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Running

Common running injuries (and how to deal with them)


Rosemary Marchese – Physiotherapist.

If you love to run, it’s quite likely that you run a lot. With this comes the increased risk of injury. Some injuries will occur because of the mileage you clock up, the shoes you wear or from muscle imbalances and poor alignment. Trail runners face the added challenges of uneven surfaces and sometimes even slippery surfaces.

When dealing with any acute injury it’s a good idea to apply the RICE method – Rest, Ice, Compression and Elevation. If things don’t settle down quickly then you should get to a physiotherapist. If you think you need an Xray it’s best to visit your doctor too.

Here are the most common injuries runners face:

  1. Runner’s knee

Technically known as ‘patellofemoral pain syndrome’ this annoying injury presents with vague symptoms. Pain often occurs after running or at the end of a long run and presents around/behind the patella (knee cap) and is hard to localise. It can hurt to run downhill or climb up and down stairs with this injury.

What you can do

If you can limit yourself to shorter runs then it may be okay to keep running, as long as you are not pushing yourself through pain. A lot of runners with this condition need a specific glute (butt) strengthening program and alignment issues addressed. The alignment issues often stem from the feet but even the hips and knees can contribute. Glute and quadriceps (strengthening) and hamstring and calf flexibility training can be very beneficial for improving this condition.


  1. Ankle sprains

This is more common in trail running than road running. Uneven surfaces increase the risk of an ‘ankle roll’, which can increase the risk of ligament tears or even fractures. Mild ligament sprains can take a week or two to heal whereas severe ankle sprains can take weeks to months. Complete ligament tears require surgery.

Ligament sprains must be cared for properly. Once you tear a ligament it places you at higher risk of re-injury. The build up of scar tissue in a ligament means that the ligament is not as strong and flexible as it was originally. This reduces your ability to keep yourself stable (proprioception) and react quickly to stop a fall.

What you can do

Find out what type of injury it is – is it a Grade 1, 2 or 3 injury? Grade 1 is a minor tear and can take 1-2 weeks to heal. A few physio sessions may help to get you back on track even faster. With a Grade 2 sprain you can expect a 6-8 week recovery in most circumstances. Grade 1 and 2 tears require a rehab program focussed on progressive strengthening and regaining flexibility and proprioception at the right pace. Grade 3 tears are complete tears and require referral to a specialist for assessment and planning.


  1. ITB (iliotibial band) Syndrome

The ITB is a band of tissue that runs down the outside of the thigh. It’s distal attachment point is just below the knee. Repetition and compression of this distal component can create pain. This often stems from strength imbalances and it is not unusual for hip abductor weakness to be part of the cause.

What you can do

Becoming friendly with a foam roller is often a good idea. Releasing tension in the ITB can often be achieved through a combination of massage, foam roller work and even stretching. Finding out the cause of the problem is something a physiotherapist can do. Often strengthening the gluteus medius through a string of hip abduction strengthening exercises can be a great place to start.


  1. Metatarsal pain

This pain is felt underneath the foot towards the balls of the feet. This occurs when there is too much pressure on the little bones and often need a break!

What you can do

This can be a great time to cross train, invest in some metatarsal pads and a better pair of shoes. It’s super important not to run through pain and get the condition assessed if it does not resolve rapidly.


  1. Shin splints

Pain at the front of the shins often occurs from doing too much training too fast. The area at the front of the tibia (shin bone) becomes sore, even to the touch, and can result in a stress fracture if not dealt with properly. Stiff ankles, overdoing it and not enough recovery are often culprits in this nasty injury.

What you can do 

Get your program checked and make sure your progressions are appropriate for your ability and fitness. Addressing the stiffness in your ankles and strengthening the calf and ankles can also be useful. Secondary work can then involve strengthening the core and hip muscles.