Most common running injuries and how to prevent them

If you run three or more days a week, your chances of getting injured over the next 12 months are not low. The review by Videbæk et al. (2015, Sports Medicine) places the annual incidence between 18% and 79% depending on the runner’s profile, with an average close to 40-50% among recreational runners. Most of these injuries are not traumatic: they are caused by overuse.

This guide is designed for beginner and intermediate runners who want to understand what is happening to them (or what could happen to them) and how to reduce the risk. No miracles: just the clinical classification of the most frequent injuries, with symptoms, causes and prevention backed by studies.

Why runners get injured

Running impacts the ground with 2.5 to 3 times body weight at every stride. A 70 kg runner who covers 10 km at a cadence of 170 steps per minute accumulates about 10,000 impacts. The body adapts, but it needs time.

The main modifiable risk factor is a sudden increase in volume. The “10% rule” (not increasing weekly mileage by more than 10%) is a guideline, not a dogma, but it helps. Other factors: inadequate footwear, hard surfaces without progression, hip and foot strength deficits, and lack of rest.

The 7 most common running injuries

1. Runner’s knee (patellofemoral syndrome)

It is the most common injury: it accounts for between 16% and 25% of consultations for pain in runners (Taunton et al., 2002, British Journal of Sports Medicine).

• Symptoms: diffuse pain around or behind the kneecap, worse when going down stairs or after sitting for a long time.
• Causes: weakness of the gluteus medius, dynamic knee valgus, excess volume.
• Prevention: hip and quadriceps strength. You can start with these exercises to strengthen the knees.

2. Iliotibial band syndrome

Sharp pain on the outer side of the knee that appears mid-run and forces you to stop.

• Causes: friction of the band over the femoral condyle, aggravated by weak hip abductors and prolonged downhill running.
• Prevention: strengthen the gluteus medius (lateral hip raises, Bulgarian split squats), avoid sudden increases in downhill running.

3. Plantar fasciitis

It affects about 10% of runners at some point in their athletic life.

• Symptoms: pain in the heel or arch of the foot in the first steps of the morning.
• Causes: overload of the fascia, worn-out shoes, shortened calves and soleus.
• Prevention: strengthen the intrinsic foot muscles (heel raises with the knee bent and straight, 3×15), roll the sole over a ball, check your running shoes every 600-800 km.

4. Achilles tendinopathy

Estimated incidence of 6-18% in runners (Lopes et al., 2012, Sports Medicine).

• Symptoms: pain and stiffness in the tendon, especially at the start of activity.
• Causes: increased intensity (intervals, hill repeats), switching to a shoe with a lower drop without adaptation.
• Prevention: eccentric calf raises (Alfredson protocol: 3×15, twice a day) have the strongest evidence.

5. Medial tibial stress syndrome

Pain on the inner side of the shin, typical of runners who increase mileage too quickly or return after a break. You can find the full details in this guide on shin splints.

• Prevention: gradual progression, varied surfaces, anterior tibialis strength.

6. Stress fracture

Less frequent (1-7% of injuries in runners) but more serious. It is mainly located in the tibia, metatarsals and femoral neck.

• Symptoms: focal pain that worsens with load and does not subside with relative rest.
• Warning sign: if it hurts when hopping on one leg at a specific point, see a doctor. It may require an MRI.

7. Hamstring strains and tears

Most common in runners who do intervals or sprints without a strength base.

• Prevention: Nordic curl (3×6-8, 2 times a week) reduces the risk by around 50% according to the meta-analysis by van Dyk et al. (2019, BJSM).

How to prevent injuries: what actually works

Effective prevention is not a magic stretch. It rests on four pillars:

1. Volume progression: no more than 10-15% per week. Every 3-4 weeks, a recovery week (-30%).
2. Strength training 2 days a week: squats, deadlifts, lunges, Nordic curls, heel raises. A meta-analysis by Lauersen et al. (2014, BJSM) showed that strength training reduces sports injuries by up to 50%.
3. Real rest: 7-9 hours of sleep and at least one full day without running.
4. Specific warm-up: 5-10 minutes of mobility and easy running before intervals or long runs. Here is more context on why warming up reduces the risk of injury.

Recommendations by level

• Beginner (0-20 km/week): run-walk plan, 3 alternating days, basic strength 2 days.
• Intermediate (20-50 km/week): one quality day (intervals or threshold), one long run, the rest easy runs. Strength 2 days.
• Advanced (>50 km/week): periodization with loading and recovery weeks, specific strength work and weekly load control.

Common mistakes and contraindications

• Stretching cold before running. Long static stretches do not prevent injuries and may even reduce short-term performance. Dynamic mobility is better.
• Ignoring pain for 3-4 consecutive sessions. Pain that persists for more than a week or that appears before running needs assessment.
• Changing shoes without a transition. An abrupt change in drop or cushioning multiplies the risk of tendinopathy.
• Running every day at the same pace. 80% of the volume should be easy (conversational, RPE 3-4/10).
• Skipping strength work “because it takes away from running”. It is the other way around: it supports your volume.

See your doctor if you have focal pain that does not subside within 7-10 days, marked swelling, night pain, or if you are pregnant and want to keep running (you will need individualized guidance).

What to do tomorrow

1. Check your volume over the last 4 weeks. If you have increased by more than 15% from one week to the next, reduce it by 20-30% this week.
2. Add two strength sessions of 30-40 minutes: squats, Romanian deadlifts, lunges, heel raises and planks.
3. Check your shoes. If they have passed 700-800 km or the midsole is creased, it is time to rotate them.

Frequently asked questions

How long does it take for runner’s knee to heal?

With proper management (reduced load and hip strength), improvement is usually noticeable within 4-6 weeks. Chronic cases may take 3-6 months and an assessment by a physiotherapist.

Can I keep running with plantar fasciitis?

It depends on the pain. If it is mild (<3/10) and does not change your running form, you can maintain low volume. If you are limping or the pain exceeds 4/10, stop and get treatment. Running with high pain turns the injury chronic.

Do insoles prevent running injuries?

The evidence is limited. Custom insoles may help in cases of altered biomechanics or established pain, but there is no solid evidence that they prevent injuries in healthy runners.

Is it better to run on asphalt or on trails?

Trails reduce impact but increase the risk of sprains due to uneven ground. Alternating surfaces is the most sensible option if your ankle is strong.

How often should I change my running shoes?

Between 600 and 800 km for most models. If you notice the cushioning “collapses” or new discomfort appears without a change in training, check them before then.

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