Running is one of the most popular forms of exercise in Australia — and one of the most injury-prone. Studies suggest that between 50–70% of recreational runners sustain an injury in any given year. The good news: most running injuries are overuse injuries that are entirely preventable with the right training approach, footwear and movement patterns.
1. Patellofemoral Pain Syndrome (Runner's Knee)
What it is: Pain around and behind the kneecap, typically during or after running, stairs and prolonged sitting.
Causes: Weak hip abductors and external rotators allowing the knee to collapse inward (dynamic valgus), poor foot pronation control, sudden increase in mileage.
Treatment: Hip strengthening (especially glutes), VMO activation, taping, footwear assessment, temporary reduction in mileage. Chiropractic care addresses any patellar tracking issues and spinal/pelvic contributors.
2. ITB Syndrome (Iliotibial Band Syndrome)
What it is: Sharp or burning pain on the outer side of the knee, typically appearing at a predictable point in a run (often around 20–30 minutes).
Causes: Tight TFL muscle, weak hip abductors, increased mileage, cambered road running, excessive downhill running.
Treatment: Hip strengthening, TFL soft tissue therapy, foam rolling, gait retraining, temporary mileage reduction. Not actually a "friction syndrome" — it's compression of fat tissue under the ITB.
3. Shin Splints (Medial Tibial Stress Syndrome)
What it is: Pain along the inner border of the tibia (shin bone), typically in the lower two-thirds of the shin.
Causes: Rapid increase in training volume, running on hard surfaces, inadequate footwear, poor ankle dorsiflexion, weak foot intrinsic muscles.
Treatment: Relative rest (switch to low-impact cross-training), calf and foot strengthening, footwear review, gradual return to running on softer surfaces. If pain is focal (one spot) rather than diffuse, rule out stress fracture with imaging.
4. Plantar Fasciitis
What it is: Sharp heel pain, classically worst with the first steps in the morning or after prolonged sitting.
Causes: Tight calf and Achilles complex, weak foot intrinsics, sudden increase in running volume, prolonged standing on hard floors, poor footwear.
Treatment: Calf and plantar fascia stretching, intrinsic foot strengthening, night splints in severe cases, shock-wave therapy, taping, footwear modification. Most cases resolve within 6–12 months with conservative management.
5. Achilles Tendinopathy
What it is: Pain, stiffness and sometimes a visible thickening of the Achilles tendon, typically 2–6 cm above the heel insertion.
Causes: Increased running volume or intensity too quickly, poor calf strength, reduced ankle dorsiflexion, training on hills, age-related tendon degeneration.
Treatment: Heavy slow resistance (HSR) calf loading is the gold standard — eccentric and concentric calf raises with progressive load. Avoid complete rest, which worsens tendon structure. Seek guidance from an exercise physiologist or sports chiropractor for a structured loading program.
6. Stress Fractures
What it is: A microscopic crack in bone caused by repetitive mechanical stress — most commonly the tibia, metatarsals, navicular and femur in runners.
Causes: Rapid increase in training load, low bone density, nutritional deficiencies (calcium, vitamin D), relative energy deficiency in sport (RED-S).
Warning signs: Focal, point-tender bone pain that worsens with activity and is present at rest. If suspected, stop running immediately and seek medical imaging. Some stress fractures (navicular, femoral neck) require urgent management to prevent complete fracture.
7. Hip Flexor Strain
What it is: Pain at the front of the hip or groin, often with a snapping sensation, from a strain of the iliopsoas or rectus femoris muscle.
Causes: Sudden acceleration or change of direction, inadequate warm-up, muscle imbalance, excessive sitting causing shortened hip flexors.
Treatment: Active rest, soft tissue therapy, progressive stretching and strengthening, gradual return to running. Chiropractic assessment to rule out referred hip pain from the lumbar spine.
8. Piriformis Syndrome
What it is: Deep buttock pain that may radiate down the leg, mimicking sciatica. The piriformis muscle irritates the sciatic nerve as it passes nearby.
Causes: Weakness or tightness of the piriformis and external hip rotators, leg length discrepancy, excessive running on cambered roads.
Treatment: Piriformis stretching and soft tissue release, hip strengthening, gait assessment, dry needling.
The Golden Rule of Running Injury Prevention
Most running injuries share a common cause: doing too much, too soon, too fast. Respect the 10% rule (increase weekly mileage by no more than 10% per week), build strength alongside mileage, and address any pain early before it becomes a serious injury.
Running Injury Assessment in Sydney
Our sports chiropractors and exercise physiologists at Elevate Health Clinic offer thorough running injury assessments at our Bella Vista and Earlwood clinics. We identify the root cause of your injury and get you back running as quickly and safely as possible.
