The most common runner’s injuries – and how to avoid them

Posted on 19 August 2019

Everyone, it seems, is training hard for the 2019 Sanlam Cape Town Marathon. Well, everyone, that is, except those who have succumbed to injuries. Here, a Mediclinic sports doctor explains how the most common running-related injuries occur, and what you can do to avoid ending up on the injured list.

In 1998, researchers from Staffordshire University in the UK published a study that’s been giving runners nightmares for the past two decades. They studied triathletes, whose training covers swimming, cycling and running, and examined the types of injuries they suffered over a five-year period. Running was found to be the biggest culprit, causing 62.1% of injuries among elite triathletes and 58.7% of injuries among recreational, weekend warrior triathletes.

Why did running cause so many injuries? What were those injuries? And how can you avoid them? We asked Dr Herman Kotzé, a doctor of sports medicine at Mediclinic Stellenbosch and the Stellenbosch Academy of Sport.

“Among runners, most injuries are knee-related,” he says. “Runners also report a lot of ankle injuries, but I’d say percentage-wise it’s 60% knee injuries and 40% ankle or foot injuries. If you were to break it down further, my experience is that among the 40% of ankle and foot injuries, 60% of those are ankles and 40% are feet.”

Runner’s injuries include these painful conditions:

• Runner’s knee (or patellofemoral pain syndrome) is caused by the repetitive force of pounding the pavement.
• Shin splints is a nagging injury caused by inflammation of the muscles and tendons covering the shinbone.
• Achilles tendinitis is swelling of the Achilles tendon.
• Plantar fasciitis is inflammation of tissue on the footsole.
• Iliotibial band syndrome (or ITBS) is pain felt on the outside of the knee, caused by inflammation of the tendon that stretches from the pelvic bone down the thigh.

Fortunately, Dr Kotzé has tips on both prevention and treatment – and his list starts with footwear. “The most important thing as far as running is concerned is picking the right shoe. That’s imperative,” he says.

The right shoe ticks the following boxes:

• A good fit – not too loose, not too tight
• Adequate orthotic’ support inside, to help you prevent gait-related issues.
• Relatively new: Keep track of how far your shoes have run, and ideally replace them at least every 900km.

But while your shoes are fundamental to injury prevention, Dr Kotzé says most of the running-related injuries he sees come down to workload and terrain. “If I look at a runner’s training schedule, the most common injuries I’ll see relate to the amount of running they do, the terrain they’re doing it on, and the intensity at which they’re training,” he explains.

“Injury prevention has a lot to with managing your training load,” he adds. “If you increase your load, you must do it slowly. And when you increase it, ensure that your conditioning is right for that.”

As a rule, don’t increase your mileage by more than 10% a week. he says. Take at least one rest day a week, and add some recovery runs into your schedule.

Finally, make sure the terrain is appropriate. “Many runners will either train on the road or on trails – in other words, on uneven surfaces,” says Dr Kotzé. “That’s where injuries are quite common: when you suddenly go from road running to trail running, or vice versa. Very often people will try to combine the two, and that’s when you see a lot of injuries.”

The reasons for this are fairly obvious: your running technique is very different when you’re on a flat, even road, compared to the twists and turns and roots and rocks of a trail. A Mediclinic biokineticist can advise you on managing the shift between running surfaces.