Top 5 Running Injuries – Symptoms & Treatments

We are often asked throughout the training season, to diagnose and recommend treatment. Since we started providing group coaching services way back in 2003, we don’t play doctor. All we do is harvest the extent of our own experiences as coaches, and draw upon our own personal experiences with injury from running. Yes, we’ve been through injury. Injuries helped make us better athletes. When someone approaches us writhing in pain and says, “I think I broke my body”, we nod understandably, and follow with our own questions like, “what do you think it is?” and “did you sign the waiver?”. We answer many questions with “if it were me, this is what I’d do”.  That said, we’ve helped lots of people overcome both chronic and acute running injuries, many times working with your doctor. Hear are the top 5.

The Top 5 running injuries are:

  • Plantar Fasciitis
  • Achilles Tendonitis
  • Shin Splints
  • Chondromalacia Patellae
  • Iliotibial (IT) Band Syndrome


Definition: Plantar fasciitis (PF) is an inflammation of the plantar fascia, which is a thick fibrous band of tissue that runs from your heel and fans out to the forefoot bones of your foot. When this fascia is placed under too much stress it can tear. A common over-use injury, too much too soon. Coach Steve’s first experience with the ‘heartbreak of PF, was at the end of the 22 miler heading into his first marathon.


  • Pain on the bottom of your foot usually more so under the heel
  • Usually worse in the morning, or at the beginning of a run


  • Over-stressing the plantar fascia
  • Over-tight calf muscles (gastrocnemius and soleus)
  • Over-pronation of the foot
  • Over-training
  • High foot arches or rigid feet
  • Misalignment in the bony structure of your foot


  • Stop running if pain is severe
  • Read Coack Mike’s pre-pee workout
  • Decrease training time if symptoms are only mild
  • Apply ice to the area either by doing ice massage with water frozen in a Dixie cup (5 minutes) or by freezing water in a 500-ml bottle of water and rolling your foot on it for 15 minutes – repeat as necessary
  • Roll a golf ball/wooden dowel/canned food under your foot first thing in the morning and right before bed for five minutes spending extra time on the tender areas – finish with icing to get inflammation down
  • Physical therapy
  • Orthotics to control over-pronation
  • Stretch both calf muscles
  • Overnight wear either the sock or boot designed to keep foot at 90 degrees
  • Strengthen the arch muscles by pulling a hand-towel under your foot with your toes and then pushing it back out


Definition: Inflammation of the Achilles tendon, the large tendon that attaches the calf muscles to your heel Symptoms:

  • Pain that is dull or sharp usually close to the heel
  • Decreased ankle flexibility
  • Possible redness or swelling in the area
  • Crepitus (crackling noise) with ankle movement Causes:
  • Over-tight calf muscles
  • Rapid increase in distance, hill running
  • Shoes that are inflexible
  • Over-pronation of foot


  • Stop running until symptoms subside
  • Ice the area 15 minutes on/60 minutes off – repeat as necessary
  • Massage the tendon to break up any scar tissue present
  • GENTLE stretching of both of the calf muscles
  • Orthotics
  • Stop hill running until symptoms subside


Definition: Inflammation of the tendon attachment of the tibialis anterior or posterior along the tibia (shin).


  • Pain or tenderness usually along the lower half of the shin
  • Pain may be worse at the beginning of a run and then decrease as the tibialis anterior muscle warms up Cause:
  • Tight calf muscles
  • Over-pronation
  • Running on concrete
  • Training too much too soon (over-training)
  • Usually affects beginner runners because the muscles are not use to the workload and impact forces quickly leading to injury


  • Stop running until the pain is gone for 1-2 days.
  • Start back short and slow.
  • Decrease intensity/time if pain is only mild
  • Ice the area 15 minutes on/60 minutes off – repeat 2x/day, as necessary
  • Massage the area
  • Orthotics? Ask your doctor.
  • Stretch both calf muscles
  • Strengthen the tibialis anterior and posterior shin muscles by walking on your toes and on your heels. These are the two shin splint muscles. Build up to 3 sets of 20 repetitions (steps) with each leg. Do balanced cross-training to strengthen these two muscles.


Definition: A softening and/or irritating of the cartilage on the backside of the kneecap causing it to become rough.


  • Pain either behind the kneecap or just off to either side
  • Crepitus or grinding of the kneecap
  • Increase in pain after hill running
  • Possible swelling of the knee Causes:
  • Patellar tracking problem due to muscle imbalances of the quadriceps muscles. Inner quads are weaker than the outer quads often.
  • Over-pronation
  • Running on cambered surfaces (roads are all cambered for rain water runoff so you are essentially running with one foot lower than the other.
  • Pelvis and/or lumbosacral misalignments


  • Stop running
  • Ice the area 15 minutes on/60 minutes off – repeat as necessary
  • Massage
  • Correct pelvis and/or lumbosacral misalignments
  • Correct muscle imbalances:
  1. Place pillow under your knee, tighten your quads pushing your knee into the pillow while your foot lifts off the floor
  2. Lower leg extensions with your toes pointed outwards (leg is rotated outward/laterally)
  3. Do partial squats with knees bent between 45 and 60 degrees making sure knee travels out over big toe – hold each squat 5 seconds and repeat 15-20 times
  • Stretch quadriceps, hamstrings, IT bands, hip muscles, and low back
  • Orthotics
  • Avoid running on the edge of the road
  • Avoid running down hills


Definition: Pain and inflammation on the outside of your knee just above the joint line


  • Pain that usually starts about 1 mile into the run, and stays. Often no pain after the run, until you climb stairs.
  • If it is severe you will not be able to run due to the pain
  • Worse going down hill
  • Worse running on cambered surfaces


  • Over-pronation
  • Misalignment in the pelvis and/or lumbosacral area
  • Tight IT band or weak IT band muscles (gluteus maximus and tensor fascia latae) causing the tendon to rub excessively on the outer knee producing inflammation and pain
  • Worn-out shoes, cambered surfaces, turning in one direction, you run toe-in.


  • Stop running if pain is severe
  • Decrease training intensity
  • Ice the area 15 minutes on/60 minutes off – repeat as necessary
  • Massage
  • Orthotics
  • Correct pelvis and/or lumbosacral misalignments
  • Stretch IT bands, glutes, quads, hamstrings, hips, and low back
  • Strengthen abductors, quads, hamstrings, and calf muscles