Running injuries are the main reason novice runners give up. Running costs almost nothing to take up, so plenty of Australians start without a coach, a club, or any advice about what to do when a leg begins to hurt.
The response to a running injury depends on which injury it is. Sore shins and a cracked shin bone can feel similar across the first week of symptoms, and the decisions they call for pull in opposite directions. Australian conditions add heat illness on top of all of it, from spring through to the end of summer across most of the country.
Common Running Injuries
Running injuries are damage to your muscles, tendons, ligaments, or bones caused by running. Around 40 percent of runners get injured, and your knee, ankle, and lower leg have the highest risk of injury. Your foot, hip, and thigh account for most of the rest. Running is repetitive by nature, so the same tissue takes the same stress thousands of times in a single session, and a problem left untreated can return as soon as you resume your usual distance.
Injury in runners varies with experience. Beginners are injured more than twice as often as experienced. Muscles, tendons, and bones adapt to repeated impact across months of training, and anyone new to running has less of that adaptation behind them. The first weeks of a program are also when weekly distance climbs fastest in percentage terms, which stacks two risks in the same period.
Overuse Injuries
Overuse injuries develop from repeated small stresses to the same tissue without enough recovery between sessions, and they account for the largest share of running injuries. The damage accumulates across weeks rather than arriving in a single moment, and early symptoms can be mild enough to run through. The common overuse injuries in runners affect a handful of structures below your knee and around it, and each has a recognisable location and behaviour.
Medial tibial stress syndrome is the medical term for shin splints. Pain runs along the inner edge of your shinbone through the lower two-thirds of your lower leg, and the tenderness spreads along a strip rather than concentrating in one spot. The cause is repeated stress and strain on the muscles, tendons, and bone tissue around your shinbone. Flat feet, inward rolling of your foot, differences in leg length, and weak or tight calf muscles, hip muscles, and core muscles all increase the stress on your shin.
Repeated impacts can slowly damage and cause a stress fracture. Your pain narrows to one small spot you can press with a fingertip, hopping on that leg reproduces it, it arrives earlier in each run, and it can persist while you walk or wake you at night. If your shin pain concentrates in one small spot, keeps hurting while you walk, or wakes you at night, then stop running and see your doctor.
Your achilles tendon connects your calf muscles to your heel bone. Achilles tendinopathy sets in when repeated strain outpaces its repair. The pain appears at the back of the heel or a few centimetres above it, and it may feel stiff when stationary. Stretching may be enough to ease the pain.
Patellofemoral pain syndrome is the medical term for the dull ache around or behind your kneecap that runners call runner’s knee. Descending stairs, squatting, and sitting for long periods with bent knees each aggravate it, and squatting is the movement most likely to reproduce the pain during an examination.
Your iliotibial band is a band of connective tissue running down the outside of your thigh from your hip bones to the top of your shinbone. Iliotibial band syndrome is when repeated bending and straightening of your knee can irritate the tissue it moves across. Weakness in your hip muscles is one contributor, and the same band can become painful on the outside of the hip. Downhill running and running on a sloped surface such as a cambered road can bring the pain on sooner.
Your plantar fascia is a strong, thick band of tissue running along the bottom of your foot from your heel bone to your toes, and it forms the arch of the foot. Plantar fasciitis sets in when that band becomes irritated and sore. Pain concentrates under your heel and is worst with your first steps in the morning or after you have been sitting still, then eases after a few minutes of walking.
Overuse running injuries develop too slowly for a first aid response at the scene. Avoid running on the injury, consider changing to a stronger running shoe, and book an assessment with a physio, podiatrist, or sports medicine doctor before you return to running.
Sudden Injuries
Sudden injuries happen in a single moment, from one awkward step, a trip, or a landing that goes wrong. These acute injuries account for fewer running injuries, but they are the ones that call for first aid at the scene. Your response in the first hour shapes how much swelling and bleeding occurs inside the tissue.
An ankle sprain is a stretch or tear of the ligaments holding your ankle joint together, and it happens when your foot rolls inward under your body weight. Swelling, bruising, and pain and inflammation develop around the outside of your ankle within hours.
Muscle injuries in runners centre on your calf and your hamstring. A calf tear causes sudden sharp pain in the back of your lower leg during push-off. Hamstring strains cause the same at the back of the leg, closer to your buttock or behind your knee depending on which part tears. Both can leave you able to walk while unable to run.
Signs of a rupture of your achilles tendon include a pop or snap at the back of your ankle, a sensation of being kicked in the back of the leg, sharp pain and swelling near your heel, and an inability to push off or stand on your toes on that side. Walking can still be possible after a rupture, so the pop and the loss of push-off are the signs to act on rather than if you have to limp to walk.
Trips can cause cuts, grazes, and even concussions. Minor injuries can be treated with water and a bandaid, but concussions require professional medical treatment. Signs include confusion, headache, nausea, dizziness, and trouble remembering the moments around the incident.
For any of these running injuries, stop the moment a sudden injury happens. Call 000 if any of the following apply:
- your limb is bent out of shape, or bone is visible
- you cannot put any weight on your leg
- you heard a pop and cannot push off the ground or stand on your toes
- the person is confused, drowsy, vomiting, or unconscious after a knock to the head
- bleeding does not slow with firm pressure
Otherwise, treat the injury where it happened and arrange to see your doctor or a physiotherapist. For the first one to three days, keep weight off the injured leg, raise it above the level of your heart, and wrap it with a compression bandage.
Using crutches or a walking stick can help if you cannot stand on it without pain. Avoid heat, alcohol, running, and massage across the same period. Start gentle pain-free movement as early as you can manage, because prolonged complete rest weakens the tissue you are trying to protect. Avoid ice and anti-inflammatories as these interfere with swelling, which is part of the body’s natural healing process.
Heat Illness and Dehydration
Running generates heat that your body has to clear, and high temperature and humidity slow that process. Heat illnesses can range from mild to life-threatening, and the early signs overlap with hard effort, since anyone running hard is already hot, sweaty, and breathless. Once someone becomes too dehydrated to sweat, body temperature can rise rapidly. Watch for any of the following:
- an inability to keep going
- a high body temperature
- dizziness or faintness
- nausea, vomiting, or diarrhoea
- pale skin
- dry skin
- poor muscle control or weakness
- confusion, drowsiness, or a seizure
If someone has stopped sweating, treat it as serious. Otherwise, keep watching them, because heat illness can be present in someone who is still sweating heavily. Stop the run and start cooling as soon as any of the warning signs appear.
Send for an ambulance early, and start cooling while you wait. For anyone over five years of age, whole-body immersion from the neck down in cold water for 15 minutes is the most effective cooling method. If a cold bath is available, use it. Otherwise, combine several methods. Wet the skin with cold water from a hose, shower, or other source, apply ice packs to the groin, armpits, cheeks, palms, and soles, moisten the skin repeatedly with a wet cloth or spray, and fan continuously. Lie the person down in shade or a cool room, remove excess clothing, and keep checking whether they are still responding while you cool them.
Give them cool or cold water to drink only if the person is fully conscious and able to swallow. For dehydration caused by exertion, a drink containing 3 to 8 percent carbohydrate and electrolytes is suggested, and a commercially available sports drink fits that description. If the person cannot swallow safely or is drifting in and out of consciousness, give them nothing to drink and stay with them until the ambulance arrives.
First Aid Training for Runners
First aid training covers recognising a heat emergency and cooling someone while an ambulance is on the way, managing a sprain or a suspected break, controlling bleeding after a fall, checking someone after a knock to the head, and performing CPR if a heart stops during exercise. Enrol in first aid training so you can treat running injuries while an ambulance is on its way.
FAQs
How Much Water Should You Drink During a Long Run?
Drink to thirst rather than to a fixed schedule. Drinking beyond thirst dilutes the sodium in your blood and can cause exercise-associated hyponatraemia.
Can Running Cause Arthritis in Your Knees and Hips?
No. Hip and knee arthritis appears in about 3.5 percent of recreational runners, against 10.2 percent of people who do not run and 13.3 percent of elite competitors. Very high mileage sustained across many years is where that reverses.
Does Stretching Before a Run Prevent Injuries?
Not directly. Stretching increases how far a joint can freely move, which makes some running injuries less likely.
