Knee pain and other running injuries

Running injuries can affect anyone, from experienced runners who push themselves hard to beginners whose muscles are not used to running.

Below are five of the most common running injuries. Find out how to spot the symptoms, what causes the injuries and what to do if you get one, including when to get medical help.

You’ll also find tips on how to avoid becoming injured in the first place, such as choosing the right shoes and warming up properly.

Being injured can dent your motivation, so we’ve also included tips on how to get yourself up and running again once you’ve recovered.

Whatever your injury, it’s important to listen to your body. Don’t run if you’re in pain and only start running again when you’ve recovered sufficiently.

1. Knee pain

Knee pain, also called runner’s knee, can have many causes, such as swelling under the kneecap. Andy Byrne from David Roberts Physiotherapy in Manchester says that knee pain is the most common condition he treats in runners.

What does it feel like?
During your run, you may develop pain at the front of the knee, around the knee or behind the kneecap. The pain may be dull or it could be sharp and severe.

What should I do?
To help knee pain at home, Andy recommends applying ice to the knee and stretching. Hold ice (try a bag of frozen peas wrapped in a damp tea towel) on the painful area for around 20 minutes a few times a day. Never put ice directly on your skin.

To stretch the area, Andy recommends lying on your side with your bad leg on top. Bend your top leg so that your foot goes back towards your bottom, then hold it there with your hand and keep both knees touching. Hold the stretch for at least 45 seconds, breathing deeply and feeling the stretch in the thigh. Repeat this around six times a day.

If the pain is severe or the knee is swollen, see your GP straight away. If your knee pain is not severe, stop running and get it checked by a GP or physiotherapist if the pain doesn’t go away after a week. They can also recommend stretches or exercises to help you recover.

Can I still run?
Don’t run if you have pain in your knee. If you still feel pain after a week’s rest, see your GP or physiotherapist. How soon you can start running again will depend on the cause of your knee pain and how severe it is. Your GP or physiotherapist can advise you.

Try these knee-strengthening exercises.

2. Achilles pain

The Achilles tendon is the tough, rubbery cord at the back of the ankle that links the muscle to the bone. Regular running can cause wear and tear to the tendon over time.

What does it feel like?
You may have pain and swelling at the back of the ankle or heel. The pain may be minor but continuous, or it could be sudden and sharp. It may be worse first thing in the morning.

What should I do?
To treat Achilles pain at home, Andy recommends applying ice to the area if you can feel a lump there (never put ice directly on your skin). You can also gently massage the area with your fingers.

You could also try using heel wedges in your shoes. Get advice about this from a sports or running shop.

See your GP or a physiotherapist if you have Achilles pain that doesn’t disappear after three to four weeks. If you have a sudden, sharp pain, your Achilles tendon may have torn. See your GP straight away if this is the case.

Can I still run?
A sharp pain will stop you running altogether. Even if the pain is not severe, it’s a good idea to rest until the pain goes, and get it checked if it doesn’t go away.

3. Shin pain

Shin pain occurs on the front of the leg, below the knee. It’s often referred to as shin splints.

What does it feel like?
Runners are often aware of a dull pain in the shin but carry on running. However, this can cause increasing damage to the area, which can lead to a sudden sharp pain that stops you running altogether.

What should I do?
Pain can be relieved by applying ice to the area regularly for the first few days (never put ice directly on your skin). See your GP or a physiotherapist if the area is swollen, the pain is severe or it does not improve in two to three weeks.

Can I still run?
Shin pain is likely to stop you running altogether. Take a break for two to three weeks before beginning again slowly. See the Health A-Z topic on Shin splints for more information.

4. Heel pain

Pain or swelling in the heel or bottom of the foot can occur if you suddenly start doing a lot more running, if you run uphill or if your shoes aren’t supportive enough or are worn out. The medical name for heel pain is plantar fasciitis.

What does it feel like?
Heel pain is often sharp and occurs when you put weight on the heel. It can feel like someone is sticking something sharp in your heel, or as if you’re walking on sharp stones.

What should I do?
Andy recommends applying ice to the area. He says the best way to do this is to freeze a small bottle of water, then place it on the floor and roll it back and forth under your foot for about 20 minutes. Never place ice directly on your skin.

There are also several stretches you can do to help heel pain. See the Health A-Z section on treating heel pain for guidance on how to do them.

Stop running and see your GP straight away if there is a lot of swelling in the heel or the area under your foot. Otherwise, see your GP after a week to 10 days if the pain doesn’t go away.

Can I still run?
You won’t be able to run with heel pain. If you treat the pain early enough, it will normally go away in two to three weeks, after which you should be able to start running again.

5. Muscle strains

The most common strains due to running are in the hamstring muscles (which run down the back of the thigh) or calf muscles. Strains often affect new runners, whose muscles are not used to running.

What does it feel like?
The pain of a muscle strain is often sudden and feels as if someone has kicked you in the area of your calf or hamstring.

What should I do?
Most strains can be treated at home. Stop running immediately and apply ice to the painful area for around 20 minutes a few times a day (don’t put ice directly on your skin). Keeping your leg elevated and supported with a pillow will help reduce swelling. Find out more about treating strains.

Can I still run?
You won’t be able to run with a muscle strain. The time it takes for a strain to heal and for you to start running again varies from two weeks to around six months, depending on how severe the muscle strain is.

Tips for preventing injury

Wear the right shoes

It’s important to buy the correct running shoes, and it’s best to go to a running shop to get fitted. However, you don’t have to spend a lot of money.

According to Andy, expensive shoes are not necessarily better. “The most expensive shoes may just be more durable and lightweight, so are suitable for people running long distances. All running shoe brands make cheaper versions which are suitable for beginners.”

Warm up and cool down

It’s essential to warm up properly before you start running. Five to 10 minutes of brisk walking or gentle jogging before you start will warm your muscles up and help prevent injury. To cool down, carry on running at an easier pace or walk for five to 10 minutes. This will help your body recover after your run. See Tips for new runners for more information about warming up and cooling down, as well as running technique.

Build up slowly

Don’t be tempted to increase the intensity or distance of your running too quickly. “Do a similar run at least three or four times before you increase your pace or distance,” says Andy.

The Couch to 5K plan is perfect as it builds up the distance gradually. The plan is suitable for beginners and will get you running three times a week, building up to 5km in nine weeks.

Staying motivated if you have an injury

Being injured can be very frustrating. If you’re new to running, you might be tempted to give up at the first sign of injury.

Andy says that having a specific goal, such as a 5km race or charity run, will help you stay motivated through injury. “If you have something to work towards, you’ll be much more likely to get back into running once you’ve recovered.”

Running with a partner is also a great way to stay motivated. If they carry on running while you’re injured, you’ll want to get back out there once you’re better as you won’t want to let them down.

Preventing injuries while exercising

A personal trainer explains the five best ways to prevent injuries while exercising.

Media last reviewed: 28/08/2013

Next review due: 28/08/2015

Page last reviewed: 01/06/2013

Next review due: 01/06/2015

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The 4 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Alkarmel said on 11 May 2014

I have been running 30 mins for a few weeks now and have suddenly started struggling with my calves. I do stretches before hand but they seize up now and I cant run very far without having to stop. I repeat the stretches and start again but the same thing happens. I eventually am running at a snails pace and then stop altogether. Can anyone help me please?

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JenMLy said on 15 February 2014

I am on week 7 and have managed it without any injury now I am running 25 minutes I am picking up a groin pain/ache at the top inside of my right hip - do I need to change something about my running or is it down to needing better stretching - takes about 2 days to recover - thanks :)

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CathBea said on 01 November 2013

I'd been referred for physiotherapy for years of front of knee pain when climbing stairs & playing sport. Then I came across a book called Treat your Own Knees which recommended really simple exercises for stretching hamstrings and quadriceps for 30 seconds each, three times a week. (I do it while I boil the kettle!) Knee pain vanished, and I didn't need to take up the physiotherapy. A year on, still free from pain, though I only do the exercises a couple of times a week now. I know anecdote is not evidence, so would love to know if there are clinical trials showing if this could save NHS physio costs for other people.

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jan6 said on 09 October 2012

Perhaps you could provide a warning about running and pelvic floor problems. I understand this can be a serious issue, especially for women with stress incontinence and those going through menopause. I now know a couple of women who have suffered pelvic floor prolaspes after c25K.

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