Common Running Injuries and Treatment Options


Common Running Injuries and Treatment Options

By Rachel Miller, PT, OCS, Certified Running Coach


I. Recognize ‘good’ (expected)pain vs. ‘bad’pain(red flag):

      A. Expected pain:            

                        1. Soreness that lasts less than 24 hours.

                        2. No redness, swelling.

                        3. You are not limping.

                                4. Symptoms generalized (usually).


       B. ‘Bad’ pain:

                        1. Soreness lasts more than 24 hours.

                        2. Redness, swelling.

3. You limp when you walk, or your running form has changed. Sometimes you won’t even notice the change yourself- someone will tell you that you are “running funny”.



Pointer/Palm Test:   If you can take your pointer finger and point to the specific spot where your pain is, that is a ‘bad’ pain sign, especially more than 24 hours after your run. If you can take your whole palm to indicate where your pain is, it may be an expected pain sign. However, the palm can turn into the pointer to describe where the pain is- turns into a ‘bad’ pain sign. Your pain basically becomes localized.


II. Stretching:

  1. Some Types:
  1.                                                             1.      Dynamic: Stretching with movement.
  2.                                                             2.      Static: holding a position for a specific length of time.
  3.                                                             3.      Active Isolation: holding a stretch for 2 seconds by activating the antagonist muscle.
  4.                                                             4.      Contract-Relax: push against an isometric resistance, then relax as you passively stretch the muscle.


      B.  When to stretch?

      1. Before run: Dynamic before you run, or make the first ½ - 1 mile of your run       your dynamic stretch but run approx 30-60 seconds slower than your planned pace.

                              2. After run: hold stretches for at least 30 seconds.

                              3. Some people can tolerate static stretches intermittently throughout the day.


  1. C.    Precaution when injured: You should NEVER feel pain with stretching, especially in the exact place that you’ve been hurting. And if you are consistently tight in one or more muscle groups, you should begin to think the underlying cause may be WEAKNESS.
  1. More specific stretching: Foam rollers, ‘the stick’, rolling pin, self-massage. Great when feeling pain. Don’t be aggressive on site of pain- may want to perform gentle massage over the site of pain, but then use these other means around the site of pain.


  1. III.              Common Pain: Patello-femoral syndrome (‘Runner’s knee’):

›Symptoms: Pain around or underneath the patella (knee cap), possible reports of ‘knee popping’, pain up and down stairs, pain after prolonged sitting.

›Suggested Treatment: Ice, strengthen Quadriceps along with other muscle groups, stretch leg musculature including hip flexors, foam roll/massage iliotibial band, taping.


IV. Common denominators of treatment

A. Use Ice – it is your friend! Ice for 15- 20 minutes using ice pack, or about 10 minutes with ice bath. Best to do the first 48 hours after injury occurs.

B. Stretch, but don’t overdo it! Pain indicates something is wrong, so NO pain should be felt with stretching. All stretches held gently for 30 seconds, especially after a workout. Consider warming up by jogging at about 30-60 slower than your planned pace for the first ½ mile.

C. Check your shoes. Change sneakers every 300 miles or so, try alternating two pairs of shoes during training. Go to a store that specializes in runners.

D. Modify your training schedule: if you are having pain, skip the speed workout that week, lower the long run distance, substitute painfree cross-training for running.


E. Perform hip and core exercises. Perform running-specific exercise (10-15 minutes is all you need) at least 3x per week. Exercises where you stand on one leg. Examples: standing band exercises, step ups, minisquats, etc.

F. Have your running form assessed. You may be running a certain way that could be causing or contributing to injury. There may be simple ways to improve your form which will lead to more efficient and painfree running. A 'running specialist' physical therapist can assess your form. Take advantage of running clinics at Fleet Feet.


V. Physical Therapy:

A. What we do- Physical Therapists evaluate your posture, strength, flexibility, muscle imbalances, footwear, walking and running gait, training log, among other factors to determine the source of your pain. The goal of physical therapy is to restore your body’s biomechanics to enable you to run, as well as to perform all other activities, painfree.


*Many injuries are not easily diagnosed, and can mask more serious injuries such as stress fractures. If pain lasts more than a few days, see a health care professional who has experience treating runners.


Feel free to contact me with any questions or problems:

Rachel Miller, PT, OCS, RRCA Certified Running Coach

Phone: 301-881-2273


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