The old “no pain, no gain” adage shouldn’t be taken too literally if you’re experiencing pain during or after running.
When you’re trying to lose weight through running, a little bit of discomfort — such as aching legs or feeling out of breath — can be a sign that you’re strengthening your muscles and your cardiovascular system. But persistent pain is something you shouldn’t ignore.
Running injuries mainly occur when you push yourself too hard or use improper running form. And they’re common — in one study that tracked 532 novice runners during a 13-week training period, 21 percent of runners reported at least one running-related injury.
Here’s what you need to know about the most common running injuries and how to prevent them.
Common Foot and Ankle Injuries
What it is: Plantar fasciitis is inflammation of your plantar fascia, a thick band of fibers that run from the base of your heel to the metatarsals of your toes. The most common spot you’ll feel pain from this injury is your heel. Plantar fasciitis may be attributed to flat feet or abnormal walking and running mechanics.
What it feels like: Not only does it hurt while you’re running, but you might feel sharp pain the moment you get out of bed in the morning, says Aaron Forrest, a NASM-certified personal trainer and coach at Gixo in San Francisco.
How to prevent plantar fasciitis: Avoid wearing rigid footwear that does not give optimal support — like uncomfortable dress shoes — for long periods of time, as this can lead to plantar fasciitis (or make it worse). To help ease the pain, Forrest recommends doing calf stretches or rolling out your foot on a golf ball.
What it is: The Achilles tendon is the thickest, strongest tendon in your body, and you rely heavily on it for strength and flexibility. Think of it as a bungee cord — it’s made up of tiny collagen fibers, Forrest says, and those fibers can become inflamed from overuse. Achilles tendonitis can also occur due to flat feet or tight calf muscles.
What it feels like: Achilles tendonitis typically starts off as a dull stiffness in your tendon — which may subside after you’ve warmed up — but the pain may worsen when you run faster, run uphill, or train wearing low-drop or zero-drop running shoes, Forrest says.
How to prevent achilles tendonitis: Achilles tendonitis in general is caused by weak or tight calf muscles, a poor range of ankle motion, and excessive pronation — all of which can be corrected with proper training.
What it is: These are two of the most dreaded words for any runner, regardless of skill level. A stress fracture is a small crack in a weight-bearing bone. This is usually caused by adding too much intensity or load too quickly, so the bones don’t have time to adapt to the increased load. Stress fractures occur most often in the tibia (shins), fibula, and the bones of the feet, says Forrest.
What it feels like: A stress fracture feels like an aching, localized pain somewhere directly along a bone that feels tender to the touch and gets progressively worse as you run or walk on it. If you think you may have a stress fracture, call your doctor.
How to prevent a stress fracture: The best way to prevent a stress fracture is by wearing supportive running shoes and making gradual changes to your training routine. If you do end up with a stress fracture, expect to take at least six weeks off from running to allow the fracture to heal, says Forrest — and part of that time may need to be spent on crutches or in a boot.
What it is: Anyone who’s ever played sports has probably experienced at least one sprained ankle. Ankle sprains occur when you tear or stretch the ligaments that hold your ankle bones in place. It typically occurs when you twist or roll your ankle beyond its normal range of motion — slipping on gravel or stumbling on a step can be enough to put your training on hold.
What it feels like: If you can’t put weight on your foot, or your ankle looks swollen or bruised shortly after the incident, it’s likely you have a sprain.
How to prevent an ankle sprain: Unlike overuse injuries, sprains are hard to avoid — a simple misstep on uneven payment can lead to a swollen, painful sprained ankle. (However, research suggests strengthening the gluteus medius muscles may help with stability during weight-bearing activities.) The good news is, most ankle sprains heal on their own. Follow the POLICE method: protection, optimal loading, ice, compression, and elevation.
Common Knee Injuries
IT Band Syndrome
What it is: Your iliotibial band (or IT band) is a thickened strip of connective tissue that runs from the top of your hip down to the lateral side of your thigh, crosses the outside of the knee, and inserts at the very top of the tibia bone. Its main function is to stabilize the knee during foot strike. IT band syndrome occurs when the band receives friction from constant bending and extending of the knee.
What it feels like: You may not experience pain immediately when you begin a run, Forrest says, but you’ll feel a dull pain or a sharp sensation on the outside of your knee that sets in after you’ve gone a specific distance. IT band pain generally hurts more when you’re heading downhill.
How to prevent IT band syndrome: IT band syndrome is an overuse injury. Wearing supportive shoes, and cross-training to strengthen your legs and glutes, can help prevent IT band syndrome. You may also want to avoid downhill routes if you’re experiencing IT band pain.
What it is: Also called patellofemoral pain syndrome, runner’s knee is a common affliction, making up about 16 percent of all running injuries.
What it feels like: It’s characterized by a dull pain near the top of your kneecap, which can be aggravated by movements such as squatting, running downhill, descending stairs, and prolonged sitting, says Forrest.
How to prevent runner’s knee: Basically, what’s happening here is irregular rubbing of the patella against a groove in your femur, which takes place when you flex and extend your knee. The muscles in your quadriceps control how the patella moves in your femoral groove, so runner’s knee has been shown to be more common in people with tight quads and adductors and/or weak glutes and abductors.
Common Leg Injuries
What it is: Medial tibial stress syndrome — better known as shin splints — is an overuse injury. Research suggests shin splints may be caused by a slight bending of the tibia bone in your running gait.
What it feels like: You’ll know you have shin splints if the front of your lower leg is aching toward the end of a run. It will often be sore to the touch, and the pain may be severe enough that you have to slow to a walk, Forrest says.
How to prevent shin splints: Shortening your mileage and reducing your intensity and duration of your runs for a while should help your bones heal (as long as there are no other underlying issues or injuries), Forrest says.
What it is: Your calves, groin, and thighs are all subject to muscle pulls or strains caused by running. These can occur one of two ways: when you suddenly stretch a muscle beyond its typical limits (such as taking off in a sprint) or when you use a muscle too much over time.
What it feels like: Most pulls or strains are uncomfortable, but not unbearable. So how can you tell a pulled muscle from a sore muscle? You may feel a sharp pain when you pull a muscle, and you’ll likely be able to pinpoint the exact spot where it hurts.
How to prevent a pulled muscle: Strength training, stretching, and warm-ups can all help reduce your risk of pulling a muscle. The good news: A muscle pull is usually relatively easy to treat by icing the injured area and taking a few days off from running.
How to Avoid Running Injuries
Most running injuries can happen to individuals of all skill levels at any time. Forrest recommends the following steps to help avoid a running injury:
- Correct your running form.
- Make sure you are wearing proper running shoes that suit your stride — many running stores will analyze your gait and recommend the best pair for you.
- Don’t skip strength training. Adding muscle mass to your legs — especially your glutes, quads, and calves — will reduce your risk of injuries such as runner’s knee, says Forrest.
- Warm up before your run, and don’t skip stretching after every workout. Warming up can prep the muscles for work, and stretching after a workout can help with muscle recovery.
When Should I See My Doctor About a Running Injury?
Many minor running injuries can be healed at home through a combination of rest and ice. However, if you’re experiencing symptoms of a more serious injury, you should stop running and see an orthopedist as soon as possible to get diagnosed — and to avoid making the injury worse. (Continuing to run on a stress fracture, for example, can cause it to progress to a serious bone fracture, Forrest says, which can land you on crutches.) Once you start feeling better, ease back into your workout slowly to avoid reinjuring the area.