Common causes of running injuries

One of the most important factors in creating a running training plan, analyzing run technique or prescribing run strengthening exercise is knowledge of a runners injury history, and what led to these injuries. With 10+ years of working with runners as a Physiotherapist, I have come to see common causes of running injuries.  These include: 

  • Unresolved old injuries

This actually goes for most people I see and not just runners.  I cannot tell you how many times I find signs on examination that an old injury has not fully recovered. Strength deficits, poor neuromuscular timing & activation and joint mobility restrictions are just a few.  Your body can only compensate for so long and there may come a point where these deficits/imbalances are unable to cope with the level of loading you place on your body leading you to decompensate and cause tissue damage.   

  • Little training variation

One of my questions to a runner is ‘tell me about your training’.  If clients don’t run with a club or have little running experience, I often get the answer ’I run 3-4 times per week for the same distance and the same pace’ (which is often too fast).  This has many implications for injury in the body, one being excessive fatigue of repeatedly running at too high an intensity. Training well and recovering well for running requires variability in speed and distance from session to session, week to week and month to month.  If you’d like to keep it simple then follow a ‘cookie cutter’ program on the internet based on either pace or heart rate zone training. If you’d like to take your running to the next level then get a customized program. 

  • Lack of running strength training & conditioning

Another question I ask is ‘Apart from running what other exercise to strengthen your body do you do?’  The top 2 answers are:

  1. Upper body weights (often just machine) and core work (often just sit ups)

  2. Nothing

When you run you transfer 2.5 times your body weight from leg to leg, which requires good whole body function. To run well, fast and cope with normal training tissue breakdown/change I believe we all need to incorporate whole body strength work and especially single leg strength development to aid force absorption and propulsion.  The extent and type to which you do will vary dependent on your running goals, level of ability, age etc. Your legs are the most important and just doing upper body and/or core will only serve to make it harder for you to run well.  Thus, running strength training is the way to go!

  • Excessive foot strike patterns

There is no clear consensus about the best foot strike pattern when running steady state and it is not for me to go into detail about this here. However, I will say that I see a lot of recreational/inexperienced runners getting injured from an excessive and heavy heel strike with overstride or an excessive forefoot strike with little follow through contact to the heel.  These both have big implications for abnormal loading into the tissues.

There are of course more causes than this, but these rank quite highly in my experience.  The great thing is, with a simple effective approach you can address all these issues and give yourself the best chance to optimize your running and prevent running injuries. 


Lee Watkins

Founder of RUNFLOW