The Six Most Common Running Injuries and How to Fix Them

Published 6 August 2026 · 9 min read · By the Platinum Physiotherapy Clinical Team

Running is the most accessible sport there is, and by some distance the one that generates the most repetitive strain injuries. A large proportion of regular runners will pick up an injury that interrupts training in any given year, and the overwhelming majority of those injuries are not accidents — they are the predictable result of asking the body to absorb more load than it has been prepared for. Brampton has genuinely good running: the Etobicoke Creek Trail, the Chinguacousy Park loops, the Esker Lake and Heart Lake trails, and quiet residential grids in almost every neighbourhood. This guide covers the six injuries we treat most in runners, and — more usefully — the load principle that underlies nearly all of them.

The One Principle Behind Almost Every Running Injury

Tissues adapt to load, but slowly. Muscle adapts fastest; tendon and bone adapt considerably more slowly — tendon takes months, not weeks. Injury happens when the load you apply outpaces the rate at which your tissue is adapting to it. That is it. That single idea explains why injuries cluster in the weeks after someone starts a new training plan, signs up for a first half marathon, adds hill repeats, switches to a track, or returns from a layoff at their old mileage.

The practical implication is that the fix is rarely "run less forever" and almost never "buy different shoes". It is to build capacity while temporarily reducing the specific load that is provoking symptoms — what clinicians call relative rest. Complete rest feels intuitive and is usually counterproductive: it lets the tissue de-condition further, so returning at the same volume simply reproduces the injury.

Runner’s Knee (Patellofemoral Pain)

The most common running injury by a clear margin. It presents as a diffuse ache around or behind the kneecap — patients typically circle the whole kneecap with a finger rather than pointing to one spot — worse going down stairs or hills, and often after sitting with the knee bent for a long time.

Despite decades of blaming kneecap alignment, the evidence points squarely at load and strength, particularly hip and quadriceps strength. Runners with weak or poorly controlled hip abductors let the knee drift inward on landing, which concentrates load across the joint. Treatment that works: hip abductor and quadriceps strengthening, temporarily reducing hills and downhill running, and modestly increasing your step rate — running with slightly shorter, quicker strides reliably reduces load through the knee. Most cases resolve well within six to twelve weeks. See our knee pain page for detail.

Shin Splints and the Injury They Can Hide

Medial tibial stress syndrome — shin splints — is pain along the inner border of the shin bone, typically diffuse over several centimetres, sore at the start of a run, sometimes easing as you warm up, and tender to press along a length of bone. It is very common in new runners and in anyone who has recently increased mileage or moved to harder surfaces.

The critical distinction is between shin splints and a tibial stress fracture. Suspect a stress fracture if the pain is sharply focal — you can cover the sore spot with one fingertip — if it worsens progressively through a run rather than easing, if it hurts when you hop on that leg, or if it aches at night. That warrants prompt assessment and often imaging, because continuing to run on a stress fracture risks a complete fracture. Shin splints themselves respond to reducing volume and impact temporarily, calf and foot strengthening, and a gradual return.

IT Band Syndrome

Sharp, well-localised pain on the outside of the knee that appears at a fairly predictable point in a run — often the same distance every time — and is typically worse running downhill. Many runners can walk and even sprint without symptoms but cannot run at steady pace beyond that threshold.

The old model of the iliotibial band "rubbing" over the bone has largely been replaced: the current understanding is compression of a sensitive fat pad beneath the band. Practically, this changes treatment. Aggressive foam rolling of the band itself gives limited lasting benefit, because the IT band is a dense structure that does not meaningfully stretch. What does work is hip abductor and gluteal strengthening, avoiding downhill running and cambered road surfaces temporarily, and reducing crossover in your stride — running with your feet landing slightly wider apart rather than in a line.

Achilles Tendinopathy and Plantar Fasciitis

Both are load-related tendon and fascia problems, and both follow the same rules. Achilles tendinopathy causes pain and stiffness in the tendon, classically worst in the first few steps in the morning and at the beginning of a run, sometimes with a palpable thickening. Plantar fasciitis causes sharp heel pain on the first steps out of bed that eases after a few minutes of walking and returns after periods of sitting.

The treatment principle for both is progressive loading, not rest and stretching. Tendons respond to controlled, gradually increasing load: calf raises for the Achilles, progressing from double-leg to single-leg to added weight, performed consistently over months rather than weeks. For plantar fasciitis, calf strengthening plus foot intrinsic work and, for many people, custom orthotics. Both conditions are slow — expect three to six months for a full resolution of a well-established case — and both respond poorly to being ignored, so early treatment matters. Shockwave therapy is a useful addition for stubborn cases. Our heel pain guide covers this in more depth.

Hamstring Strains and Proximal Hamstring Pain

Runners get two distinct hamstring problems. Acute strains happen during fast running — a sudden pain in the back of the thigh that stops you. These need a graded return with a strong emphasis on eccentric strengthening, because the single biggest risk factor for a hamstring strain is a previous hamstring strain.

Proximal hamstring tendinopathy is different and more common in distance runners: a deep ache right at the sit bone, worst when sitting on hard surfaces, when running uphill, and when accelerating. It is often mistaken for sciatica but has no nerve symptoms. Treatment is progressive loading with initial avoidance of deep hip flexion — so temporarily reducing hills, speed work, and deep stretching, which many runners do instinctively and which usually makes it worse.

Returning to Running Without Re-Injury

The return is where most runners come unstuck. Two rules cover most situations. First, pain during the run should stay at or below a mild 3 out of 10, should settle within 24 hours, and should not be worse the next morning. If it is worse the next day, the previous run was too much. Second, increase one variable at a time — distance or pace or hills, never two in the same week — and increase total weekly volume modestly rather than in jumps.

A walk-run progression is a genuinely effective bridge back for most injuries: alternating running and walking intervals and gradually shifting the ratio over two to four weeks. Keep strengthening through the return, not just until the pain goes — the pain settles well before capacity is rebuilt, which is exactly why so many running injuries recur. Finally, treat shoes as comfort, not medicine: the evidence that a particular shoe type prevents injury is weak, and choosing what feels comfortable and changing gradually beats prescriptive shoe theory.

When to See a Physiotherapist

Get assessed if pain has persisted more than two weeks despite reducing your running, if it makes you limp or alter your gait, if you have focal bone pain or night pain, if there is swelling, or if the same injury keeps returning. Recurrence is the clearest sign that the underlying capacity problem was never addressed.

At Platinum Physiotherapy in Brampton, a running assessment is one-on-one and looks at the whole chain — hip and calf strength, ankle mobility, training history, and where the load spike came from — rather than just the sore spot. From there you get a specific strengthening program and a structured return-to-run plan with numbers in it, so you know exactly what next week looks like. We are open seven days a week and direct-bill most insurers. Read more on our sports injury rehabilitation page.

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