Running Injuries

One in three runners suffer some form of lower limb pain and injury. Most often the injury is located in one or more of the following anatomical sites:

  • Lumbo-pelvic region
  • Tibio-femoral joint (knee)
  • Patello-femoral joint (knee-cap)
  • Hip Joints
  • Lower third of the tibia (shins)
  • Posteria tibials (calf)
  • Achilles
  • Feet:
    • Meta-tarsals
    • Medial arch
    • Calcaneal

Running injuries are typically referred to as overuse injuries. These include sprains, strains, and abnormal loading of various soft and hard tissues such as bone or cartilage. Over use injuries make up almost 90% of all sports injuries, and only 10% of these need to be admitted for in-patient medical treatment such as surgery.


Running injuries are caused by a number of complex interacting factors operating at a given point in time.

Intrinsic factors related are the internal factors specific to the runner and may be congenital or developmental. Intrinsic factors may include:

  • Foot type: Flat, high arch
  • Leg length
  • Muscle weakness or imbalance
  • Flexibility limitations
  • Joint hyper or hypo mobility
  • Age, Gender
  • Weight
  • Alignment and Biomechanics (discussed later)

Extrinsic factors in running injuries are the external variables, which have some impact on the human body. These include:

Training errors

  • Intensity
  • Distance
  • Progression rate
  • Terrain
  • Fatigue/Fitness


  • Movement Control
  • Dynamic Stability

Tissue Loading

  • Repetition
  • Speed
  • Surface
  • Footwear


  • Heat
  • Humidity
  • Altitude
  • Visibility


  • Shoes
  • Clothing
  • Orthotics

It is quite clear that the factors are many and interact to produce or prevent musculo-skeletal micro-trauma in runners.


Most lower limb running injuries develop gradually without a significant event or history of trauma. These injuries are essentially due to excessive or abnormal stresses repeatedly overloading normal tissues. Micro-trauma over long periods, often years, causes tissue damage, and eventually pain.

These injuries are mechanical in nature, that is, they typically hurt when movement or loading occurs and diminish when you rest. However where significant tissue damage has occurred and there is gross oedema, the pain may linger for some time post-run. In some cases athletes complain of pain after running or even before. In those athletes with post-run pain, heat generation and the gradual nature of micro trauma can either disguise or delay the symptoms until after the event.