What Makes Running Injuries Different?

Written By Gregory Lemek

Running Injuries are a Funny Thing…

Running injuries are almost never high impact or traumatic - but as many runners know, they are almost inevitable and in some cases can become incredibly persistent.  No one type injury is inherently “worse” than another; as a PT and runner, I’ve seen firsthand how what presents as a fleeting pain in one person may become a nagging injury that keeps them sidelined for years.  With this post I want to briefly touch on why running injuries happen and outline the 6 most common running injuries.  In subsequent posts, I’m going to describe my own personal experience with each of these injuries over the past 15 years as a runner.

Why do Running Injuries Happen?

Again, we know why they DON’T happen - isolated traumatic events.  As for why they DO happen, that’s a little more complicated.  The research (and my own clinical and personal experience) points to several factors.

  • Intrinsic Factors (related to the individual)

    • strength

    • mobility

    • bone density

    • energy availability

    • gait factor

  • Extrinisic Factors (related to training/environment)

    • training volume

    • Group vs individual training

    • Training surface

    • footwear

When we look at these factors, the strongest evidence is in favor of strength, energy availability, and training volume/increase.  For all of the top 6 running injuries, a mix of these factors is likely involved.  We don’t have great clinical tests to assess whether an injury is likely ( e.g. someone who has significant “gait faults” may still be less likely to be injured than someone with perfect form); instead, we have to look at all of the factors as a whole.

The Top Six Running Injuries

There are six injuries that are seen more often than any others - to the knee, foot/ankle, and lower body bone.  Over the next few weeks, I’m going to go more in depth on each of them as well as on my own experience with them (yes, I’ve had all 6 to some extent over the last 15 years).

Knee

  • Patellofemoral Pain (aka runner’s knee)

  • IT Band Pain

Foot & Ankle

  • Achilles Tendinitis

  • Plantar Fasciitis

Bone

  • Bone Stress Injury (commonly called stress fractures)

How does treatment for each of these intersect?

All of these injuries typically require some degree of manual techniques to calm symptoms and/or exercises to build strength and tissue tolerance.  However, there is one more commonality that is even more vital: the partnership between PT and patient.  Too often, rehab focuses only on the physical. But we now know that beliefs and attitudes around injury play a huge role in recovery. It is just important to be heard, understood, and motivated in the partnership with your provider to overcome any of these injuries.

Gregory Lemek