Running injuries: common causes and prevention

Running is repetitive. Every stride loads the same tendons, muscles and bones, so small mismatches between what you ask and what the body can currently handle add up. Newcastle Hospitals' leaflet defines load as how much the body has to work while running, and capacity as the body's ability to cope with that load.

Overload is when muscles and tendons are repeatedly made to work harder than their capacity, with insufficient rest and recovery. The leaflet's example is a runner who does 2 miles a few times a week and then one week attempts 10 miles. The body feels fine at the start but struggles once it passes the distance it is used to.

Matching load to capacity is therefore the core of injury prevention, and it explains why most running injuries have a recognisable story of a recent change.

The Newcastle advice names shin splints, pain in the hip and knee, and Achilles tendinopathy as typical overload problems. NHS pages on individual conditions fill in the picture, and each has its own pattern.

Shin splints, according to the NHS, cause pain and tenderness along the front of the lower leg, usually during exercise like running, and tend to get better within a few weeks. NHS knee pain advice lists tendonitis, with pain between kneecap and shin often caused by repetitive running or jumping, among causes of knee pain.

The NHS says shin splints are more likely if you have started exercising after not being active for some time, run or jump on hard surfaces, or do not have a good running technique. These factors apply more widely.

Newcastle Hospitals lists returning to running after time off, for example after an injury or maternity leave, as a common cause of overload. So is running more often per week, which shortens recovery, raising intensity or distance when training for a race, and changing type, such as road to trail.

Muscle imbalance can also be part of the problem. We tend to have a dominant leg, and a strength difference between legs may contribute to overload. The leaflet suggests simple home checks: a single-leg stand for balance, and single-leg bridge, single-leg sit-to-stand and single-leg heel raises for strength.

The suggested strategy for adding distance is to increase by 10% each week, which gives the body time to adapt. This is called progressive overload. Free programmes can help, usually covering around 12 weeks, such as British Heart Foundation plans for 5k to marathon distances and Couch to 5K for beginners.

Cross-training with the cross trainer, swimming or cycling targets different muscle groups, rests muscles that are working hard in running, builds strength and keeps cardiovascular fitness up.

If you are new to running and have a pre-existing condition, the leaflet advises checking with your GP or local health service before starting.

Newcastle Hospitals says strength training for runners can increase power and speed, reduce injury risk by addressing imbalances and weaknesses, and improve endurance. The suggested routine is done 2 to 3 times a week, usually 3 sets of between 3 and 10 repetitions.

Listed strength exercises include double and single-leg bridges, dead bug, forward plank, forward lunge, single-leg deadlift, single-leg heel raises, squats and single-leg sit-to-stand. Flexibility work includes fire hydrants, calf stretches and a seated hamstring stretch, each held for about 20 seconds and repeated three times. Running-specific drills include skips, high knees on the spot and fast step-ups.

The aim is gradual progression, not maximum effort, and pain that rises during an exercise is a signal to ease back.

The Newcastle leaflet says to seek medical advice if a fall or trauma caused the pain, if pain is constant even at rest, if there is significant swelling, bruising or bleeding, or if you cannot put any weight through the painful leg. These suggest something beyond simple overload.

For knees, the NHS says to call 111 if the knee is very painful, you cannot move it or put weight on it, it is badly swollen or has changed shape, it locks or gives way, or you have a high temperature with redness or heat around it. For shin pain, get help from NHS 111 if pain is severe or you have injured the shin.

For shin splints, a GP should see you if the pain is getting worse or not improving after you have tried self-help, and the NHS says physiotherapy may be needed.

Complete rest is rarely the answer. Newcastle Hospitals says maintaining normal activities, including work, improves the chance of recovery by keeping you moving, and that you do not have to be pain-free to remain at work. Temporary lighter duties may be needed and are worth discussing with a manager.

For shin splints, the NHS suggests switching to gentle exercise such as yoga or swimming while healing, exercising on softer ground when better, warming up and stretching, and making sure shoes support your feet. It adds that you should not rush back at your previous level but build up slowly.