Top 5 Running Injuries

Causes and Treatment Options

Running has one of the largest participation rates in Australia. It is popular because of its health benefits, it’s affordability and you can burn calories in a fraction of the time compared to walking or cycling. However running injuries are common, often due to  people doing too much, too soon.

Top 5 Running Injuries

1.Patello-femoral Pain or Runner’s Knee

Knee cap pain accounts for about 40% of all running injuries.   The cartilage covering the back of the knee cap becomes irritated and painful.  Pain is felt at the front or inner part of the knee. This normally presents as pain at the front or inner part of the knee.

  • Running downhill or an increase in distance
  • The addition of other activities that load the knee cap such as prolonged sitting, kneeling and lunging
  • Poor alignment of the hips, knees and feet.
  • Resting or modifying the distance ran and keeping to flat terrain is often needed until the acute pain settles.
  • Exercises to improve strength and muscle balance around the hip and knee can help.
  • Taping the knee cap to improve alignment can make rapid improvements in pain.
  • A running assessment by a physio can help.  Shortening stride length and landing with a slightly flexed knee will help reduce the load on the knee cap.

2. Plantar Facitis

Plantar Facitis accounts for 15% of running injuries.  Pain is felt in the arch of the foot as is normally worse after rest and eases as you get moving.

  • High arches or flat feet
  • Tight calf muscles
  • Change in terrain
  • Poor muscle control in the legs and pelvis
  • Can be more prevalent when spending time without shoes on especially walking on hard floors at home, or if trying to run barefoot.
  • Rest from running until foot pain settles
  • Try rolling a golf ball through the arch
  • Ice using a small jar with frozen water and roll through the arch.
  • Pain is normally less when in shoes compared to barefoot.
  • Physio is often very helpful especially in the acute phase. Treatment may include taping, dry needling and exercises to improve any muscle weakness through the legs, pelvis and spine. A running assessment can help identify technique issues and see if things like orthotics will help control the foot to reduce the load through the plantar fascia.

3. Shin Splints

Shin splints are reported to account for 15% of running injuries and pain is felt along the shin bone.

  • New runners, returning to running after a long break or a high increase in load, particularly sprint sessions
  • Extremely high arches or flat feet.
  • Shoes that are old and worn out
  • Rest from running or reduce the distance covered.
  • Ice after exercise.
  • To prevent recurrence, gradually increase distance.
  • Get advice about appropriate shoe wear.
  • Physio can help to recover more quickly by using taping, dry needling and massage.   The physio can also monitor training load to allow the athlete to continue the most important aspects of training until they can take sufficient time off.

4. Iliotibial Band (ITB) Pain

ITB pain accounts for 12 % of running injuries. Pain is felt on the outside of the knee.   It is most common in long distance endurance runners and with Triathletes.

  • An increase in distance too quickly
  • Increase in downhill running
  • Glute weakness
  • Running technique
  • Reduce distance and avoid hill climbs
  • Use a foam roller through the ITB
  • Physio is very useful to help settle pain, review running form and provide exercises and advice to assist recovery and prevent recurrence.  Techniques include massage and dry needling through the ITB, stretches and strength work particularly for the butt and thigh muscles.

5. Achilles Pain (Achilles Tendonopathy)

Achilles problems account for 11% of running injuries.  Pain is felt at the back of the leg where the calf inserts into the foot. Pain is normally worse in the morning and improves with activity in the acute phase.

  • A big change in intensity or distance covered in training.
  • Weak calf muscles
  • Reduce the distance and intensity of training to the point where the achilles pain is not increased by running on the day of training and the next morning.
  • Rest from running may be required to allow symptoms to settle.  Swimming or using a cross trainer during this time, are useful alternatives to running to maintain fitness.
  • A specific calf strengthening program is required to settle symptoms initially and then to rebuild the tolerance to running.  Getting help from a physio is really helpful at this stage to give clear guidelines on when you can progress your exercises and running load and when you may need to back off.  This injury does time to fully settle.


The information in this post is intended to assist runners to understand when training load may be impacting on injury.  Seeking advice from a physio when symptoms first begin can prevent a long term injury and get you back training for that next event pain free.  New to Running? See  safe running tips for beginners. 

Written by Physiotherapist Sandy Woolman November 2018