What should you do to prevent running injuries?
Follow the 10% rule for mileage increases, incorporate strength training 2-3 times per week, run most miles at easy effort, wear properly fitted shoes, and include adequate rest days in your training plan.
The single most predictive factor for running injuries is training error — too much mileage, too fast, too soon. A systematic review in the British Journal of Sports Medicine found that rapid increases in training load are associated with significantly higher injury rates. The 10% rule (never increasing weekly volume by more than 10%) provides a practical safeguard.
Beyond training load management, runners should follow the 80/20 polarized training model: 80% of running should be at easy, conversational pace, with only 20% at moderate to hard intensity. This approach, supported by research from Stephen Seiler, reduces injury risk while simultaneously improving performance more than high-intensity approaches.
What are the most common running injuries?
The five most common running injuries are patellofemoral pain syndrome (runner's knee), medial tibial stress syndrome (shin splints), Achilles tendinopathy, plantar fasciitis, and iliotibial band syndrome.
Runner's knee (patellofemoral pain) accounts for 19-30% of all running injuries. It causes pain around or behind the kneecap that worsens with running, stairs, squatting, or prolonged sitting. The primary causes are weak hip muscles (particularly the gluteus medius), quadriceps imbalances, and overtraining (Source: British Journal of Sports Medicine).
Shin splints (medial tibial stress syndrome) are the second most common, affecting 13-20% of runners. They cause pain along the inner edge of the shinbone during and after running. Risk factors include running on hard surfaces, wearing worn-out shoes, sudden increases in mileage, and overpronation. Untreated shin splints can progress to stress fractures.
- Runner's knee (patellofemoral pain) — 19-30% of runners, knee pain
- Shin splints (MTSS) — 13-20%, inner shin pain
- Achilles tendinopathy — 6-17%, heel/calf pain
- Plantar fasciitis — 4-10%, bottom of foot pain
- IT band syndrome — 5-14%, outer knee pain
How does strength training prevent running injuries?
Strength training reduces running injury risk by 50% or more according to a major meta-analysis. Targeting the hips, glutes, core, and calves corrects the muscle weaknesses that cause most running injuries.
A landmark 2014 meta-analysis in the British Journal of Sports Medicine found that strength training reduced sports injuries by one-third and overuse injuries by nearly 50%. For runners specifically, hip and gluteal weakness are the most common contributors to knee injuries, IT band syndrome, and shin splints.
A runner-specific strength program should include: single-leg squats, hip bridges, clamshells, calf raises, deadlifts, and core anti-rotation exercises like Pallof presses. Perform 2-3 strength sessions per week, focusing on moderate weight and higher repetitions (3 sets of 12-15 reps). Schedule strength sessions on easy run days or after hard sessions, not before them.
What role do running shoes play in injury prevention?
Properly fitted running shoes reduce impact forces and improve comfort, but no single shoe type prevents all injuries. Comfort is the strongest predictor of injury reduction. Replace shoes every 400-500 miles.
The relationship between running shoes and injury prevention is more nuanced than marketing suggests. A large randomized trial in the British Journal of Sports Medicine found that prescribing shoes based on foot type (pronation) did not reduce injury rates compared to neutral shoes. However, runners who found their shoes comfortable had significantly fewer injuries.
Visit a specialty running store for a gait analysis and professional fitting. Key considerations include adequate toe box width, appropriate cushioning for your body weight and running surface, and drop height (heel-to-toe differential) that matches your running style. Transition gradually if changing shoe type — the body needs time to adapt to different mechanical demands.
How should you warm up before running?
A dynamic warm-up of 5-10 minutes is more effective than static stretching before running. Include leg swings, walking lunges, high knees, and butt kicks to prepare muscles and joints for the demands of running.
Static stretching before running can temporarily reduce muscle power output and running economy. A 2014 meta-analysis in the Scandinavian Journal of Medicine & Science in Sports found that pre-exercise static stretching reduced strength by 5.4% and power by 2.0%. Dynamic warm-ups, by contrast, increase core temperature, activate key muscle groups, and improve neural readiness.
An effective running warm-up takes 5-10 minutes: start with 2-3 minutes of brisk walking, then perform dynamic exercises including leg swings (forward/back and side-to-side, 10 each direction), walking lunges (10 each leg), high knees (20 steps), butt kicks (20 steps), and A-skips (20 steps). Then start running at an easy pace for the first mile before progressing to your target pace.
What training mistakes lead to running injuries?
The most common training errors are increasing mileage too quickly, running too fast on easy days, neglecting rest days, ignoring early warning signs of pain, and skipping strength training entirely.
Training errors cause an estimated 60-70% of all running injuries. The most prevalent mistake is violating the 10% rule — studies show that runners who increase weekly mileage by more than 30% have a significantly elevated injury risk. Other common errors include running every session at moderate-to-hard effort (violating the 80/20 rule) and increasing both mileage and intensity simultaneously.
Many runners ignore early pain signals, continuing to train through worsening symptoms. This converts manageable issues into serious injuries. A good rule is the 2-day test: if pain is present at the same location during 2 consecutive runs, take 3-5 days off from running and cross-train (cycling, swimming, or elliptical). If pain persists after rest, see a sports medicine professional.
When should a runner see a doctor?
See a healthcare provider if pain persists beyond 7-10 days of rest, if you experience sharp or worsening pain during runs, if swelling is visible, or if pain changes your running form or daily activities.
Warning signs that require prompt medical evaluation include: bone pain that is localized to one spot and hurts when you press on it (possible stress fracture), progressive weakness in the foot or ankle, sudden-onset swelling in a joint, pain that wakes you at night, and any numbness or tingling in the legs or feet.
Sports medicine physicians, orthopedic specialists, and physical therapists with running expertise are the best healthcare providers for running injuries. They can perform biomechanical assessments, prescribe targeted rehabilitation, and determine if imaging (X-ray, MRI, ultrasound) is needed. Early intervention typically leads to faster recovery and reduced time away from running.
