Did you know that over 50% of regular runners have more than one injury yearly? Some of these injuries happen through accidents, but most are caused by other factors. We’re going to take a look at the most common running injuries and some of the best ways to avoid them.

The Most Common Running Injuries 

Most running injuries occur in the lower extremities. Here are the most common running injuries across multiple studies:

  • Tendinopathies in the patellar, Achilles, and hamstring tendons
  • Iliotibial band syndrome (IT band injury)
  • Patellofemoral pain syndrome (runner’s knee)
  • Hamstring strains
  • Medial tibial stress syndrome (shin splints)
  • Tibial stress fractures
  • Ankle sprains
  • Plantar fasciitis

Depending on the type of running you participate in (light running, marathons, ultra-marathons, etc.), you may be at higher risk for specific injuries on this list. We’ll look at each injury in more detail and then discuss prevention strategies.


Tendinopathy is a broad term to describe any tendon pains that cause pain and swelling. Achilles tendinopathy includes both tendonitis and tendinosis. Tendinitis is when your Achilles tendon is swollen and inflamed because of small micro-tears. Tendinosis is the degeneration of the collagen fibers in the Achilles tendon that is also caused by overuse.

achilles tendon diagram

Image from Cleveland Clinic

Tendon injuries in the knees, Achilles, and hamstrings are all common running injuries. To prevent tendon injuries, gradually increase the intensity or duration of your runs and implement eccentric exercise* training.

Iliotibial Band Syndrome

Iliotibial band syndrome (IT band syndrome) is where the iliotibial band (on the outside of your leg) gets irritated and swollen from rubbing against your knee or hip bones. This is less common than tendon injuries and is treated by strengthening and flexibility exercises for the core and legs. 

it band diagram

Image from Cleveland Clinic

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (sometimes called “runner’s knee”) is common amongst runners. This is a blanket term for pain in the front of the knee and around the patella and/or kneecap. Problems with alignment and overuse can all contribute to patellofemoral pain syndrome. We’ve written a post on patellar tracking disordera common type of patellofemoral pain amongst runners and athletes. You can read more about treatment and causes on that page!

patellofemoral joint diagram showing the different parts of the knee

Image from BetterPT

Hamstring Strains

Hamstring strains occur when you pull or tweak one of your hamstring muscles. Usually, you will experience sudden sharp pain in the back of your thigh. Mild hamstring strains can be treated at home with required rest, relative stretching, and a gradual return to running. Make sure to see a doctor if you can’t bear weight on the injured leg or walk without significant pain.

glute diagram

Image from Upswing Health

Medial Tibial Stress Syndrome

Medial tibial stress syndrome, or shin splints, is pain along the inner edge of the Tibia (shinbone). You might experience tenderness or soreness in the lower leg. The pain may cease at the beginning of your run but then gradually come back. This isn’t a sign that your shin splints are healing; you should still seek treatment. If you seem to have a mild case, introduce a little more rest and scale down your mileage. Other options will need to be considered if symptoms don’t improve in three weeks. Long-term management of shin splints includes rethinking your training schedule, seeking physical therapy, revaluating your running shoes, and more.

Tibial Stress Fractures

Tibial stress fractures are microscopic fractures of the tibia bone in the lower leg caused by overuse or repetitive stress. Symptoms are very similar to shin splints but gradually develop a slight pain inside the shin. They require an extended period of relative rest, followed by a more gradual return to activity. Healing times can vary from 4-12 weeks, and treatment should begin immediately. Physical therapy can help with the recovery process and can help you maintain your strength, flexibility, and fitness during your rest period.

shin diagram

Image from Mobility Mastery

Ankle Sprains

A sprained ankle occurs when you twist, turn, or roll your ankle in a way that can dramatically stretch or tear the ligaments that hold your ankle bones together. Usually, ankle sprains don’t need serious medical attention and can be treated relatively easily. Early mobilization improves recovery from ankle sprains, and exercise therapy and functional bracing while running for six to 12 months prevents re-injury.

ankle sprain diagram

Image from the Institute of Athletic Medicine

Plantar Fasciitis

Plantar fasciitis refers to inflammation of the plantar fascia. This thick band of tissue runs across the bottom of your feet and connects your toes to your heel bone. You may experience intense pain at the bottom of your heel when standing up after being sedentary for long periods. Plantar fasciitis can be significantly improved with stretching, heel raises, and orthoses that provide arch support. 

plantar fasciitis diagram

Image from Mayo Clinic

How to Avoid the Most Common Running Injuries

External accidents do not cause most running injuries. According to multiple studies, most running injuries are due to overuse and usually respond to conservative treatment options and rehabilitation. We’ll share the top ways you can avoid running injuries to keep you on your feet!

  1. Conduct research on proper footwear. Minimal shoes have spiked in popularity, but success has varied, and more research needs to be done. Some people respond better to certain running shoes than others. Consider scheduling a running shoe consultation to perform an analysis on your body type.
  2. Consider getting a gait analysis. A gait analysis assesses your form and tracking when you run. Your stride and foot impact areas can be measured and evaluated. From there, you can watch a frame-by-frame replay and understand your running style and corrections that you can work towards. You can also use that information to help determine what type of running shoe might be best for you.
  3. Work on improving your flexibility to keep proper movement possible. Tight muscles can work against your efforts at keeping good alignment. Try to keep your body loose by implementing regular stretching or yoga.
  4. *Make mobility exercises a regular part of your workout routine. Running-specific training routines also strengthen critical and supporting muscles you use while running. You can also find a physical therapist to help you formulate a mobility exercise routine to prevent injuries before they start!
  5. Build a running schedule that is gradual. One of the top causes of overuse injuries is taking on too much mileage too fast. You can find training plans online or hire a private running coach to help you meet your goals and monitor your progress.

If you’d like to get assistance with preventing running injuries or treating an existing injury, we would be happy to see you! Contact ISMI today to schedule an appointment with one of our Physicians.


Fields KB, Sykes JC, Walker KM, Jackson JC. Prevention of running injuries. Curr Sports Med Rep. 2010 May-Jun;9(3):176-82. doi: 10.1249/JSR.0b013e3181de7ec5. PMID: 20463502.

Van der Worp MP, ten Haaf DS, van Cingel R, de Wijer A, Nijhuis-van der Sanden MW, Staal JB. Injuries in runners; a systematic review on risk factors and sex differences. PLoS One. 2015 Feb 23;10(2):e0114937. doi: 10.1371/journal.pone.0114937. PMID: 25706955; PMCID: PMC4338213.

*Please always consult your physician before beginning any exercise program. This general information is not intended to diagnose any medical condition or to replace your healthcare professional. Consult with your healthcare professional to design an appropriate exercise prescription. If you experience any pain or difficulty with these exercises, stop and consult your healthcare provider.