Running Injuries 101: What to Do About the 5 Most Common Ailments

Sarah Wassner Flynn
by Sarah Wassner Flynn
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Running Injuries 101: What to Do About the 5 Most Common Ailments

Most runners have as many injury stories as they do training shoes in their closets. In fact, it may seem as though you can’t truly call yourself a runner unless you have an orthopedic surgeon or a physical therapist on speed dial. The sport’s simplicity— its repetitive and weight-bearing nature—also accounts for its tendency to damage the body.

The bad news about these injuries is that they are often hard to avoid. The good news? They’re totally treatable. Here, we break down the most common running ailments—and how to avoid them.

Note: As with any health issue, it’s important you speak with your doctor for a proper diagnosis and treatment plan. What follows is general advice that may or may not apply to your specific ailment.

Shin Splints

  • The definition: An aching pain in the front of the lower leg.
  • The causes: Usually, shin splints are brought on by an increase in mileage. A change of running surface or speed—especially over-striding—can also strain the lower leg tendons.
  • The symptoms: Tight calf muscles and tender shin bones that tend to flare up post-run.
  • The treatment: Ice, ice baby: Grab a bag of frozen peas and place it on the irritated spot a few times a day to reduce inflammation. Calf and Achilles stretches will also help to loosen up the lower leg muscles and reduce the strain on your shins. You may need to stop running altogether for a week or two if the pain is severe.
  • Avoid it: New to running? Don’t overdo it. Gently increase your mileage by just 10 percent every week, and stick to softer surfaces, like grass or a bouncy track, which are more forgiving than rock-hard pavement.

Plantar Fasciitis

  • The definition: Inflammation of the plantar fascia, the thick tissue covering the bones on the bottom of the foot.
  • The causes: Trauma (stepping on a sharp object or otherwise straining your foot), overuse, inflexible calf muscles, over-pronation (your foot rolls inward when you run), high arches and incorrect shoes.
  • The symptoms: Pain at the base of the heel, which is more intense when you’re barefoot. Pain is often most severe in the mornings or at the start of a run.
  • The treatment: Ice, physical therapy and the addition of orthotics—supportive shoe inserts that an orthopedist can help you select. Rolling the afflicted foot over a tennis ball or a massage bar for 30 minutes a day, and stretching your calf can also relieve the pain.
  • Avoid it: Wear supportive shoes, especially when you’re not running. Flimsy flip flops that lack arch support are a main culprit of PF, so if you must wear sandals, opt for something studier, like Birkenstocks.

Chondromalacia Patella or Patellofemoral Pain Syndrome (Runner’s Knee)

  • The definition: A softening or wearing away and cracking of the cartilage under the kneecap, resulting in pain and inflammation.
  • The causes: Weak thigh muscles, instable hips, tight hamstrings or Achilles tendons, usually brought on by insufficient stretching, overpronation and overtraining.
  • The symptoms: Nagging aches in the knee, especially during longer training runs. May also present itself as tightness in the adductor muscle in your upper thigh or groin.
  • The treatment: Rest, ice and strength work: Studies show that a lack of hip stability, especially among women, is directly linked to the development of runner’s knee.
  • Avoid it: Take the time to incorporate stretching and strength training into your routine (especially hip- and core-strengthening exercises). Balancing your running with cross-training (think: the elliptical machine or a stationary bike) a few times a week will give your legs a much-needed break from the pounding.

Iliotibial (IT) Band Friction Syndrome

  • The definition: Pain and inflammation on the outside of the knee, where the iliotibial band (a group of fibers that run along the outside of the thigh) turns into tougher, less flexible tendon tissue. When the band rubs against the femur (thigh bone) as it runs alongside the knee joint, it can become irritated and inflamed.
  • The causes: Overuse, faulty biomechanics and weak hips and glutes.
  • The symptoms: Pain and soreness in the middle of the IT band, which may increase to a more severe, even debilitating, pain at the outside of the knee.
  • The treatment: Rest, deep tissue massage, foam rolling along the outside of the leg, hips and hamstrings. Strength exercises like leg lifts and squats are key for targeting weak hips and glutes.
  • Avoid it: Use a foam roller regularly after your runs to loosen up tight muscles. Scale back on the miles as soon as you feel a twinge of pain along the IT band. The injury can go quickly from bad to worse, so responding immediately with rest can lead to a faster recovery.

Achilles Tendonitis

  • The definition: Inflammation, irritation and swelling of the Achilles tendon (the tendon that connects the muscles of the calf to the heel).
  • The cause: Over-pronation, over-training, excessive speed work and tight or fatigued calf muscles.
  • The symptoms: Pain along the back of the tendon, inflexibility in the ankle or redness and swelling in the afflicted area. Hearing a crackle when you move your ankle—the sound of scar tissue rubbing against the tendon— is another indicator of Achilles tendonitis.
  • The treatment: Rest until the pain is gone as well as a steady routine of icing (up to 30 minutes several times a day) and calf stretching. Wrapping your foot or inserting a foam wedge heel pad in your shoe can also boost support and speed up the healing process.
  • Avoid it: Gradually increase your mileage, wear supportive shoes, and keep your calfs strong and flexible by doing toe-raises and stretching regularly. And if you’re prone to sore Achilles, avoid activities that add extra stress to the area, like hill running.

About the Author

Sarah Wassner Flynn
Sarah Wassner Flynn

A longtime runner and triathlete, Sarah has been able to blend her passions for endurance sports and writing into a freelance career. She’s covered everything from profiles on Olympic gold medalists to tips on training for your first 5K for numerous media outlets. When she’s not writing about races, Sarah is usually training or competing in one. She also writes kid’s and teen nonfiction books and articles for National Geographic and Girls’ Life Magazine. Sarah lives just outside of Washington, D.C. with her husband, Mark, and their three children. Follow her on Instagram (@athletemoms) and Twitter (@athletemoms).


17 responses to “Running Injuries 101: What to Do About the 5 Most Common Ailments”

  1. Avatar Thaer M. Mohazia says:

    Thanks a lot for the info and help, but what about the back pain after fairly long walks or runs?

    • Avatar Tim Jackson says:

      I’d guess… rest with ice

    • Avatar Shawn says:

      Stretching. After long runs I laid on the floor with my legs straight out and then brought my knees to my chest several times. Before other common stretches.

    • Avatar Tetrygon says:

      Yoga.. Do some spinal flexes (i.e. cat, cow, cobra, sun salutations) doing very simple yoga once or twice a day for a week will help in that area.

  2. Avatar JJ says:

    Unfortunately there are a few inaccuracies in this column. For example, chondromalacia patella (CMP) and patellofemoral pain syndrome (PFPS) are not the same syndrome. CMP occurs from softening of the patellar articular cartilage, while PFPS is defined by pain around the kneecap without any damage to the articular cartilage. PFPS is much more prevalent in runners.

    Second, there is no conclusive scientific evidence that over-pronation is a cause for any running-related injury. That is a common myth, perpetuated by the running shoe companies to help sell their products.

    Lastly, these conditions are usually not inflammatory in nature. For the most part, pain is caused by tissue degeneration from overuse, not from inflammation.

    Source: I’m an athletic trainer and biomechanist

  3. Avatar Elaine Page says:

    I’m greatful for any information on my injury which sucks , rest , rest and more rest is the way forward I have learnt through being stubborn , I’m so looking forward to my first run back when I’m injury free ☺

    • Avatar Pearly says:

      After spending Close to three years trying to run w a running group and dealing with foot pain of various types, all written about in this article, I finally got the message that my body and leg style was not the best for running.

      I had most of the issues mentioned in the article, mainly flat feet which caused overpronation, which pulled at the calf/heel tendons the wrong way and caused trouble there. This went on for three years.

      I finally switched things 180 and worked with a personal trainer for under 3 months. Cardio, strength and weights combined with a cleaner diet than before and I am 15 pounds lighter, and overall look leaner, more toned.

      Highly recommend thid sensible, sustainable, injury free alternative to those where running is just not working out.

  4. Avatar je says:

    When you talk about avoiding Achilles tendinitis, do you mean we should do heel raises, where we go up on our toes and lift our heels off the ground to work out our calves, or toe raises, where we lift our toes off the ground? I know a lot of people interchange the names and exercises, so I want to make sure I know what you mean.

    • Avatar Pearly says:

      I’d think you need to do the opposite. Stand on a step with the front half of your foot, then slowly lower the back half of your foot down the step. Return to the beginning and repeat 15x. The other foot should be off the step.

  5. Avatar Mary in KY says:

    I freeze a 20 oz water bottle (cap off) then put cap on and roll under foot. Same function as tennis ball, but added benefit of ice.

  6. Avatar sam says:

    i run 2-3 times a week 6-12 miles each run , i never stretch , nor do i feel the need to stretch , should i stretch regardless in order to prevent future injuries , or is stretching not a necessity? Do most people stretch pre or post run?

  7. Avatar Tarun Dhillon says:

    Thanks this is useful !! Any suggestions on how to deal with corns on top of the little fingers on the feet. Tired the local chemist stuff without much success

  8. Avatar Ben O' Connor says:

    I cannot stress enough how taking Omega 6 capsules (Cod Liver Oil) helped alleviate the majority of these pains for me. After starting running a few years back to lose weight the pain became to much and I stopped, gained more weight and totally defeated the purpose. 5 moths ago (at 20 stone) I decided to give it another go but with the addition of taking a Cod Liver Oil capsule once a day and drinking copious amounts of water and the results were brilliant, no aches and pains other than the expected exhaustion and muscle ache and I am now down to 16.7 stone and running 10k every second day pain free.

  9. Avatar ewakama says:

    Any advice for hip pain? I suppose I probably need to strengthen them, but just curious.

  10. Avatar Sue gibson says:

    I lost weight in 1975 – the only times I have briefly regained it was when I was nine months pregnant. I do not believe in running and as such am still a pain free seventy year old. I did notice an increase in activity (although I had an active job and did yoga and swimming prior to losing weight) because I was carrying less weight = less strain on heart and other muscles. I have never enjoyed running – I have watched several running, tennis playing friends of mine in tremendous pain from arthritis when they have had to give up. There is arthritis in the family but I have so far avoided such. I do agree w the non impact forms of exercise…+ a healthy diet as described above.

  11. Avatar Em says:

    How about with a stress fracture on my top left foot? I was told to wear a boot for 4-6 weeks, but how long do I need to wait before I can start running again after that?

  12. Avatar Katy Jones says:

    Warming up is so importan! Too many people forget to do that and then they hurt. their feet and ankles and they are so painful too.

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