Running injuries are rarely caused by a single moment. They develop when load, strength, and tissue capacity fall out of balance. Here’s why the most common running injuries occur.
Bayley Forbes is an osteopath and strength & conditioning coach based in Ringwood, Victoria. He founded Summit Osteo & Performance to help people bridge the gap between treatment and performance — combining hands-on care with tailored movement and strength programs to support long-term recovery and better performance.
Running is one of the most accessible forms of exercise — but also one of the most common sources of overuse injuries. Most running injuries aren’t sudden or traumatic; they develop gradually due to load, tissue capacity, technique, and recovery factors.
Understanding why injuries happen helps runners adjust their training and reduce irritation before it becomes a setback.
Below is a breakdown of the most common running injuries and the key factors that contribute to them.
Shin splints are one of the most frequent running complaints.
They occur when the tissues along the inner shin become overloaded.
Common contributors:
• Sudden increases in running volume
• Inadequate recovery between sessions
• Hard surfaces too often
• Limited calf strength or endurance
• Reduced ankle mobility
• Running technique that loads the shin excessively
Shin splints reflect a load vs capacity imbalance, not structural damage.
Runner’s knee appears as pain around or behind the kneecap, especially during stairs, hills, or longer runs.
Key contributors:
• Hip control deficits
• Weakness in quads or glutes
• Sudden increase in hill running
• Increased stride length
• Reduced capacity of patellofemoral joint to tolerate load
The knee often hurts because it is “caught in the middle” — load coming from both the hip and foot.
The Achilles is heavily loaded during running due to elastic recoil and propulsion demands.
Contributing factors:
• Sudden change in training intensity
• Low cadence running (overstriding)
• Weak calf complex
• Limited ankle mobility
• Poor load progression
• Transitioning too quickly into speed work
Tendon irritation responds well to gradual loading and strength work.
The plantar fascia helps absorb load and stabilise the foot during running.
Common causes:
• Insufficient calf strength
• Rapid increases in running volume
• Poor recovery between sessions
• Stiff big toe limiting push-off
• High or low arches affecting load distribution
Foot strength and gradual load progression are key for improvement.
ITB syndrome presents as pain on the outside of the knee, often during longer runs or downhills.
Key contributors:
• Hip weakness
• Reduced pelvic control
• Increased downhill running
• Overstriding
• Sudden spike in mileage
Improving hip control typically provides long-term benefit.
Hip-related running pain often appears as:
Front hip tightness
Side hip pain
Deep glute ache
Pain during hill running
Contributors:
• Weak hip stabilisers
• Inadequate glute activation
• Poor recovery
• Rapid weekly load increases
• Running technique that overloads one region
Strength is a major player in resolving these issues.
Lower back pain can occur when the trunk or hips fatigue.
Contributing factors:
• Reduced trunk endurance
• Overstriding
• Excessive forward lean
• Limited hip mobility
• Rapid load progression
Back discomfort during running doesn’t mean damage — often it reflects fatigue or reduced tissue tolerance.
Across all running injuries, the main patterns are:
✔ Load increases too quickly
✔ Tissues become sensitive from high repetition
✔ Strength is insufficient for training volume
✔ Running technique amplifies load
✔ Recovery is not keeping up
✔ Footwear or terrain changes alter mechanics
Running injuries are predictable — and modifiable.
The information in this article is general in nature and does not constitute personalised medical or health advice. Always consult a qualified healthcare professional for assessment and guidance tailored to your individual needs.
