Top 5 Running Injuries: Causes, Recovery, and Physical Therapy Solutions
Whether you're training for your next race or simply enjoying a jog around Lake Merritt, running offers powerful mental and physical benefits. However, it also places unique stresses on the body that can sometimes lead to injury. Physical therapy can help both treat and prevent many common running injuries—without relying solely on rest.
Let’s look at 5 of the most common running injuries—and how physical therapy can help.
Runner’s Knee (Patellofemoral Pain Syndrome)
What it is:
Pain around the kneecap, often worsened by stairs, squatting, or sitting for long periods. Knee pain accounts for 48.8% of all injuries in runners and patellofemoral pain is 25% of all running-related knee injuries. Patellofemoral pain is usually worse with activity and does not decrease after a warm-up.
Why it happens:
Running places approximately 4.6 times more force on the patellofemoral joint compared to walking. Risk factors for patellofemoral pain include recent increases in running volume, speed, or elevation (such as an increase in downhill running). Additional risk factors include a history of patellofemoral pain, being female—who are statistically more likely to experience this condition—and early sports specialization during youth.
How PT helps:
A strength-based rehab program targeting the hips and quadriceps can significantly reduce symptoms and improve function. A physical therapist will also rule out patella tendon pain, IT band pain, or Osgood-Schlatters.
IT Band Syndrome (Iliotibial Band Syndrome)
What it is:
Pain on the outside of the knee, especially during downhill running.
Why it happens:
The iliotibial (IT) band plays a key role in stabilizing the knee and kneecap, while also helping to transfer force through the thigh during running. Pain in the area often results from compression on the outer side of the knee. Iliotibial band pain is more common in male runners and individuals who are just beginning to run consistently. Training factors that increase the risk include more downhill running, higher running speeds, and increased training volume.
How PT helps:
Physical therapy can help guide you in properly offloading the iliotibial band, gradually introducing strengthening and jumping activities, and initiating a return-to-run program
Shin Splints (Medial Tibial Stress Syndrome)
What it is:
An aching pain along the inner shin that is usually more than 10 centimeters in length.
Why it happens:
Medial tibial stress syndrome can be related to an increase in training load and intensity, ankle range of motion, or weakness in the calf muscles.
How PT helps:
Physical therapists use running gait retraining if needed, a strength program that focuses on single-leg stability, and a gradual return to run program to treat shin splints. A physical therapist will also differentiate between medial tibial stress syndrome and a stress fracture, and refer to an appropriate medical provider if needed.
Plantar Fascia Pain
What it is:
Stabbing pain in the heel, typically worse with the first steps in the morning, when you start running, or after sitting for a long period of time.
Why it happens:
Often caused by an increase in running volume, an increase in uphill or speed work, poor ankle and big toe mobility, and weak foot and calf muscles.
How PT helps:
A guided loading program that progresses from lower body strengthening to jumping and running, manual therapy for range of motion improvement, and foot-strengthening exercises can reduce pain and restoring function.
Achilles Tendinopathy
What it is:
Pain or stiffness in the Achilles tendon, especially when you first start running, after you cool down, or during push-off.
Why it happens:
Usually related to an increase in running volume, an increase in speed work, or weakness in the calf muscles.
How PT helps:
Gradual calf strengthening and lower body loading can help re-educate the achilles tendon, decrease pain, and eventually progress the runner to tolerate running again.
Why Choose Physical Therapy First?
Seeing a physical therapist early can help you break the cycle of pain, recover faster, and reduce your risk of future injuries. At Derek Lam Physical Therapy and Performance, I go beyond treating symptoms—I address the root cause. Every session is one-on-one and includes detailed movement analysis, hands-on therapy, and a personalized plan tailored to your running goals.
If you're struggling with a running injury, I’m here to help. Let’s get you back to doing what you love—stronger, faster, and pain-free.
Ready to book your first visit with me? Visit www.derekorthopt.com or click here to schedule online. I’m here to help you get back to doing what you love—pain-free.
📍 Derek Lam Physical Therapy and Performance
🏢 399 Grand Ave, Oakland, California 94109
🌐 www.derekorthopt.com
📆 Book Online Now
Resources:
Taunton, Jack E., et al. A retrospective case-control analysis of 2002 running injuries. BJSM 36.2 (2002): 95-101; Van Tiggelen, D, et al.
Effect of bracing on the prevention of anterior knee pain—a prospective randomized study." KSSTA, Arthroscopy 12.5 (2004): 434-439.Hall
Giarmatzis G et al.,(2015) J. Bone & Min. Res.; Willy RW et al., (2016) J. Biomechanics; Willy RW et al., (2016) JOSPT.
Willy, RW., et al. (2019). Patellofemoral pain: clinical practice guidelines linked to the international classification of functioning, disability and health from the academy of orthopaedic physical therapy of the American physical therapy association. JOSPT, 49(9), CPG1-CPG95.
