Running is one of the most accessible and beneficial forms of exercise—but it also carries a high risk for injury, especially when done without proper training or recovery. At our orthopedic practice, we see runners of all levels—from weekend joggers to seasoned marathoners—struggling with similar issues that often boil down to overuse, improper mechanics, or muscle imbalances.
Whether you’re training for your next big race or just starting out, understanding common running injuries—and how to prevent them—can keep you on track, pain-free, and performing your best. Let’s break it down by region: foot and ankle, knees, and hips.
- Plantar Fasciitis
What it is: Inflammation of the band of tissue that runs along the bottom of your foot, causing heel pain—especially with your first steps in the morning.
Why it happens: Tight calf muscles, poor arch support, and increasing mileage too quickly.
Prevention tips: Stretch your calves and arches regularly, wear proper footwear with good arch support, and avoid dramatic increases in running intensity or volume.
2. Achilles Tendinitis
What it is: Pain and stiffness in the back of the ankle, often due to inflammation of the Achilles tendon.
Why it happens: Overuse, tight calf muscles, and lack of strength in the surrounding muscles.
Prevention tips: Gradually build up your running program, incorporate eccentric heel drops, and avoid hills when first recovering.
3. Stress Fractures in the Foot
What it is: Tiny cracks in the bones of the foot, most commonly the metatarsals.
Why it happens: Overtraining, poor nutrition, and improper footwear.
Prevention tips: Vary your training surface, cross-train to reduce repetitive impact, and ensure you’re eating enough to support bone health.
What it is: A stretching or tearing of the ligaments around the ankle, typically caused by a twist or roll.
Why it happens: Uneven terrain, weak ankle stabilizers, or worn-out footwear.
Prevention tips: Strengthen ankle muscles, improve balance with proprioception exercises, and run on even surfaces when possible.
5. Runner’s Knee (Patellofemoral Pain Syndrome)
What it is: Pain around or behind the kneecap, often aggravated by hills or stairs.
Why it happens: Poor alignment, weak hips or glutes, and overuse.
Prevention tips: Strengthen the hip and core muscles, use proper running form, and don’t ignore pain when it starts.
What it is: Pain on the outside of the knee, often due to irritation where the iliotibial band crosses the joint.
Why it happens: Weak hip abductors, tight IT band, or running on uneven surfaces.
Prevention tips: Foam roll the outer thigh, strengthen glutes and hips, and vary your running terrain.
7. Patellar Tendinitis (Jumper’s Knee)
What it is: Inflammation of the tendon connecting the kneecap to the shinbone.
Why it happens: Repetitive jumping or impact, weak quads, or poor mechanics.
Prevention tips: Strengthen your quads and core, warm up thoroughly, and don’t ramp up volume too quickly.
8. Hip Flexor Strain
What it is: Pain in the front of the hip, usually due to overstretching or repetitive strain.
Why it happens: Muscle imbalances, poor posture, or tightness from prolonged sitting.
Prevention tips: Stretch regularly, especially after sitting or running, and include hip-strengthening exercises in your routine.
9. Gluteal Tendinopathy
What it is: Pain in the outer hip due to inflammation of the gluteal tendons.
Why it happens: Weak glute muscles, overuse, or improper running form.
Prevention tips: Focus on strengthening the glutes and hips, and manage your training load carefully.
10. Lower Back Pain
What it is: Discomfort or stiffness in the lumbar spine, often linked to tight hamstrings or weak core muscles.
Why it happens: Poor posture, inadequate core strength, or leg length discrepancies.
Prevention tips: Strengthen your core, stretch hamstrings and hip flexors, and monitor your form.
Injury Prevention: Full-Body Tips
While each injury has its own causes and treatment strategies, a few core principles can help you avoid most running-related injuries:
Warm up and cool down properly. Start with dynamic stretching and end with static stretches.
Follow the 10% rule. Increase your mileage or intensity by no more than 10% per week.
Strength train. Incorporate exercises targeting your core, hips, and lower legs to improve stability and performance.
Listen to your body. Pain is a signal. Don’t ignore it or try to “push through.”
Get fitted for the right shoes. Your footwear should support your gait, arch type, and running goals.
FAQs: What Runners Ask Most About Injuries
Q: How do I know if I should see a doctor for a running injury?
A: If your pain doesn’t improve with rest, lasts more than a few days, or affects your ability to walk or run normally, it’s time to get it evaluated. Early intervention often prevents minor issues from becoming major setbacks.
Q: Is it okay to run through pain?
A: Mild soreness is normal, but sharp or persistent pain is not. Pain that worsens during or after a run should be taken seriously.
Q: Can cross-training help prevent running injuries?
A: Yes. Activities like swimming, cycling, and yoga can maintain cardiovascular fitness while giving your joints a break from repetitive impact.
Q: Do I need to take rest days even if I feel fine?
A: Absolutely. Rest days are when your body repairs and strengthens itself. Skipping rest can lead to overuse injuries.
Q: What role does nutrition play in injury prevention?
A: A huge one. Proper nutrition supports bone density, muscle recovery, and energy levels. Runners should prioritize protein, calcium, vitamin D, and hydration.
Don’t Let Injuries Derail Your Progress
Running should be a lifelong habit—not a cycle of injury and recovery. If you’re experiencing pain or want help developing a sustainable training plan, our orthopedic team is here to support you with expert care tailored to your needs.
Is injury-prevention top of mind for you? Schedule an appointment today.
ROC is a proud sponsor of the 2025 Portland Marathon. This post is part of our “Never Miss a Mile” campaign. To see all of our running tips, please visit our Portland Marathon page.
