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The Most Common Running Injuries

by | Jan 19, 2021 | Running

Running is a great way to stay active and healthy but with an increase volume or intensity in training, injuries can occur. Here are some of the most common running injuries along with some advice on how to help relieve the symptoms and reduce your likelihood of injury in the first place.

Achilles tendinopathy

What is it?
Often referred to as Achilles tendonitis or tendonosis, Achilles tendinopathy affects the tendon at the back of the leg. The Achilles tendon connects the muscles of the calf (gastrocnemius and soleus) to the back of your heel and helps with plantarflexion (pointing your foot). Symptoms of Achilles tendinopathy usually develop gradually and include stiffness and pain around the Achilles region which is worse in the morning, but it often eases quite quickly. It may be sore when you start activity but quickly reduce as you continue and is often sore the next day. The tendon may be painful to touch and swelling may be present at the area of the Achilles tendon affected.

Why does it occur?
Whilst running, the foot should move through dorsiflexion during heel strike and plantarflexion during the push off phase of a stride. This repetitive movement means the muscles and the Achilles tendon are working constantly, in a spring-like fashion. Runners have a high chance of developing Achilles tendinopathy due to overuse, which disrupts the structure of the tendon and causes detriment to the spring-like mechanism.

Increases in loading are the biggest contributor to the onset of Achilles tendinopathy, whether this be from training or competition. Also, reduced recovery between training sessions, training on different surfaces and poor or different footwear are all factors that can contribute to the development of symptoms.

Predisposing factors for Achilles tendinopathy include gender – it is more common in males – type 2 diabetes and genetic predisposition. Altered lower limb biomechanics such as reduction in range of motion of the ankle joint and restricted flexibility of the calf muscles also contribute to Achilles tendinopathy arising.


What is it?
The plantar fascia is a sheath of connective tissue that runs under the sole of your foot. The plantar fascia plays an important role in foot biomechanics. While running it acts as a shock absorber and stabilises the foot as it moves through the different motions that occur during gait. Plantarfasciitis is an overuse condition that causes pain normally felt on the inside of the heel and under the foot. It is typically worse in the mornings or after periods of inactivity but may start to feel better during activity. In more severe cases, bearing weight on the affected foot may cause pain.

Why does it occur?
Plantarfasciitis regularly results from activities that require maximal plantarflexion, so runners are high risk. Other factors that contribute to causing Plantarfasciitis include having abnormal foot biomechanics, high or low arches of the foot, reduced ankle dorsiflexion and increased BMI. Tightness in muscles groups of the lower body may also contribute to Plantarfasciitis as it may change running biomechanics.

What will help?
Treatment will include correcting any biomechanical faults by strengthening weak muscle groups in the lower limbs and strengthening muscles of the foot that will take stress off the plantar fascia. Soft tissue therapy will also be used to stretch out the plantar fascia and release tension in muscle groups such as the calf, hamstrings and glutes. Some people find self-massage of the sole of the foot using a golf ball or frozen bottle of water to be beneficial. Taping or orthotics may also be used to support the plantar fascia.

Patellofemoral Pain Syndrome (PFPS)

What is it?
PFPS is a term used for pain that is felt at the front of the knee around the patella (knee cap). It is quite a broad term as there are many different causes and structures that could be at fault and may be different from person to person that experiences pain in this region.

Why does it happen?
One likely characteristic that will contribute to PFPS is an increase in loading of the patellofemoral joint i.e. increases in repetitive load (gym or running) will overload the patellofemoral joint structures and can cause pain. Other factors that may contribute to patellofemoral pain occurring all affect the movement and position of the knee and patella. These factors include knee valgus (knock knees), reduced flexibility, rotation of the thigh bone and the shin bone, and weakness of different muscle groups.

What will help?
Treatment will first include reducing pain by decreasing the load going through the patellofemoral joint. This can be done by addressing the different factors that alter knee biomechanics with soft tissue therapy to release areas of tension and help improve flexibility. Strengthening exercises will help in improving surrounding weak muscle groups. Taping the patella will also help to reduce load through the joint. A thorough rehab programme to retrain hip, knee and foot movements will be used to help treat PFPS.

Medial Tibial Stress Syndrome or “Shin Splints”

What is it?
Medial tibial stress syndrome (MTSS) which is more commonly referred to as “shin splints” is pain felt around the front and inside part of the shin bone. Pain may occur during or after exercise and can ease with rest. Those suffering with MTSS are at greater risk of developing a stress fracture.

Why does it happen?
It’s not always clear why people suffer from this condition, but runners, walkers and people that do activities with repetitive weight bearing movements seem to be susceptible to the symptoms. They can also occur with an increased intensity in these activities. Running biomechanics, decreased flexibility, shoe type, surface type and training errors are all factors that contribute to causing the condition.

What will help?
Initial treatment will start with rest and ice and then treating the underlying causes. Treating the muscles of the lower leg, increasing range of motion of the foot and ankle and addressing issues of running biomechanics will help. 

How can you avoid these injuries?

  • Make sure you are increasing your training in small increments. Don’t push yourself or over do it by jumping ahead stages in your training. By increasing little by little you will still get to that goal your aiming for but in a safe way! Make sure you get enough rest between training sessions, so your body has a chance to recover before you go out running again.
  • Good footwear is a runner’s necessity! However, there is no one size fits all when it comes to the perfect trainer for running. A lot of different factors come in to what shoe suits you the most; your foot biomechanics, your running technique, what surfaces you run on etc. By assuring your trainers have good cushioning and supports your foot yet still allows the foot to move through its range of motion is a good baseline and then it is about finding what works best for you. Having good trainers will help with injury prevention if they are right for you and your biomechanics and give you the support you need while load is going through your foot as you run. When changing from old to new running trainers, try shorter distance runs first to wear the new trainers in before taking them out for the big runs.
  • Strength training is a great way to help prevent running injuries and to help improve your training. Check out our blog on why runners should be strength training here.

  • Get booked in for regular ‘Maintenance Massage’. Having sports massage is another way to help keep injuries at bay as it may help reduce tension in muscles, improves range of motion at joints, helps with recovery and possibly help with DOMS. Here’s our blog that goes into further detail on the benefits of sports massage.

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