Preventing overuse injuries in runners


Written by: Dr Tom Eaton (Accredited Exercise Physiologist)

After a long cold winter, many of our Exercise Physiology team and clients will be dusting off the runners and hitting the pavement to improve fitness, complete a fun run, or break some PB’s.

Running is a fantastic activity with a number of well-established health benefits, but after a long break the risk of developing an overuse injury is high.

Common overuse injuries associated with running include plantar fasciitis, achilles tendinopathy, medial tibial stress syndrome (shin splints), patellofemoral joint pain (runner’s knee) and iliotibial band syndrome¹.

Factors that contribute to injury are complex and often multi-faceted, but there are several ways we can reduce the chances of developing an overuse injury or pain.

Managing load to Reduce Injury

Overuse injuries occur when body structures such as tendons, muscles and bone fail to adequately adapt to a sudden increase in load (exercise)².

Risk factors for overuse injury include the frequency, duration and intensity of exercise, and individual factors such as training experience, biomechanics, and anthropometrics (body structure)¹. Of these factors, we have most control over the frequency, duration and intensity of exercise.

For new runners, or those returning from more than 3 months off, it is important to start with a relatively low running load, gradually increasing over the course of 2-3 months³.

A great way to do this is with walk-run intervals, which has the advantage of balancing intensity, frequency and duration with adequate rest. When first starting, 3 sessions per week of approximately 20 minutes with a walk to run ratio of approximately 3-4:1 is appropriate³.

As an example, a new runner may begin with short intervals of 1 min walking to 15 seconds running, while a more experienced runner may begin with 4 minutes of walking to 1 minute of running.

A general rule of thumb for progression of running is to increase frequency, duration or intensity by no more than 10% per week4.

For those interested in resuming running, the Couch to 5k program does a great job of adequately managing the training parameters mentioned above, with appropriate progressions of intensity and duration each week. The C25k program can be found online or on the app store.

Alternatively, chat to one of our staff who can help put together an appropriate return to run program, with the added benefit of strength exercises.


Strength exercises to assist in returning to running

Another strategy for preventing overuse injuries and appropriately loading the body, is to strengthen the structures most involved in running. Strength training programs have been demonstrated to reduce overuse injury risk by up to 66%5, provided appropriate exercise prescription and dose are used. Running requires trunk strength, hip strength and mobility, upper and lower leg strength, and good ankle and foot mobility¹.

A well-rounded return to running program will include exercise to address all of these components to prevent overuse injury. Below are some suggestions for exercises to complete at home or in the gym with the assistance of our staff.

  1. Dead bug (trunk strength)
  2. Single leg glute bridge (hip strength)
  3. Crab walk (hip strength and mobility)
  4. Hip circles/hurdles (hip mobility)
  5. Hamstring bridge/slider (leg strength)
  6. Reverse lunge (leg strength)
  7. Eccentric bent-knee calf raise (lower leg strength, ankle and foot mobility)
  8. Banded dorsiflexion (ankle and foot mobility)

If you are interested in starting to run or returning after a layoff and are look for some guidance to prevent injury, please call our Exercise Physiology team at Inspire Fitness on 9857 3007 . Happy running!

  1. Kozinc, Ž., & Sarabon, N. (2017). Common running overuse injuries and prevention. Montenegrin Journal of Sports Science and Medicine, 6(2), 67.
  2. DiFiori, J. P., Benjamin, H. J., Brenner, J. S., Gregory, A., Jayanthi, N., Landry, G. L., & Luke, A. (2014). Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. British Journal of Sports Medicine, 48(4), 287-288.
  3. Johnston CA, Taunton JE, Lloyd-Smith DR, McKenzie DC. Preventing running injuries: practical approach for family doctors. Can Fam Physician. 2003;49:1101-1109.
  4. Fredericson M, Misra AK. Epidemiology and aetiology of marathon running injuries. Sports Med 2007;37:437-439.
  5. Lauersen JB, Andersen TE, Andersen LB Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis Br J Sports Med 2018;52:1557-1563.