DPT
If you are a runner, like myself, chances are you’ve probably sustained a running-related injury. Unfortunately, running-related injuries (RRI) remain high, with a likelihood of 75% of runners sustaining a running-related injury each year. I personally dealt with an Achilles tendinitis injury when training for the Steamtown Marathon last year in 2024, which temporarily disrupted my training plan. I remember thinking, “How am I going to train for the rest of my program with this pain/discomfort?” Fortunately, I was able to rehab my injury while continuing my training program and ultimately finishing the marathon with a PR!
If I’ve learned anything about injured runners, it’s that the last thing they want to hear is, “You need to stop running.” Unless, of course, the runner in question sustained a stress fracture, in which case they really do need to stop running! Fortunately, knowledgeable Physical Therapists, like myself, can help guide runners back to pain-free running.
Running and Injury Risk
Running is a popular and beneficial form of exercise. It promotes musculoskeletal health, cardiovascular fitness, and mental well-being while being an accessible activity for many. However, running involves high repetition at high loads. As a run progresses, the cumulative load increases, leading to fatigue. When the load capacity exceeds a runner’s tissue tolerance, this is where injury occurs. This article will discuss the 6 most common running related injuries (RRI).
Patellofemoral Pain Syndrome (PFPS)
PFPS is characterized by anterior and retro kneecap pain that worsens throughout a run. Runners with PFPS often experience pain when touching the kneecap and with deep knee flexion (think deep squats). It is more common in females and is frequently associated with weak quadriceps and hip strength. Physical therapy approaches include education and symptom management, neuromuscular retraining, therapeutic exercise, and gait retraining
Medial Tibial Stress Syndrome (MTSS)
MTSS, commonly known as shin splints, involves traction periostitis, which is an inflammation of the connective tissue surrounding the shin bone. It often presents as broad pain along the medial shin border and is prevalent among high school and college athletes, as well as military personnel during basic training. Pain usually starts at the beginning of a run, subsides after warm-up, but returns during or post-run. If untreated, it can progress to a stress fracture. Risk factors include higher body mass index (BMI) or additional weight-bearing loads (e.g., military gear), overstriding, low foot arches and increased pronation. Pt treatment approaches include addressing training errors, rest and support (temporary orthotics), stretching and strengthening, neuromuscular control, and gait mechanics assessment.
Iliotibial Band Syndrome (ITBS)
ITBS occurs due to inflammation of the bursa beneath the iliotibial band (ITB) on the outer part of the thigh. It is more common in females and often associated with weak hip muscles, abnormal mechanics, and running on uneven terrain (e.g., crowned roads, downhill running, canted tracks). PT treatment approaches include pain management (cupping, dry needling, massage, foam rolling), strength training to improve load capacity, and gait retraining to decrease lateral knee stress.
Plantar Fasciitis (Plantar Heel Pain)
Plantar fasciitis presents as pain on the bottom of the foot, typically at the heel, and is aggravated by the first few steps in the morning or after prolonged rest. It is more common in males over 40, military personnel, individuals with prolonged standing jobs, those with increased BMI, and individuals experiencing stress, depression, or anxiety. Risk factors include tight calf muscles, decreased big toe mobility and weak intrinsic foot muscles. PT treatment approaches include strengthening of calf and intrinsic foot muscles, stretching, and gait retraining
Achilles Tendinopathy
Achilles tendinopathy is a degenerative process that leads to decreased tendon stiffness and poor force transfer. It presents as pain in the Achilles tendon and during active plantarflexion (pointing the foot downward). Runners may also experience palpable thickening of the tendon and restricted ankle range of motion. This condition is more common in middle-aged males, individuals with greater BMI, weaker calf muscles, and those with training errors. PT treatment approaches include isometric exercises for pain relief, progressive eccentric calf strengthening, collagen supplementation (in some cases), and gait retraining
Bone Stress Injury (BSI)
A bone stress injury occurs due to localized decreased bone mineral density, which may result in a stress fracture. The condition progresses from a stress reaction (bone swelling) to a stress fracture when the initial reaction is not managed properly. If left untreated, a full fracture can occur. Risk factors include repetitive high mileage (>40 miles/week), poor biomechanics, diet/nutrition deficits, genetics/hormonal imbalances, medication use, and low BMI. PT considerations include the following: runners with BSI should not run, some cases may require surgical intervention, and prolonged rehabilitation may be necessary.
Conclusion
Running-related injuries are common but manageable with proper intervention. Physical therapy plays a critical role in recovery, focusing on symptom management, strength training, neuromuscular control, and gait retraining. If you sustain a running-related injury, working with a knowledgeable Physical Therapist can help guide you back to pain-free running while minimizing the risk of re-injury.
Dr Gabriela Rodriguez, PT, DPT is a Physical Therapist at ProClinix Sports Physical Therapy & Chiropractic in Yorktown. For any questions regarding her article or to learn more about ProClinix, feel free to reach out to her at 914-898-3338 or via email at grodriguez@proclinix.com. In addition to their Yorktown location, ProClinix has other convenient locations in Ardsley, Armonk, Larchmont, Pleasantville, Tarrytown, and West Harrison.
Examiner Media – Keeping you informed with professionally-reported local news, features, and sports coverage.