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What You Should Know - Running Right to Avoid Common Injuries

Woman running down the road with mountains in the backgroundBy Ross Henshaw, M.D., Sports Medicine Specialist, OrthoConnecticut.
Running is a wonderfully efficient way to improve your health, except when it produces chronic injuries. The best way to safely enjoy a running program is to gradually build the intensity of your workouts.


Typically, a running coach or trainer will recommend increasing distances no more than 10 percent a week. If you have an underlying health condition or are new to exercise, make your first step a consultation with your physician. If you have a history of orthopedic injury or joint pain, seek the advice of an orthopedic surgeon.


Hip Bursitis

This is an overuse injury caused by friction between the iliotibial tendon band and the hip bone. This large tendon travels over the bony prominence on the outside of the hip, goes all the way down to the leg and attaches just below the outer side of the knee. When we run, this band rubs back and forth over the outer hip bone; over time the friction creates inflammation. Our bodies have natural “cushions” called “bursa” that are designed to reduce this friction, but if they have not had time to adapt they can swell and hurt, causing pain in the front of the knee. This condition is common among runners.

Kneecap Pain and Patella Tendonitis

This results in pain in front of the knee and is common among runners. The quadriceps muscle in the front of the thigh powers our ability to straighten the knee. It works by using the kneecap or “patella” for leverage across the knee. This generates pressure and can cause the kneecap to become sore. The quadriceps muscle tapers to become a tendon that attaches to the kneecap and then to the shin bone (tibia) via the patella tendon. When strained, the quadriceps and patella tendons can also develop micro tears and become inflamed. Treatment includes rest, anti-inflammatories, strengthening exercises, cross training and progressing back to running while avoiding hills.

Shin Splints

This can occur on one or both shins, but most commonly on the dominant leg. This condition is caused by inflammation where the Soleus muscle in the calf attaches to the tibia. As the muscle helps runners with “pushing off,” it pulls on the attachment site, which may become inflamed and swollen. This pain usually hurts only when running. Treatment for this overuse is rest and cross training.

Achilles Tendonitis

The strong Achilles tendon is prone to inflammation when starting a running program. Our calf muscle tapers off to become the Achilles tendon that inserts into the heel and powers the push-off of the running stride. Running uphill demands more stretch from the calf, forcing it to work harder. This can lead to micro tears of the small Achilles fibers.

Micro tears do not become full tendon ruptures, but cause inflammation and swelling as the body tries to repair and regenerate the area. The usual treatment is rest, stretching, strengthening, cross-training and as the pain dissipates, a gradual return to running with limited hills.

Plantar Fasciitis

The most common early symptom of this comes with morning’s first step. The plantar fascia is a tight band of tissue that supports the foot arch. It attaches to the heel and traverses across the sole, attaching broadly across the end of the foot.

When we run, the plantar fascia can become overstressed at the smaller attachment on the heel, especially in individuals with tight calf muscles. Initially, inflammation starts after the run and hurts upon standing after a period of inactivity. When the foot and ankle bend to stand flat, the fascia stretches and hurts. The best treatment is to recognize it early and rest.


Most of us can enjoy running without ever suffering from these common maladies. My best advice is to cross train and to recognize symptoms early and not ignore the pain. If you pay attention to symptoms, you can help avoid painful injuries and stay active.

About OrthoConnecticut

OrthoConnecticut is the region’s premier, multi-specialty orthopedic and pain management practice. Thirty-one fellowship- trained, board-certified physicians offer patient care at nine offices in Danbury, Darien, New Canaan, New Milford, Norwalk, Ridgefield, Sharon, Southbury and Westport. The practice’s urgent care service, OrthoCare Express, is open 7 days a week for emergencies and is available in Danbury, Darien, Norwalk and Westport. To make an appointment with Dr Henshaw, or to learn more about OrthoCare Express, please visit http://www.myorthoct.com/, or call 1.833.ORTHOCT (1.833.678.4628).