Quick answer: The most common running injuries include runner’s knee, IT band syndrome, plantar heel pain and shin splints. Achilles tendon pain, stress fractures, hamstring strains and ankle sprains also affect runners. The knee is the most common place to get hurt. Many running injuries follow a sudden jump in how much you run. Building up gradually and doing regular strength training are sensible ways to lower your risk.
How common are running injuries?
Very common. Studies of distance runners report that between 1 in 5 and 4 in 5 get a leg injury, depending on how injury is defined and how long runners were followed. The knee is the most common site. Most are overuse injuries: the load from running rises faster than your muscles, tendons and bones can adapt.
The most common running injuries
Runner’s knee (patellofemoral pain)
Pain around or behind the kneecap, made worse by squatting, stairs, running downhill or sitting for a long time. Changes seen on a scan don’t always match how much it hurts. Exercise therapy, including hip and knee strengthening, may ease the pain and improve function. Read more in our guide to runner’s knee.
IT band syndrome
The main cause of pain on the outside of the knee in runners. At first it hurts after a run, then during runs, and it is often worse running downhill. The exact cause is still debated, and weak hip muscles may play a part. See our guide to IT band syndrome.
Shin splints
Pain along the shinbone, usually after increasing your running or running on hard surfaces. Pain that is in one small spot, gets worse with every run or hurts when you walk could be a stress fracture instead, so get it checked.
Stress fractures
Small cracks in a bone caused by repeated loading. They are most common in the bones of the lower leg and foot. Sudden jumps in training and not eating enough for the training you do raise the risk.
Achilles tendon pain
Pain and stiffness at the back of the heel, often worse first thing in the morning and at the start of a run. See our guide to Achilles tendon pain.
Plantar heel pain (plantar fasciitis)
Pain under the heel that is usually worst with your first steps in the morning. See our guide to plantar fasciitis.
Hamstring strain
Sudden pain at the back of the thigh, usually when sprinting or speeding up. Nordic hamstring exercises can roughly halve hamstring injuries, although most of that research is in team sports such as football.
Ankle sprain
A stretch or tear of the ankle ligaments, usually from rolling the ankle on uneven ground. See our guide to ankle sprains.
Knee pain after running: where does it hurt?
- Front of the knee, around or behind the kneecap: usually runner’s knee (patellofemoral pain).
- Outside of the knee: often IT band syndrome.
- Just below the kneecap, after lots of running or jumping: often a patellar tendon problem. See our guide to patellar tendinitis.
- Swelling, locking or the knee giving way: get it checked soon, and the same day if the knee locks or keeps giving way, as it can mean a ligament or cartilage injury.
For a full assessment of knee pain, see our knee pain physiotherapy page.
What raises your risk?
- Big jumps in distance: in a study of more than 5,200 runners, a single run more than 10% longer than their longest run in the previous 30 days was linked to a higher risk of an overuse injury.
- Not eating enough: under fuelling for your training raises the risk of stress fractures.
- Not doing strength work: strength training may lower injury risk, as the next section explains.
Choosing shoes to match your foot type probably makes little or no difference to injury risk, although the trials were all in military recruits. There is no strong evidence for any one type of running shoe, so pick a pair that feels comfortable.
How to prevent running injuries
- Build up gradually: keep each run within about 10% of your longest run in the last 30 days, and increase weekly distance slowly.
- Strength train: in a large review of sports injury trials, strength training cut injuries to less than a third, while stretching showed no benefit. The strength result came from only 4 trials, and the review covered sport in general, not running. Regular leg and hip strength work is a good place to start.
- Protect your hamstrings: add Nordic hamstring exercises if you do speed work.
- Warm up: a few minutes of walking or easy jogging gets you ready to run. Stretching is fine if you enjoy it, but it isn’t a way to prevent injuries. See our guide to stretching before a run.
- Plan easy days: mix harder runs with easy runs and rest days.
- Eat enough: athletes need about 1.2 to 2.0 g of protein per kg of body weight a day, which is 72 to 120 g for a 60 kg runner, plus enough carbohydrate to fuel training. If you have kidney disease, check with your doctor before eating more protein. Vitamin C helps the body make collagen; peppers, strawberries, broccoli and citrus fruit are good sources.
Your technique matters less than many people think. Read what the research says about foot strike.
When to see a doctor or physiotherapist
Call 999 or go to A&E if you heard a crack when you were injured, if your leg or ankle has changed shape or is pointing at an odd angle, or if your foot is numb, tingling, cold, or a blue or grey colour.
See a doctor the same day or go to A&E if you can’t move your knee or put any weight on your leg, if the knee or ankle is badly swollen, or if the area is hot and red and you have a high temperature.
Get it checked soon if you have bone pain that builds with each run, pain in one small spot on a bone, or pain when walking, as these can be signs of a stress fracture.
See a physiotherapist if pain isn’t improving after a few weeks, keeps coming back, or stops you running. A physiotherapist can find the cause, give you a rehab plan and guide your return to running.
Frequently asked questions
What is the most common running injury?
The knee is the most common place runners get injured, and runner’s knee (pain around or behind the kneecap) is one of the most common diagnoses.
Why does my knee hurt after running?
Pain at the front of the knee is usually runner’s knee. Pain on the outside is often IT band syndrome. Pain just below the kneecap after lots of running or jumping is often a tendon problem.
How do I avoid running injuries?
Build up your distance gradually and do regular strength training. Keeping each run within about 10% of your longest run in the past 30 days is a useful rule.
Do I need running shoes for my foot type?
Probably not. Choosing shoes by foot posture probably makes little or no difference to injuries, based on trials in military recruits. Comfortable shoes that suit the surface you run on are a sensible choice.
Does stretching prevent running injuries?
Research hasn’t shown that it does. In sport generally, strength training has better evidence for preventing injuries, although only a few trials have tested it.
Sources
- van Gent et al. 2007, BJSM: incidence of running injuries
- Crossley et al. 2016, BJSM: patellofemoral pain consensus
- Cochrane: exercise therapy for patellofemoral pain
- BMC Musculoskeletal Disorders 2015: IT band syndrome review
- van Dyk et al. 2019, BJSM: Nordic hamstring exercise
- Lauersen et al. 2014, BJSM: exercise to prevent sports injuries
- Frandsen et al. 2025, BJSM: how much running is too much?
- Cochrane: running shoes for preventing running injuries
- OrthoInfo (AAOS): stress fractures
- ACSM position statement 2016: nutrition and athletic performance
- NHS: Knee pain
- NHS: Shin splints
- NHS: Vitamin C
- Taunton et al. 2002, BJSM: a retrospective case-control analysis of 2002 running injuries
- Cleveland Clinic: Iliotibial band syndrome
- NIH: Vitamin C
- NHS: Sprains and strains
Need help with this? Our sports injury and running rehab team at Total Health by Hong Kong Sports Clinic can assess you and start treatment in your first session, in Central, Kai Tak or Tin Hau. Message us on WhatsApp to book.
