Running Injury Prevention 9 Signs You Might Be Running Too Much By Elizabeth Quinn, MS Elizabeth Quinn, MS Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics. Learn about our editorial process Updated on May 25, 2021 Medically reviewed Verywell Fit articles are reviewed by board-certified physicians and nutrition and exercise healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Michael Lau, PT, DPT, CSCS Medically reviewed by Michael Lau, PT, DPT, CSCS Facebook LinkedIn Twitter Michael Lau, PT, DPT, CSCS, is a licensed physical therapist, strength and conditioning coach, and co-founder of The Prehab Guys. Learn about our Medical Review Board Print Running is one of the easiest ways to get fit, but it's also the most common cause of sports injuries. Runners are at higher risk for overuse injuries that develop slowly from chronic stress after piling on the miles from season to season and year after year. Overview These sorts of injuries typically develop without any obvious traumatic event to cause an injury. Most are the result of a wide variety of factors that over time lead to chronic stress on the joints and soft tissues. Overuse injuries can be hard to treat, so prevention is the best solution. You can't always avoid or prevent every injury, but runners who follow some basic guidelines can reduce the likelihood of developing chronic aches and pains. How do you know if you are heading towards an overuse injury? Here are nine warning signs to watch for. How to Start Running 1 You Are Running Too Much Nico De Pasquale Photography/Taxi/Getty Images Increasing running mileage or time too quickly is the leading cause of running injuries in recreational runners. Use the 10% rule (increase mileage by no more than 10% per week) to help prevent overuse injuries while allowing the body to adapt to training levels. For some runners, at some stages, maintaining the same mileage week to week or increasing by just 5% at a time is wiser. Listen to your body to determine when to push harder and when to maintain. Some runners just overtrain. Too much mileage is likely to lead to injury in those not able to tolerate running at an extreme level. Cutting down on total running mileage and cross-training by cycling or swimming will help overcome this problem without compromising on fitness levels. Load management is the most important variable to avoid running injuries. Not allowing enough rest and recovery time between runs may also contribute to injuries. It is during the rest phase after exercise that our muscles get stronger. Not allowing this rest leads to continual breakdown. It is critical to alternate rest with exercise to perform well. 2 You're Not Cross-Training Momo Productions/Iconica/Getty Images Lower-extremity and core strength training should be added to routine training for runners. Running is a single-leg sport and typically a linear (straight line) sport; however, the forces imposed on the body cause lateral and rotational movements. So the body has to be strong to resist those forces. This is why cross-training with strengthening and conditioning is so important for runners. Why You Should Run a 5K Race Runners should perform strength training for the following muscle groups: quadriceps, hamstrings, hips (squats, deadlifts, and lunges), calves (heel raises), shoulders (shoulder shrugs), upper back (dumbbell rows), chest (push-ups), biceps (curls), triceps (triceps kickbacks), and lower back (extension: lie on stomach and lift feet and arms off ground). Be sure to include lateral and rotational exercises. 3 You Run on Hard or Uneven Surfaces Getty Images/Hagephoto Hard surfaces increase the amount of stress on the muscles and joints and increase the risk of chronic tissue trauma. Soft surfaces (like sand) may cause the heel to sink and your foot to slide on push-off, leading to Achilles tendon overuse (Achilles tendonitis). Consistently running on one side of a road may cause injuries due to the road camber. The average road slants about seven to nine degrees so the result is that you are running on a slanted surface where one leg is hitting the ground at a higher level than the other. This may lead to a variety of biomechanical problems. Uphill running can stress the Achilles tendon and the muscles in front of the leg (tibialis anterior) that lift the foot and toes. Running uphill may be particularly difficult for people with tight calves and Achilles tendons. Downhill running places additional stress on the knees, which may result in pain developing in front or on the outer side of the knee. It's a good idea for runners to vary their routes to avoid overdoing uphill or downhill running and find a nice balanced mix, including some flat runs. In addition, use your cross-training to help your body take on the challenges and demands of various terrains. If you often run downhill, work on strengthening your hips. If you frequently run on uneven or soft surfaces, emphasize foot, ankle, and Achilles strengthening. 4 You Wear Worn-Out Shoes Henrik Sorensen/Taxi/Getty Images Shoes are the most important piece of equipment for runners. Buy a shoe that matches your foot type and weight and that feels comfortable. Flat-footed runners (and pronators) should buy stability shoes with support. Those with high arches (or supinators) and heavy runners should look for good cushioning and arch support. It is often recommended that you replace running shoes after 350–550 miles, depending on your running style, body weight, and the surface on which you run. 5 You Have Poor Running Technique Peathegee Inc/ GettyImages Every runner has a unique running style, and some styles can lead to overuse injuries. A rear foot strike lands flat or on the outer back portion of the heel and then rolls onto the sole and ends with the push-off from the ball of the foot. By contrast, a heavy heel-strike can lead to excessive traumatic forces and actually slow you down. While it's common practice to land on the midfoot or forefoot (ball of the foot), it also places more stress on the Achilles tendon (which will contract to counterbalance the force of the strike). For these runners, strengthening and stretching the calves and Achilles is recommended to reduce injuries. It can be hard to know if your technique might be putting you at risk of injury. If you are concerned, consult with a skilled healthcare professional who has experience with treating running injuries, or a qualified running coach. Should You Run on Your Toes, Heels, or Midfoot? 6 Your Hips and Knees Are Not Strong Enough Getty Images Runners can help reduce overuse injuries by adding some specific exercises to strengthen the hips and knees. Increasing the stability of the muscles supporting these two major joints can take some of the pressure off them during the repetitive pounding of running. 7 You Don't Recover Thomas Barwick/Taxi/Getty Images Runners who fail to recover sufficiently can significantly increase their risk of an overuse injury. It's important to let muscles rest from the pounding that running may cause, so add some days of yoga, stretching, swimming, weight training, or cycling to give your running muscles a break. In addition, make sure you are always well hydrated and fueling your body with nutritious foods, as well as restful sleep. Listen to your body and give it what it needs, whether that is an afternoon nap, a protein boost, or an extra day off from running. Keeping Hydrated During Your Runs 8 You Have Biomechanical Faults Jan-Otto/ GettyImages Your natural footstrike rotation (how much you pronate or supinate, and the speed at which it happens) may increase your risk of a running injury. In general, runners who pronate (roll the foot inward when they land) or supinate (roll the foot outward when they land) excessively may have a higher risk of running injuries than those with a neutral foot strike. If you have a chronic ankle or foot issue that is getting worse, consult with a healthcare professional who is experienced in treating running injuries. They can assess your ankle and foot as well as the rest of your kinetic chain (the hip and knee can contribute to foot issues) and your running form and suggest solutions, such as orthotics. While orthotics are not the ultimate fix for everything, they can help with certain specific ankle and foot pathologies. 9 You Have a High Body Weight technotr/Getty Images The heavier the runner, the more stress on the load-bearing tissues of the lower body. If you are overweight, losing excess body fat makes running less stressful and will likely result in fewer overuse injuries. 9 Common Running Injuries and How to Prevent Them 10 Sources Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. van der Worp MP, ten Haaf DSM, van Cingel R, de Wijer A, Nijhuis-van der Sanden MWG, Staal JB. Injuries in runners; a systematic review on risk factors and sex differences. PLoS One. 2015;10(2):e0114937. doi:10.1371/journal.pone.0114937 Fokkema T, de Vos R-J, van Ochten JM, et al. Preventing running-related injuries using evidence-based online advice: the design of a randomised-controlled trial. BMJ Open Sport Exerc Med. 2017;3(1):e000265. doi:10.1136/bmjsem-2017-000265 Fokkema T, de Vos R-J, Visser E, et al. 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J Sports Sci Med. 2020;19(1):20-37. Rice H, Patel M. Manipulation of foot strike and footwear increases achilles tendon loading during running. Am J Sports Med. 2017;45(10):2411-2417. doi:10.1177/0363546517704429 Malisoux L, Chambon N, Delattre N, Gueguen N, Urhausen A, Theisen D. Injury risk in runners using standard or motion control shoes: a randomised controlled trial with participant and assessor blinding. Br J Sports Med. 2016;50(8):481-487. doi:10.1136/bjsports-2015-095031 Janney CA, Jakicic JM. The influence of exercise and BMI on injuries and illnesses in overweight and obese individuals: a randomized control trial. Int J Behav Nutr Phys Act. 2010;7:1. doi:10.1186/1479-5868-7-1 By Elizabeth Quinn, MS Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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