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How to Prevent the Most Common Running Injuries

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Ask anyone who used to be a runner why they stopped pounding the pavement and we'll bet money their answer involves some kind of injury. Knee pain, torn tendons, even just shin splints they couldn't shake—runners are so often nursing aches and pains.

Why? Because running looks so easy. But you actually need to have a plan beyond just lacing up your sneakers and heading out the door.

"Most individuals jump right into a running program without initial assessment of their biomechanics and strengths and weaknesses, which tells you what muscles you need to focus on most in cross training. Then, they start putting in the miles on an improper foundation, which then leads to injury," says exercise physiologist Bob Seebohar, R.D., C.S.C.S., CLIF Bar Registered Dietitian and owner of eNRG Performance in Littleton, CO. (That stands even if you're a seasoned runner, by the way.)

Whether you're training for your first 5K or you've been logging miles for years, no one is immune to running injuries—unless you know how to prevent them.

Shin Splints

What it feels like: This usually manifests as a sharp pain in the shin area when you walk or run, but it can also be a dull pain throughout the day, Seebohar says. Shin splints are relatively common—but not an ache to be taken lightly. "If left untreated, the condition can worsen to the point where the muscle tendon is pulling on its attachment to the bone and eventually result in a stress fracture," says Janet Hamilton, C.S.C.S., a registered clinical exercise physiologist and owner of Running Strong Professional Coaching in Atlanta.
Prevent it: Shin splints are usually the result of upping your mileage too quickly, Seebohar points out, so be sure to stick to the rule of increasing distance by no more than 10 percent each week. Also helpful: strengthening the anterior tibialis muscle on the front of the shin. Seebohar suggests toe tapping on the ground or walking on your heels for 15 to 20 meters at a time. (Here, five stretches that can help treat and prevent shin splints.)

Runner's Knee

What it feels like: "This is a catch-all term for several different diagnoses, but the most common presentation is pain either just underneath the kneecap or in the tendon below the kneecap," Hamilton says. Because it's an overuse injury, the discomfort tends to come on gradually, often feeling minor enough that you think you can just run through it. But pushing past the pain can easily catapult you into a next-level injury because the tendon itself is weakened, she adds. The ache can also actually go away during a run, but come back afterward, Seebohar adds, so watch out for knee pain throughout the day.
Prevent it: "Runner's knee is typically caused by muscle imbalances, namely tight hamstrings, which put pressure on the knee and, with weak quads, can misalign the knee cap," Seebohar explains. That means the best prevention techniques are full squats, one-leg squats, and any stretching exercise that will target the hamstrings. Knee pain can also be due to shoes that have run through their support, Hamilton points out, so be sure you're grabbing a new pair every 400 miles or so. (Psst: Learn how to extend the life span of your fitness gear.)

IT Band Syndrome

What it feels like: The iliotibial band—the ligament that runs from the hip, along the outside of the thigh, and down to the shin—sometimes gets inflamed or becomes super tight, causing pain when you continue to run on it. "This usually feels like a dull pain on the side of the leg or a sharp pain on the outside of the knee," says Seebohar.
Prevent it: ITBS is typically related to limited strength and mobility in the lower back or hips, Seehobar says. More specifically, Hamilton says she sees it most commonly associated with weak hips, a weak pelvic floor, and a weak low back or core. Strengthen up: Try these four butt exercises to do now and 10 knee-friendly lower-body toners, which will hit all the muscles Hamilton mentioned. Seebohar also recommends finding myofascial release (like with a foam roller) on the lower back, glutes, hips, hamstrings, quads, and calves.

Plantar Fasciitis

What it feels like: The most common cause of heel pain, plantar fasciitis manifests as pain on the bottom of the foot between the ball and the heel, where your plantar fascia ligament is, Seebohar explains.
Prevent it: The best prevention is wearing supportive footwear, both experts agree. "Plantar fasciitis can be caused by wearing minimal shoes when you're not used to them, or running too many miles," Seebohar says. You can also prevent the pain by strengthening your feet (try these two easy exercises to prevent foot pain) and gradually increasing your training distance rather than tacking on three more miles just because you're feeling energized today.

Stress Fractures

What it feels like: When you overuse certain muscles, they are no longer able to absorb the shock. The stress spills over onto the bones, where a crack (fracture) develops, Seebohar explains. They can happen anywhere, but in runners, the most common areas are metatarsals (any bone in the foot) and lower leg bone (tibia), sometimes even the femur or even the pelvis, says Hamilton. Pain ranges from acute to painful enough to sideline you from a race.
Prevent it: There are a lot of factors that can help you avoid a stress fracture, including supportive shoes, gradually increasing mileage, and cross-training with non-weight-bearing activities like cycling, swimming, or yoga to offset any muscle weaknesses. One oft-overlooked habit? "If someone has repeated stress fractures, there is often an underlying nutritional issue to be addressed," Hamilton says. On top of making sure you're fueling enough in general, studies show that stocking up on calcium and vitamin D can help reduce your risk of developing a stress fracture. (And try these six healing foods to help you recover from a running injury faster.)

Achilles Tendinitis

What it feels like: This one is felt in the back of the heel or along the Achilles tendon just up from the heel bone. In addition to pain, you may have visible swelling or a knot in the tendon which can be very tender to pressure, Hamilton explains. Seebohar adds that folks usually feel the sharp pain of Achilles tendinitis first thing in the morning.
Prevent it: The inflammation is thanks to running too many miles, climbing up steep hills, or a lack of strength and mobility training. That means the smartest track to prevention is gradually adding both mileage and hills so your body doesn't feel overloaded, says Seebohar. He also suggests strengthening the back of the leg by doing eccentric calf raises: Beginning on your tiptoes, lift one foot as you gradually lower your other heel. Then, place your feet back side by side to raise back to the starting position.

Muscle Strains

What it feels like: Mild strains can happen anywhere on your body. The muscle will feel slightly stiff yet still stretchy enough to use. In a severe strain, the muscle will feel torn and deliver pain with pretty much every movement.
Prevent it: In the winter, one of the easiest ways to get injured is by skipping your warm-up, Hamilton says. We get it: You're cold, so you want to get that heater started in your body. But sprinting straight out the door places a high load on tendons that aren't ready yet. "Warm-up brings blood flow and raises the temperature in the tissues. This enhances tissue elasticity and also helps the metabolic processes, since oxygen is released from the hemoglobin more readily in warmer tissues," she explains. Warm up like you would in the warmer months, with five to 10 minutes of walking before you start pounding the pavement.

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