Running seems simple.
Put on your shoes.
Head outside.
Start running.
But then your knee starts hurting.
Or your shins ache every time you increase your distance.
Maybe your Achilles tendon feels stiff the morning after a run, or pain underneath your heel makes the first few steps out of bed miserable.
You rest.
It feels better.
You start running again.
And the pain comes right back.
Sound familiar?
Running injuries are extremely frustrating — especially when running is something you genuinely enjoy.
But here’s one of the most important things to understand:
Running isn’t inherently bad for your body.
In many cases, running injuries develop when the demands of training begin to exceed what your body is currently prepared to tolerate.
At Restorative Touch Physiotherapy in Hamilton, that’s one of the biggest things we look at when helping runners.
Not simply:
“Where does it hurt?”
But:
“Why is this tissue struggling to handle your current running workload?”
Why Do Runners Get Injured?
Running places repeated forces through your body.
Every step requires your:
- Feet
- Ankles
- Calves
- Knees
- Hips
- Muscles
- Tendons
- Bones
to absorb and produce force.
That’s not necessarily a bad thing.
Your body is designed to adapt to physical stress.
The problem can occur when training demands increase faster than your body can adapt.
A simple way to think about it is:
Training Demand > Current Capacity = Increased Risk of Problems
Rehabilitation and appropriate training work toward changing that relationship:
Capacity ≥ Training Demand
That’s why simply resting every time something hurts doesn’t always solve the problem.
Running Injuries Are Often Load-Related
Many running injuries are related to training load.
Maybe you:
- Increased your mileage
- Started running more frequently
- Added hills
- Increased your speed
- Started interval training
- Changed your running surface
- Returned after a long break
- Started training for a race
- Added running on top of another sport
Sometimes the change seems small.
But your body experiences the total workload.
Imagine you’ve been running 15 kilometres per week.
You suddenly begin running 30.
Your cardiovascular system may feel capable of doing it.
Your tissues may not be ready yet.
That’s an important distinction.
Your lungs can sometimes progress faster than your muscles, tendons, joints, and bones.
The Weekend Warrior Problem
This is especially common among recreational runners.
You work all week.
You barely have time to exercise Monday through Friday.
Then Saturday arrives and you run 15 kilometres.
Your body goes from relatively low physical demand to a significant training load.
The issue isn’t that running 15 kilometres is inherently harmful.
The question is:
Have you prepared your body to tolerate 15 kilometres?
Running injuries often make more sense when you look at what happened in the weeks leading up to the pain.
Common Running Injuries
Runners can experience many different injuries.
Some of the most common include:
- Runner’s knee
- Patellofemoral pain
- IT band-related pain
- Shin splints
- Achilles tendinopathy
- Plantar heel pain
- Calf strains
- Hamstring strains
- Hip pain
- Ankle sprains
- Stress reactions and stress fractures
- Low-back pain
Each condition is different.
And that’s why every running injury shouldn’t be treated with the same three stretches.
Runner’s Knee
“Runner’s knee” commonly refers to patellofemoral pain, which usually causes discomfort around or behind the kneecap.
You may notice pain with:
- Running
- Hills
- Stairs
- Squatting
- Lunging
- Sitting for long periods
Training changes can play a significant role.
For example, rapidly increasing your running volume or suddenly adding hills can expose the knee to more load than it’s accustomed to.
Treatment often involves a combination of:
- Training modification
- Progressive strengthening
- Hip and knee exercises
- Running-load management
- Gradual return to running
The goal isn’t necessarily to stop running forever.
It’s to determine how much running your knee can currently tolerate and progressively build from there.
Shin Splints
Pain along the shin is common among newer runners and people who suddenly increase training.
“Shin splints” usually refers to medial tibial stress syndrome.
Symptoms commonly occur along the inner portion of the shin.
Potential contributing factors can include:
- Sudden mileage increases
- Running frequency
- Changes in training surface
- Lower-leg capacity
- Previous injuries
- Recovery
- Footwear
- Overall training load
But shin pain deserves attention.
Not every painful shin is simply shin splints.
A bone stress injury can produce similar symptoms and may require significantly different management.
Pain that becomes very localized, increasingly severe, occurs with normal walking, or persists at rest should be assessed.
Achilles Tendon Pain
The Achilles tendon connects your calf muscles to your heel.
Running places significant demand on this tendon.
Achilles tendinopathy often presents as:
- Pain around the Achilles
- Morning stiffness
- Pain when beginning a run
- Symptoms after running
- Reduced tolerance to hills or faster running
One of the most important components of Achilles rehabilitation is usually progressive loading.
That can eventually involve:
- Calf raises
- Heavy calf strengthening
- Single-leg exercises
- Plyometrics
- Hopping
- Running progression
Rest may calm symptoms.
But the tendon eventually needs to regain the ability to tolerate running.
Plantar Heel Pain
Pain underneath the heel can make running extremely frustrating.
A common presentation is plantar heel pain, often called plantar fasciitis.
Symptoms may include:
- Pain underneath the heel
- Pain with the first steps in the morning
- Pain after prolonged sitting
- Pain during or after running
Treatment may involve:
- Load management
- Calf strengthening
- Foot strengthening
- Mobility work
- Footwear considerations
- Progressive return to running
Again, the goal isn’t simply reducing symptoms.
We want your foot and lower leg to become capable of handling running again.
IT Band Pain
Pain around the outside of the knee is often blamed on the iliotibial band.
One common mistake is trying to aggressively stretch or foam-roll the IT band endlessly.
The bigger picture may include:
- Training volume
- Hills
- Running frequency
- Hip strength
- Lower-limb capacity
- Running mechanics
The IT band itself is a strong connective structure.
Treatment should focus on the runner and their overall training demands rather than simply attacking the painful area with a foam roller.
Hamstring Injuries
Hamstring injuries are particularly common during faster running and sprinting.
The hamstrings need to tolerate significant forces as running speed increases.
Rehabilitation may progress from:
Basic strengthening
→
Heavier resistance
→
Lengthened-position strengthening
→
Running
→
Faster running
→
Sprinting
Returning to easy jogging doesn’t necessarily mean your hamstring is ready for maximum-speed running.
The rehabilitation needs to match the activity you’re returning to.
Calf Strains
Your calves do a tremendous amount of work during running.
A calf strain can therefore significantly limit your ability to run.
Rehabilitation may include:
- Calf strengthening
- Soleus strengthening
- Single-leg loading
- Balance
- Hopping
- Plyometrics
- Gradual running progression
One of the biggest mistakes is returning to running as soon as walking becomes pain-free.
Walking and running place very different demands on the calf.
Stress Fractures and Bone Stress Injuries
This is one running injury that shouldn’t simply be “run through.”
Bone stress injuries can develop when repetitive loading exceeds the bone’s ability to recover and adapt.
Risk can be influenced by:
- Rapid increases in training
- High running volume
- Inadequate recovery
- Nutrition
- Low energy availability
- Previous bone stress injuries
- Other individual health factors
Symptoms may become increasingly localized and painful.
If a bone stress injury is suspected, appropriate medical assessment is important.
Is Running Bad for Your Knees?
This is one of the biggest fears among runners.
People are often told:
“Running will destroy your knees.”
That’s an oversimplification.
Running places load through your knees — but load isn’t automatically harmful.
Your body adapts to appropriately progressed physical activity.
The better question is:
Is your knee currently prepared for the amount and type of running you’re doing?
Someone who gradually builds to running 40 kilometres per week is very different from someone who goes from almost no running to 40 kilometres per week.
Is There a Perfect Running Form?
Probably not.
There isn’t one running technique that every runner needs to copy.
People naturally run differently.
Some runners:
- Heel strike
- Midfoot strike
- Forefoot strike
- Take shorter strides
- Take longer strides
- Have different cadence
- Move their arms differently
Running mechanics can matter in certain situations, particularly if changing a specific aspect of someone’s gait helps modify symptoms or redistribute load.
But changing someone’s running form simply because it doesn’t look “perfect” isn’t necessarily appropriate.
Don’t fix something just because it looks different.
Does Running Cadence Matter?
Cadence refers to how many steps you take per minute.
In some runners, a small change in cadence can alter running mechanics and redistribute load.
But there isn’t one magical cadence everyone needs to achieve.
You’ve probably heard:
“Every runner should run at 180 steps per minute.”
That’s far too simplistic.
Cadence should be considered in the context of:
- Running speed
- Height
- Leg length
- Running experience
- Symptoms
- Individual mechanics
If cadence is modified during rehabilitation, it should be done for a reason.
Does Footwear Cause Running Injuries?
Shoes matter.
But there’s no universally perfect running shoe.
The best shoe is generally one that:
- Fits properly
- Feels comfortable
- Matches your activity
- Doesn’t consistently aggravate symptoms
More expensive doesn’t automatically mean better.
And changing shoes won’t necessarily fix a training-load problem.
If you doubled your running volume in three weeks, buying a $300 pair of shoes probably isn’t addressing the main issue.
Do You Need Orthotics to Run?
Some runners may benefit from orthotics.
Others don’t need them.
Orthotics can sometimes help modify symptoms or redistribute load.
But they shouldn’t automatically be prescribed simply because someone has flat feet or experiences running pain.
Your foot shape is only one part of the picture.
Why Does My Running Injury Keep Coming Back?
This is where rehabilitation often falls short.
You develop pain.
You stop running.
Your pain disappears.
You wait another week.
Then you start running again at your previous mileage.
The pain returns.
Why?
Because:
Rest reduced your symptoms.
But:
Rest didn’t necessarily increase your capacity.
If the same workload caused the original problem, immediately returning to that workload may reproduce it.
This is why rehabilitation needs to bridge the gap between feeling better and being ready.
Rest vs. Rehabilitation
Rest can be useful.
Sometimes temporarily reducing your running load is exactly what you need.
But complete rest isn’t always the long-term solution.
Imagine an Achilles tendon that becomes painful at 20 kilometres of running per week.
You stop running for a month.
Your Achilles feels great.
But during that month, it hasn’t been exposed to running.
Then you immediately return to 20 kilometres.
The tendon may still be unprepared.
Rehabilitation instead asks:
How can we gradually rebuild the ability to tolerate running?
Strength Training for Runners
Runners sometimes believe the only way to become better runners is to run more.
But strength training can be an important part of a well-rounded running program.
Depending on the runner, exercises might include:
- Squats
- Split squats
- Lunges
- Step-ups
- Deadlifts
- Calf raises
- Soleus raises
- Hamstring exercises
- Hip strengthening
- Single-leg exercises
The goal isn’t to turn every runner into a powerlifter.
It’s to develop enough strength to support the demands of running.
Don’t Forget the Calves
If you run, your calves matter.
A lot.
Your calf muscles repeatedly absorb and produce force during running.
That’s why calf strengthening frequently appears in running rehabilitation.
A program may progress from:
Double-leg calf raises
to
Single-leg calf raises
to
Loaded calf raises
to
Hopping and plyometrics
to
Running
Progression matters.
Do Runners Need Core Strength?
Core training can be useful, but runners don’t need to spend half their rehabilitation doing planks.
Running is a whole-body activity.
A good strength program should consider the entire athlete.
That may include:
- Lower-body strength
- Trunk strength
- Upper-body strength
- Balance
- Coordination
- Plyometrics
Core exercises can be one part of the program.
They shouldn’t necessarily become the entire program.
Can You Run Through Pain?
Sometimes mild symptoms can be managed while continuing to run.
Other times, continuing to run is inappropriate.
It depends on:
- The suspected injury
- Pain severity
- Whether symptoms worsen during the run
- How you feel afterward
- How you feel the following morning
- Whether your running mechanics change
- Whether a bone stress injury is suspected
This is why blanket advice such as “never run with pain” or “just push through it” isn’t particularly useful.
Context matters.
How Do You Return to Running After an Injury?
A return-to-running program should gradually rebuild your exposure.
For example, someone might progress through:
Walking
→
Walk/jog intervals
→
Continuous easy running
→
Longer runs
→
Faster running
→
Hills
→
Normal training
The exact progression depends on the injury and the runner.
One of the biggest mistakes is changing too many variables at once.
If you simultaneously increase:
- Distance
- Frequency
- Speed
- Hills
it becomes much harder to know what your body is actually tolerating.
What About the 10% Rule?
You’ve probably heard that runners should never increase mileage by more than 10% per week.
It’s a convenient guideline.
But human beings don’t adapt according to a perfectly fixed mathematical formula.
A safe progression depends on the individual runner, their training history, injury history, intensity, recovery, and goals.
The better principle is:
Progress gradually and monitor how your body responds.
Recovery Is Part of Training
Running adaptation doesn’t occur only while you’re running.
Recovery matters too.
Consider:
- Sleep
- Nutrition
- Hydration
- Rest days
- Training intensity
- Other sports
- Strength training
- Work demands
- Life stress
Your body experiences all of it.
Someone training for a race while sleeping poorly and working long hours may tolerate training differently than someone with excellent recovery.
How Physiotherapy Can Help Running Injuries
A physiotherapy assessment can help determine what may be contributing to your symptoms.
Depending on the injury, we may assess:
- Strength
- Mobility
- Balance
- Running history
- Training volume
- Training intensity
- Foot and ankle function
- Knee function
- Hip function
- Running mechanics
- Previous injuries
Treatment may include:
- Therapeutic exercise
- Progressive strengthening
- Load management
- Mobility exercises
- Running modifications
- Education
- Manual therapy when appropriate
- Gradual return-to-running programming
The goal isn’t simply to get you pain-free in the clinic.
The goal is to get you back to running.
How Athletic Therapy Can Help Runners
Athletic therapy is particularly valuable when rehabilitation needs to bridge the gap between basic recovery and higher-level activity.
Running requires more than being able to perform a few exercises on a treatment table.
You eventually need to tolerate:
- Repetitive impact
- Single-leg loading
- Higher forces
- Fatigue
- Speed
- Hills
- Longer distances
Athletic therapy can help progressively prepare your body for those demands.
For competitive and recreational runners alike, the goal is the same:
Don’t just feel better. Be ready.
Therapeutic Exercise Is the Foundation
At Restorative Touch Physiotherapy, therapeutic exercise is at the foundation of how we approach rehabilitation.
Passive treatments can sometimes help manage symptoms.
But if the goal is returning to running, your body eventually needs to load.
You need to rebuild:
- Strength
- Endurance
- Tissue capacity
- Balance
- Coordination
- Confidence
Running itself is a physical demand.
Your rehabilitation should prepare you for that demand.
How Restore You Can Help Runners
Our Restore You program fits naturally into running rehabilitation.
Why?
Because running injuries aren’t always about one painful body part.
A runner may come in because their knee hurts.
But their goal isn’t:
“I want my knee to hurt less while I’m sitting here.”
Their goal is:
“I want to run again.”
Restore You focuses on closing that gap.
Depending on the runner, the program may work on:
- Lower-body strength
- Calf capacity
- Hip strength
- Single-leg control
- Balance
- Mobility
- Core strength
- Plyometrics
- Conditioning
- Return-to-running progression
As you improve, the exercises should progress with you.
The goal is to move from:
Pain → Movement → Strength → Capacity → Running
When Should a Runner See a Physiotherapist?
Consider getting assessed if:
- Pain persists for more than a couple of weeks
- Pain repeatedly returns when you run
- You’re changing your running mechanics because of pain
- Your training volume is decreasing because of symptoms
- Pain occurs during normal walking
- You can’t progress your running
- You’re unsure whether it’s safe to continue
- You’re preparing to return after an injury
Getting assessed doesn’t automatically mean someone will tell you to stop running.
Often, the goal is figuring out how much you can safely continue doing while you rehabilitate.
When Should Running Pain Be Taken More Seriously?
Seek appropriate assessment if you experience:
- Severe pain
- Significant swelling
- Inability to bear weight
- Pain following significant trauma
- Increasingly localized bone pain
- Pain at rest or at night that is unusual for you
- Progressive weakness
- Significant neurological symptoms
Suspected bone stress injuries deserve particular attention because continuing to run can potentially worsen the injury.
Frequently Asked Questions About Running Injuries
What is the most common cause of running injuries?
There usually isn’t one single cause. Training changes, tissue capacity, recovery, previous injuries, strength, and individual biomechanics can all contribute.
Should I stop running if something hurts?
Not automatically. Some injuries require significant load reduction, while others can be managed while continuing modified running. The appropriate decision depends on the condition and severity.
Is running bad for your knees?
Running places load through the knees, but load itself isn’t inherently harmful. Gradual training progression and sufficient physical capacity are important.
Should runners lift weights?
Strength training can be a valuable addition to running and may help improve the physical capacity needed to tolerate training.
What are the best exercises for runners?
There isn’t one perfect routine, but runners commonly benefit from exercises targeting the calves, quadriceps, hamstrings, hips, and overall single-leg strength.
Are squats good for runners?
They can be. Squats are one way to build lower-body strength, but they should be part of a broader program tailored to the runner.
Do runners need strong calves?
Calf strength and endurance are particularly important because the calf complex handles substantial repeated loading during running.
Do I need orthotics for running?
Not necessarily. Orthotics can be useful for some runners, but they shouldn’t automatically be prescribed to everyone experiencing running pain.
What’s the best running shoe to prevent injuries?
There isn’t one universally best shoe. Comfort, fit, training demands, and individual preference all matter.
Can physiotherapy help running injuries?
Yes. Physiotherapy can help identify the injury, assess contributing factors, manage training load, progressively strengthen the affected area, and guide return to running.
How long should I rest from running?
That depends entirely on the injury. Some runners may continue modified running, while other injuries require temporary cessation. A suspected bone stress injury, for example, requires a very different approach than mild muscle soreness.
Why does my injury return every time I start running again?
Your symptoms may settle faster than your physical capacity returns. If you immediately resume your previous mileage, your training demand may once again exceed what the tissue can tolerate.
Can Restore You help me return to running?
Yes. Restore You can help bridge the gap between injury recovery and running by progressively developing strength, mobility, conditioning, single-leg capacity, and confidence before returning to normal training.
Running Injury Treatment in Hamilton
If running hurts, the answer isn’t necessarily:
“Stop running.”
And it isn’t:
“Just run through it.”
The better question is:
What is causing your symptoms, how much load can you currently tolerate, and what needs to improve to get you back to running?
At Restorative Touch Physiotherapy on Hamilton Mountain, we take a progressive approach to running injuries.
Through physiotherapy, athletic therapy, therapeutic exercise, and our Restore You program, we can help identify what’s limiting you and build a rehabilitation plan around your running goals.
Whether you’re trying to run your first 5K, preparing for a 10K, training for the Around the Bay Road Race, chasing a marathon goal, or simply want to run around your neighbourhood without pain, your rehabilitation should prepare you for the demands that matter to you.
Because the goal isn’t simply to get you off the treatment table.
It’s to get you back on the road.
Contact Restorative Touch Physiotherapy in Hamilton to book a running injury assessment or Click here to book online!