Running Injuries

Running Injuries

Running injuries are usually overuse injuries of the foot, lower leg, knee, and hip. View the most common injuries here as well as when to seek medical advice and top tips for avoiding running injuries.

On this page:

  • Running injuries
  • When to seek medical advice
  • Emergency first aid
  • Avoiding running injuries

Common running injuries

Select from the options below to view more detailed information on specific running injuries. If you are not sure what your injury is then why not try our sports injury symptom checker?

Heel pain

Plantar Fasciitis - the most common cause of heel pain, often radiating into the arch of the foot and is usually worse first thing in the morning.

Bruised heel - heel pain which doesnt radiate into the arch of the foot and gets progressively worse with use.

Calcaneal stress fracture - stress fracture of the heel bone with persistent symptoms similar to bruised heel.

Bunion - deformity of the forefoot causing on the inside of the forefoot

Athletes foot - how to treat and avoid this common and preventable skin condition.

Ingrown toenail - toe pain caused by the toes growing down into the skin at the sides of the nail.

Blisters - prevention is better than a cure. Learn how to treat blisters already formed as well as how to prevent them occuring in the first place.

Extensor tendonitis - gradual onset pain along the top of the foot

Metatarsal stress fracture - gradual onset and persistant pain in the midfoot area.

Lower leg and ankle

Shin splints - gradual onset pain on the inside lower part of the shin made worse with use. Learn how to cure this peristent and very common running inury.

Calf strain - Sudden onset pain at the back of the lower leg. More likely caused by sprinting, jumping or a sudden change of direction.

Ankle sprain - how to treat sprained ankles and prevent them recurring as well as possible complications.

Achilles tendonitis - gradual onset pain at the back of the ankle, usually worse first thing in the morning and can be stubborn to treat.

Achilles tendon rupture - a complete rupture of the achiiles tendon. Runners over the age of 40 who have a history of achilles pain are particularly susceptible.

Peroneal tendonitis - gradual onset pain on the outside of the ankle.

Knee pain

MCL sprain (medial ligament sprain) - a tear to the medial ligament on the inside of the knee, more likely to be a sudden acute injury.

Medial cartilage meniscus injury - injury or degeneration of the cartilage meniscus on the inside of the knee. Can be gradual or sudden onset.

ACL injury - anterior cruciate ligament sprain, a sudden onset knee joint injury, less common in runners and more likely caused by twisting the knee.

Iliotibial band syndrome - sometimes known as runners knee causes pain on the outside of the knee which comes on gradually, often at a specific point in a run only to ease with rest.

Jumpers knee (patella tendonitis) - persistant pain at the bottom front of the patella or kneecap.

LCL sprain (lateral ligament injury) - ligament tear on the outside of the knee, can be acute but often in runners is gradual onset.

Osgood Schlatters Disease - common overuse injury affecting children, with pain under the front of the knee at the top of the shin bone.

Patellofemoral pain syndrome - also known as runners knee. Pain is caused by friction between the kneecap and the bone underneath.

Thigh & Groin

Hamstring strain - sudden onset pain at the back of the thigh from a tear to one of the hamstring muscles.

Thigh strain - muscle tear causing sudden onset pain at the front of the thigh.

Groin strain - sudden onset groin pain on the inside of the thigh

Hernia - occurs when an internal part of the body such as the intestine, pushes through a weakness in the muscle wall.

Gilmore's groin - also known as a sportsmans hernia, a vague type of groin pain that's increased by running, sprinting, twisting and turning.

Lower back

Low back pain

Sciatica

Should I seek professional treatment?

If you have any of the following symptoms you should seek further medical assistance.

  • Severe pain, especially on walking
  • Severe swelling (oedema)
  • Altered sensation in the foot – such as a feeling of “pins and needles” (paresthesia) or a “loss of feeling” (anaesthesia).
  • Unable to complete normal daily activities after the initial 72 hours.

Further medical assistance can be sought through either your local GP or a private clinician such as a podiatrist, physiotherapist, sports therapist, osteopath or chiropractor. If you have followed the P.R.I.C.E. principles (see below) and are still unable to walk after 72 hours or still have severe pain that is not subsiding after the first 72 hours you should visit your local A&E department for further assessment.

Secondly, if you have applied for P.R.I.C.E. principles and still have weakness that lasts a long time (more than 2 weeks) or have ongoing discomfort in your foot or heel, you are highly recommended to seek advice from a specialist expert - such as a podiatrist or physiotherapist, osteopath, or chiropractor - who can provide you with advice and an appropriate and effective recovery and rehabilitation program.

Immediate first aid for acute running injuries

The PRICE principles are the gold standard set for treating acute sports injuries. The acronym stands for Protection, Rest, Ice, Compression and Elevation and should be applied as early as possible and continued for at least the first 24-72 hours.

Protection

Protection of the damaged tissue is vital to prevent further damage and enable the healing process to start efficiently and effectively. There are a number of ways to protect the injured area all with the same aim of limiting further movement and use of the joint/muscle/ligament/tendon. One way this can be achieved is by using a support or splint.

Rest

In the early stages, rest is one of the most important components of the P.R.I.C.E principle but is often neglected or ignored. It does not only refer to the prolonged period of time that the athlete will be out of action but also to the immediate period after the injury.

An athlete must know when to stop training and allow the injured area to heal otherwise repetitive minor injuries can often result in a more severe injury that keeps the athlete out for much longer.

If an injury is sustained during sporting activity some athletes have a tendency to 'run it off'. This implies that by continuing to participate in the exercise, the injury will simply go away. In fact, in the majority of cases, this is not true and is not advisable.

Ice

Ice therapy, also known as cryotherapy, is one of the most widely known and used treatment modalities for acute sports injuries. It is cheap, easy to use and requires very little time to or expertise to prepare.

The application of ice to an injury, in the acute phase, can substantially decrease the extent of the damage. It achieves this in a number of different ways:

  • Decreases the amount of bleeding by closing down the blood vessels (called vasoconstriction).

  • Reduces pain (pain gate theory)

  • Reduces muscle spasm

  • Reduces the risk of cell death (also called necrosis) by decreasing the rate of metabolism

Ice is usually applied to the injured site by means of a bag filled with crushed ice which is wrapped in a damp towel. The damp towel is essential as it forms a barrier between the bag of ice and the skin and reduces the risk of an “ice burn”. DO NOT leave the ice on for more than 15 minutes as you could cause an “ice burn”.

There are a small number of areas that you should not apply ice to which include the neck, the outside bone of the elbow, the collar bone (upper end), the front of the hip (bony part) and the outer bone of the knee. The reason for this is there is a superficial nerve just below the skin in these areas that can be damaged by applying ice to it. Always check for contraindications.

Compression

Applying compression to an injured area minimises the amount of swelling that forms after an injury in two ways and should be applied for the first 24 to 72 hours from the onset of injury. Compression can be applied through a number of methods. The most effective of these is by using a compression bandage which is an elasticated bandage that simply fits around the affected limb.

Elevation

Elevation of the injured limb is the final principle of PRICE but is equally as important as the other 4. Elevation allows gravity to drain the fluid away from the injured site. This aids in decreasing the swelling which in turn may decrease the pain associated with the oedema (swelling).

Read more on PRICE principles

Preventing running injuries

Gait is the way in which we move our whole body from one point to another. Most often, this is done by walking, although we may also run, skip, hop etc. Gait analysis is a method used to assess the way we walk or run to highlight biomechanical abnormalities.

What are Biomechanical abnormalities?

Being able to move efficiently is important in avoiding injuries. Having joints capable of providing sufficient movement and muscles capable of producing sufficient force is vital to generate an efficient gait cycle. If joints are stiff (usually caused by muscle tightness), limiting the range of motion, or muscles are weak, the body must find ways of compensating for the problem, leading to biomechanical abnormalities.

Examples of biomechanical abnormalities include:

  • Overpronation
  • Oversupination
  • Increased Q angle
  • Hip hiking (or hitching) - lifting the hip on one side
  • Ankle equinus - limited ankle dorsiflexion
  • Pelvic tilt - can be either anterior, posterior or lateral

Biomechanical problems such as these are usually caused by muscular imbalances (tight muscles working against weak muscles), although they can sometimes be caused by structural problems, such as leg length discrepancies resulting in hip hiking.