A running assessment can examine training load, movement and lower-limb capacity.

Running injuries commonly develop when training load rises faster than the body can adapt. They often affect the knee, shin, calf, Achilles tendon, ankle, heel or foot. Symptoms may also involve the hip or lower back.

The important question is not simply whether running caused the pain. Instead, consider whether your recent running, gym work and recovery demands exceeded your current tissue capacity. Early load adjustment and an appropriate rehabilitation plan may help you stay active while addressing the cause.

What Are Running Injuries?

Running injuries include painful or limiting conditions associated with repeated running load. Some develop gradually over days or weeks. Others occur suddenly during sprinting, changing direction, landing awkwardly or running over uneven ground.

Each stride requires the foot and lower limb to absorb force, control the body and produce push-off. These demands repeat thousands of times during a training week. Therefore, a relatively small mismatch between training and capacity can become significant when repeated frequently.

Common symptoms include:

• pain during or after running
• morning stiffness in the Achilles tendon or heel
• shin pain that builds during impact activity
• front or outer knee pain during hills or longer runs
• calf tightness or pain during faster running
• foot or ankle pain after changes in distance, terrain or footwear
• pain that returns at a similar point during each run

Where Do Runners Commonly Feel Pain?

Most running-related problems affect the lower limb. However, the painful location does not always identify the diagnosis. The symptom pattern, training history and physical assessment provide more useful information.

Common Running Injuries

Runner’s Knee

Runner’s knee commonly causes pain around or behind the kneecap. It may become noticeable during longer runs, downhill running, stairs, squatting or after sitting with the knee bent.

Shin Splints

Shin splints usually cause a broader area of pain along the inner shin. Symptoms commonly develop after increases in impact load, hills, running frequency or training intensity.

Achilles Tendinopathy

Achilles tendinopathy may cause tendon pain, thickening or morning stiffness. Faster running, hills and sudden increases in training can aggravate symptoms.

Plantar Fasciitis

Plantar fasciitis commonly causes heel or arch pain. Symptoms may feel worse during the first steps after rest and can return during longer periods of standing, walking or running.

Tibial Stress Fracture

A tibial stress fracture usually causes more localised bone pain than shin splints. Pain may persist after exercise, worsen with hopping or begin earlier during each run. Suspected bone stress injuries need prompt assessment and impact-load modification.

Calf Muscle Strain

A calf muscle strain often occurs during sprinting, hills or forceful push-off. Symptoms may include a sudden pull, local tenderness, reduced calf strength and pain during walking or calf raises.

Running Pain by Training Demand

The activity that aggravates your pain can provide useful clues. However, it does not confirm a diagnosis on its own.

Why Do Running Injuries Develop?

Running injuries rarely have one cause. They commonly occur when several factors combine and the total demand exceeds what the body can currently tolerate.

Training Load Changes

Risk may increase when runners change several variables at once. Examples include adding more kilometres, running faster, adding hills, increasing gym load and entering a race within the same training period.

Reduced Recovery

Sleep, nutrition, illness, work demands, travel and closely spaced hard sessions can affect recovery. A training plan that was previously manageable may become excessive when recovery capacity changes.

Strength and Physical Capacity

Calf, foot, thigh, hip and trunk capacity help runners absorb and produce force. Reduced capacity does not automatically cause injury. However, it may contribute when training demand rises beyond what those areas can tolerate.

Previous Injury

A previous injury may affect strength, movement confidence or training consistency. Returning to full running before rebuilding these qualities can increase the chance of another flare-up.

Footwear and Terrain Changes

A different shoe model, worn footwear, a change in heel-to-toe drop or a switch between road and trail running can alter load distribution. Introduce major footwear and terrain changes gradually rather than combining them with a sharp training increase.

Can You Keep Running With Pain?

Some runners can continue modified training while recovering. The decision depends on the likely diagnosis, pain behaviour, running mechanics and how symptoms respond later that day and the following morning.

How Can Physiotherapy Help Running Injuries?

Physiotherapy for running injuries begins by identifying the likely condition and the factors that are keeping it irritated. The assessment may include your symptom history, recent training changes, previous injuries, running goals and recovery pattern.

Your physiotherapist may also assess:

• walking, squatting and single-leg control
• calf, hamstring, quadriceps and hip strength
• ankle, knee and hip mobility
• hopping, landing or running tolerance where appropriate
• footwear and recent terrain changes
• running technique when it is relevant to the problem

Treatment depends on the diagnosis. A plan may involve temporary load modification, progressive strengthening, mobility work, symptom management and graded return-to-running exposure. A structured running assessment may help when symptoms recur, technique questions remain or you need a plan matched to your pace, distance and goals.

For a broader treatment pathway, see sports injury physiotherapy. Healthdirect also provides a general public overview of physiotherapy in Australia.

How Can Runners Reduce Injury Risk?

No strategy prevents every running injury. However, sensible training progression and adequate physical capacity may reduce avoidable overload.

How Do You Return Safely to Running?

A graded return usually works better than repeatedly testing whether you can complete your old distance or pace. Your starting point should match the diagnosis, current walking tolerance, strength and previous running level.

Spacing early impact sessions by about 48 hours is a common starting point, but it is not a fixed rule for every injury. Your diagnosis, symptom response and training history should guide the final schedule.

When Should You See a Physiotherapist?

Arrange an assessment when pain keeps returning, changes your stride, limits normal training or becomes progressively easier to provoke. Earlier assessment is also sensible when you are unsure whether the problem involves a muscle, tendon, joint or bone.

Progressive rehabilitation helps prepare the lower limb for running load.

Running Injuries FAQs

What to Do Next

If running pain is affecting your training, a physiotherapist can assess the likely injury, review your recent workload and guide an appropriate rehabilitation and return-to-running plan.

Choose your preferred PhysioWorks clinic below to book an assessment.

References

1. Naderi A, Alizadeh N, Calmeiro L, Degens H. Predictors of running-related injury among recreational runners: a prospective cohort study of the role of perfectionism, mental toughness, and passion in running. Sports Health. 2024;16(6):1038-1049. doi:10.1177/19417381231223475
2. Correia CK, Machado JM, Dominski FH, de Castro MP, Fontana HB, Ruschel C. Risk factors for running-related injuries: an umbrella systematic review. J Sport Health Sci. 2024;13(6):793-804. doi:10.1016/j.jshs.2024.04.011
3. Leppänen M, Viiala J, Kaikkonen P, et al. Hip and core exercise programme prevents running-related overuse injuries in adult novice recreational runners: a three-arm randomised controlled trial. Br J Sports Med. 2024;58(13):722-732. doi:10.1136/bjsports-2023-107926
4. Wu H, Taddei UT, Mena SR, Willy RW. Do exercise-based prevention programs reduce injury in endurance runners? A systematic review and meta-analysis of randomised controlled trials. Sports Med. 2024;54(4):905-922. doi:10.1007/s40279-023-01983-3