Running myths and realities – What to do for a running injury?

You've injured yourself while running and don't know what to do. Should you stop completely? Continue despite the pain? Take anti-inflammatories and push through it? This uncertainty is frustrating, especially when running is part of your routine and well-being.

In a follow-up study of beginner runners, 108 of the 225 people who had stopped running after six months cited an injury as the main reason. This accounted for 48% of the dropouts in this group.¹ The return to running depends on the specific injury. However, studies do not provide a training progression that works for everyone.²

Can you keep running when you're injured?

Running can sometimes continue in a modified form, depending on the injury and its assessment. However, some injuries require a temporary break. The distance, duration, pace, and frequency of runs can be adjusted. Studies have not found a consistent link between any of these factors and injuries². The decision also takes into account pain, swelling, and your ability to walk or perform daily activities. A physical therapist can help you decide when and how to resume running. Read the NHS’s advice on returning to running.

You can adjust your weekly running mileage. A 2007 review linked high weekly mileage to injuries among men who run long distances. It also found a link to previous injuries. These findings do not establish a specific mileage threshold that is dangerous for everyone.³ A systematic review published in 2024 found associations with training, health, lifestyle, body composition, and movement patterns. The studies vary widely, and their quality ranges from low to very low. Therefore, no single factor can explain all injuries.⁴

• Alternating between walking and running can make it easier to get back into shape, once your injury allows you to run
• Shortening your runs and scheduling recovery days allows you to tailor your return to running to your symptoms
• Relief from medication alone is not enough to determine whether you can resume running the same distance
• Getting enough sleep is part of recovery and well-being

This article provides concrete recovery strategies. To understand why injuries recur, consult our article on recurrent running injuries.

When should you see a physical therapist for a running injury?

It’s a good idea to see a physical therapist if your pain persists, limits your activities, or makes it difficult to get back to running. A professional who works with active people can assess your running and sports needs and work with you to develop a plan.

After an injury, seek urgent medical attention if the pain is severe or getting worse, if there is significant swelling or bruising or if these symptoms are getting worse, if you cannot put weight on the area or take a few steps, or if the area is very stiff or difficult to move. A high fever or feelings of heat, cold, or chills after the injury also warrant seeking medical attention.

Go to the emergency room if you heard a cracking sound when the injury occurred, if the area is misshapen, numb, or tingling, or if the skin turns blue, gray, or cold. Any one of these signs may be enough. If the pain gets worse or doesn’t improve despite treatment, have it evaluated. Read about the signs that require medical attention, according to the NHS.

Is there a training regimen that prevents injuries?

No universal formula for distance, duration, or running frequency has been shown to prevent injuries in all runners. Scientific data does not consistently link these training factors to the risk of injury.²

Does running wear out your knees?

Running is not consistently linked to an increased risk of knee osteoarthritis. Osteoarthritis alters the joint and can cause pain or stiffness; it is not simply a result of wear and tear from impact. A 2023 review found no increased risk of knee osteoarthritis among runners. The results of an earlier review were more mixed. The limited quality of the studies prevents a definitive conclusion about a causal effect.^{5, 6} This earlier review also included studies on surgery for knee osteoarthritis. Runners underwent this surgery less frequently in that review. The pooled odds ratio is 0.46, with a 95% confidence interval of 0.30 to 0.71. These figures describe a statistical association, with its margin of uncertainty, and do not guarantee individual protection.⁶ For more information, see our article “Does Running Cause Osteoarthritis?”

The association with fewer surgeries is therefore reassuring. However, it does not prove that running caused this difference between the groups.⁶

Can you treat yourself?

Some minor injuries can be treated at home, provided there are no concerning medical signs and the injury is healing well. You can adjust the amount of stress placed on the injured area and choose appropriate shoes (see the article on shoes, Link to Blog #13) and a running style suited to your symptoms (see the article on running technique, Link to Blog #12).

See also: What shoes to wear for running and the best running technique.

How can you manage a running injury in your daily life?

Daily care involves a combination of appropriate physical activity, other tolerable activities, adequate sleep, and exercises tailored to the injury. When running is permitted, alternating between running and walking can be part of the plan. Medications are used to provide relief; they should not be the sole factor in deciding when to resume running.

The following measures should be chosen based on your situation:

• Alternate between walking and running during permitted runs. Allow for recovery days between runs. Reduce or stop running if pain increases during the session, if sharp pain occurs, or if swelling persists. Seek advice if symptoms do not return to their usual level.
• Do not take medication for the sole purpose of continuing to run as you did before. Consult your pharmacist or doctor for pain relief, without stopping a prescribed treatment on your own. Pain helps you adjust your activities, but its intensity does not accurately reflect the condition of the tissues.
• Choose another low-impact activity, such as swimming, cycling, or running in water. These options can help you stay physically active while you recover. Also, adjust the duration and intensity of these activities if they trigger pain.
• Prioritize sleep and set aside enough time to sleep according to your needs. Sleep supports your health and helps you prepare for physical activity. The recovery time also depends on the type and severity of the injury. Read expert recommendations on sleep for athletes.
• Choose strengthening exercises in consultation with the professional treating the injury. For prevention, a study involving 118 recreational runners tested a program targeting the muscles of the foot and ankle. The exercises were taught and supervised for eight weeks, then continued with remote follow-up. Over the course of a year, this group experienced fewer injuries than the group that followed a warm-up and stretching routine without this strengthening. This result supports a preventive approach; it does not demonstrate treatment for an existing injury.⁷

Where can I learn more about running injuries?

The podcast “Parle-moi de santé” explores the prevention and treatment of running injuries in its first episode. Alexis Gougeon interviews Blaise Dubois.

Episode #1 discusses the prevention and treatment of running injuries.

Watch the episode on YouTube:

You can also listen to the episode on Podbean.

Source:

Links open in a new tab.

1. Fokkema T, Hartgens F, Kluitenberg B, Verhagen E, Backx FJG, van der Worp H, et al. Reasons and predictors of discontinuation of running after a running program for novice runners. J Sci Med Sport. 2019;22(1):106-111. (Back to section: 1)
2. Fredette A, Roy JS, Perreault K, Dupuis F, Napier C, Esculier JF. The Association Between Running Injuries and Training Parameters: A Systematic Review. J Athl Train. 2022;57(7):650-671. (Back to sections: 1, 2, 3)
3. van Gent RN, Siem D, van Middelkoop M, van Os AG, Bierma-Zeinstra SM, Koes BW. Incidence and determinants of lower extremity running injuries in long-distance runners: a systematic review. Br J Sports Med. 2007;41(8):469-80; discussion 480. (Back to section: 1)
4. Correia CK, Machado JM, Dominski FH, de Castro MP, de Brito Fontana H, Ruschel C. Risk factors for running-related injuries: An umbrella systematic review. J Sport Health Sci. 2024;13(6):793-804. (Back to section: 1)
5. Burfield M, Sayers M, Buhmann R. The association between running volume and the prevalence of knee osteoarthritis: A systematic review and meta-analysis. Phys Ther Sport. 2023;61:1-10. (Back to section: 1)
6. Timmins KA, Leech RD, Batt ME, Edwards KL. Running and Knee Osteoarthritis: A Systematic Review and Meta-analysis. Am J Sports Med. 2017;45(6):1447-1457. (Back to sections: 1, 2, 3)
7. Taddei UT, Matias AB, Duarte M, Sacco ICN. Foot Core Training to Prevent Running-Related Injuries: A Survival Analysis of a Single-Blind, Randomized Controlled Trial. Am J Sports Med. 2020;48(14):3610-3619. (Back to section: 1)