The ranking
Most are overuse injuries, linked to poorly managed training load rather than an isolated trauma.[2]
Plantar fasciitis
Pain under the heel or arch, typically with the first steps in the morning.
Typical causes: too fast an increase in running volume, worn or poorly fitted shoes, lack of flexibility in the calf and arch, prolonged standing. What to do: stretch the calf and plantar fascia, progressively strengthen the foot muscles, adjust your shoes and temporarily reduce running volume without stopping completely. If the pain persists beyond a few weeks despite these adjustments, a more thorough assessment is needed.
Tibial periostitis
Pain along the edge of the shin, common after a rapid increase in running volume.
Typical causes: too fast an increase in volume or intensity, hard terrain, worn shoes, imbalance between the leg muscles. What to do: temporarily reduce training load, strengthen the muscles that stabilise the shin, work on running technique, then progressively reintroduce volume following the 10% weekly rule.
Achilles tendinopathy
Pain at the back of the ankle, sensitive to load and accelerations.
Typical causes: a sudden increase in intensity (hills, sprints), lack of calf strengthening, switching shoes too quickly. What to do: eccentric calf strengthening remains the go-to approach for both prevention and treatment, adjusting training load without stopping sport completely, which would weaken the tendon further.
Iliotibial band syndrome
Pain on the outside of the knee, common among distance runners.
Typical causes: increased mileage, repeated running on cambered terrain, weak hip stabiliser muscles. What to do: strengthen the gluteus medius and hip rotators, adjust running technique if needed, temporarily cut back on long runs until the pain improves.
Patellar tendinopathy
Pain below the kneecap, worsened by going down stairs and hills.
Typical causes: sports with repeated jumping and landing, a sudden increase in training volume, quadriceps weakness. What to do: eccentric quadriceps strengthening, a progressive training load, avoiding a complete stop to sport, which delays healing.
Patellofemoral pain syndrome
Diffuse pain around the kneecap, often linked to a muscular imbalance.
Typical causes: imbalance between the different sections of the quadriceps, weak hip muscles, a rapid increase in training volume. What to do: strengthen the quadriceps and hip stabilisers, work on keeping the knee aligned during everyday and sporting movements, temporarily adjust running volume.
Ankle sprain
Uneven terrain and fatigue at the end of a run increase the risk of a misstep.
Typical causes: uneven terrain, fatigue towards the end of a run, a previous sprain that wasn’t properly rehabilitated, leaving the ankle weaker. What to do: work on proprioception regularly, even as prevention, strengthen the peroneal muscles, and only return to sport once you’ve regained full ankle stability and mobility.
Hamstring muscle injury
Common during accelerations and sprints, at the end of a session when fatigue sets in.
Typical causes: sprinting and accelerating at the end of a session when fatigue sets in, lack of eccentric strengthening, insufficient warm-up before intense efforts. What to do: regular eccentric hamstring strengthening, allowing enough recovery time before returning to maximum speed, then reintroducing sprinting very gradually.
Stress fracture
The result of repeated overload not caught in time, often in the shin or foot.
Typical causes: build-up of load without enough recovery, too fast an increase in training volume, insufficient energy intake to support that load. What to do: localised bone pain that worsens with effort and persists at rest needs to be assessed quickly, it’s not an injury to manage on your own. It generally means stopping impact activity while the bone heals, followed by a very gradual return.
Low back pain
Pain or stiffness in the lower back, often appearing during effort or in the hours following a run.
Cause: lack of core strength and trunk stability, a stride pattern that increases strain on the lower back, too fast an increase in volume or elevation gain, or a pelvic position compensating for another weakness (hips, glutes). What to do: strengthen the core and trunk stabiliser muscles, work on running posture, progress volume cautiously. See a professional if the pain persists at rest or radiates down the leg.
How to prevent these injuries
- Increase your running volume by no more than 10% per week
- Add regular strength training, not just running
- Pay attention to pain that persists beyond the warm-up
- Match your shoes and terrain to your runner profile
How do you know which injury matches your running pain?
It’s impossible to make a diagnosis remotely without a proper assessment, but a few simple markers can already point you in the right direction and help you know whether to be concerned or simply adjust your training. Here are the four things to look at first.
1. The exact location of the pain
Pain under the heel or arch points to plantar fasciitis. Along the edge of the shin, it’s more likely periostitis. At the back of the ankle, the Achilles tendon is the main suspect, while discomfort around or under the kneecap suggests the knee. This simple location check already rules out a good number of possibilities.
2. When the pain appears
Pain that appears only on waking or with the first steps in the morning, then eases with walking, is typical of a tendinopathy or fasciitis. Pain that builds gradually during a run and worsens with distance points more towards a developing overuse injury, such as periostitis.
3. Your recent training history
Almost all of these injuries appear after a change: an increase in volume, returning after a break, a change of shoes or terrain. Spotting what changed in the previous two to three weeks often gives a more reliable clue than the pain itself.
4. How the pain evolves over time
Discomfort that stays stable, disappears with warm-up and doesn’t change your stride can be monitored while adjusting training. Pain that worsens session after session, persists at rest, or changes the way you run should be assessed by a professional before you keep training through it.
Can most running injuries really be prevented?
Yes, the vast majority of overuse injuries in running (plantar fasciitis, periostitis, tendinopathies) can be avoided or significantly reduced through progressive training load management[2] and regular strength training.[3] These are the two levers that come up most consistently, well ahead of shoe choice or terrain.
The central role of progressiveness
Tissue (tendon, bone, muscle) adapts to the load placed on it, but that adaptation takes time. Increasing volume or intensity too quickly doesn’t leave room for that adaptation, which explains most of the injuries in this ranking.[2] The 10% weekly progression rule remains a simple benchmark, to be adjusted according to your level and history.
Strength training, often the great forgotten piece
Many runners only run, without strengthening the muscles that stabilise the stride (calves, hamstrings, hips, core). Targeted strengthening work, even in small but regular doses, significantly reduces the risk of overuse injury.[3]
What to do if the pain persists despite these precautions
Even with cautious progression, pain can still set in. In that case, it’s better to have it assessed quickly rather than wait for it to worsen: a digital rehab program like HOPP lets you start an assessment and get exercises suited to your injury without waiting for an appointment.
Frequently asked questions
How do I know which injury matches my running pain?
Look at the exact location of the pain, when it appears (at rest, during warm-up, at the end of a session), and what has recently changed in your training. These three markers alone can already point you toward the right injury page, before a more thorough assessment if needed.
Can most running injuries really be prevented?
Yes, in most cases. Limiting your training volume increase to 10% per week and doing regular strength training are enough to avoid, or significantly reduce, the risk of the most common overuse injuries in runners.[3]
What is the most common injury among runners?
Plantar fasciitis and tibial periostitis are among the injuries most frequently seen in clinic among runners, along with Achilles and patellar tendinopathies.[1]
Why do runners get injured so often in the shin and foot?
Running is a sport with repeated impacts: the foot, shin and knee absorb thousands of shocks per session. Too fast an increase in volume, or poor training load management, explains most of these overuse injuries.[2]
How can you avoid these running injuries?
The 10% weekly volume progression rule, regular strength training and careful training load management remain the best levers for prevention.
Pain that’s settling in?
Identify your injury and start your program in 3 minutes.
