The Five Most Common Running Injuries — and How to Come Back Properly
Most common running injuries trace back to the same thing: doing too much, too soon, on a body that was not quite ready. Here is what goes wrong, and how to return without repeating it.
1Runner’s Knee
Properly called patellofemoral pain, this is the most common running complaint we see. A dull ache around or behind the kneecap that builds during a run, hates downhills, and complains after you have been sitting a while.
It is rarely a knee problem. It is usually a hip problem that the knee is paying for — when the glutes cannot control the thigh, the kneecap tracks poorly and the joint surface gets irritated.
What helps: hip and glute strengthening, a temporary increase in cadence to reduce load per step, and reducing downhill volume while it settles. Rest alone almost never fixes it.
2Shin Splints
Medial tibial stress syndrome — a diffuse ache along the inside edge of the shin, typically after a jump in training volume or a change of surface.
The important distinction is between shin splints and a stress fracture. Shin splints ache over a broad area and ease as you warm up. A stress fracture is sharply tender at one specific point, hurts when you hop on that leg, and gets worse as you run, not better.
If you can put a fingertip on the exact painful spot and it makes you wince, stop running and get it assessed.
What helps: load reduction rather than complete rest, calf strength work, and honest examination of what changed in your training three to four weeks before the pain started.
For more detail, including a return-to-running plan, read our full guide to shin splints.
3Achilles Tendinopathy
Pain and stiffness in the Achilles, worst first thing in the morning and at the start of a run, often easing once warm before returning afterwards.
Tendons do not like sudden change. They adapt slowly, and they respond to progressive loading, not rest. This is the injury where the instinct to stop entirely does the most harm — a rested tendon becomes a weaker tendon.
What helps: structured calf loading, starting with isometrics if it is very irritable and progressing to heavy slow resistance. Expect eight to twelve weeks, not two. Patience genuinely is the treatment here.
4Iliotibial Band Syndrome
Sharp pain on the outside of the knee that appears at a remarkably predictable point — the same four or five kilometres into every run — and forces you to stop.
Stretching the ITB itself achieves very little; it is a thick band of fascia that does not lengthen meaningfully. The problem is almost always control at the hip.
What helps: hip abductor strength, reducing camber and downhill running temporarily, and hands-on work to settle the irritated tissue while the strength work takes effect.
5Plantar Fasciitis
Stabbing pain under the heel with the first steps out of bed, easing as you move, returning after long periods standing.
What helps: calf and foot intrinsic strengthening, load management, and supportive footwear in the short term. Rolling the foot on a ball provides temporary relief but does not address the cause.
6Coming Back Without Repeating It
The single biggest mistake is returning at the volume you were doing when you got injured. Your tissue capacity dropped while you were off; your ambition did not.
A return that tends to hold:
- Maintain fitness through cross-training — cycling, swimming or the cross-trainer keep your aerobic base while unloading the injured tissue
- Start with run-walk intervals rather than continuous running
- Build frequency before distance, and distance before speed
- Use the 24-hour rule — if it is sore the next morning, that run was too much
- Keep the strength work going after the pain stops, because that is what stops it returning
Common Running Injuries — Your Questions
Should I stop running completely?
Usually not. Most running injuries do better with reduced load than with total rest, which allows tissue capacity to drop further. The exception is suspected stress fracture, where you do need to stop until it is assessed.
Are running injuries covered by ACC?
It depends. A sudden injury during a run — rolling an ankle, a calf tear — generally qualifies. Gradual overuse injuries that built over weeks typically do not. We will assess and tell you honestly.
Do I need new shoes?
Possibly, but shoes are a smaller factor than most runners assume. Training load matters far more. If your shoes have done 800km or more, replacing them is reasonable, but do not expect it to fix an existing injury.
How long before I can race again?
It depends entirely on the tissue. Muscle strains can be weeks; tendon problems are typically eight to twelve weeks of proper loading. We will give you a realistic timeline once we know what we are dealing with.
Is it worth getting a running assessment?
For recurring injuries, often yes. Seeing how you actually load through the leg can reveal the pattern that keeps causing the problem. For a straightforward first-time injury it is usually unnecessary.
Get back to running properly
Assessment, hands-on treatment and a return-to-running plan. ACC registered.