Running myths and realities – How to start running without getting injured?

You want to start running, but you’re afraid of getting injured in the first few weeks. Perhaps you’ve already tried and given up because of knee or shin pain. This fear is legitimate. In a supervised six-week program involving 1,696 beginners, about 11% reported an injury that limited their running for at least three consecutive sessions. Injuries were more common among older participants, those with a higher weight-to-height ratio, those who had never run before, and those who had previously experienced muscle or joint pain unrelated to exercise. These associations do not allow us to predict with certainty who will get injured¹.

One study also followed nearly 75,000 runners for about seven years. People who ran more reported fewer diagnoses of osteoarthritis and fewer hip replacements than those who ran less. Part of this association was linked to their lower body weight.² However, this association with fewer cases of osteoarthritis does not prove that running alone protects the joints.²

Note: Research does not show that a gradual increase in training volume alone is sufficient to prevent injuries. A review of studies on runners identified only two strong risk factors: having previously suffered an injury and, among men, running long distances each week.³

You can adjust the duration, frequency, and intensity of your runs. None of these adjustments alone eliminates all risk of injury. The 2007 review focused on long-distance runners. Its conclusions therefore do not accurately describe the risk for someone who is just starting to run³.

• Increasing the training load too quickly can increase the risk of sports-related injuries. The expert panel considers rapid changes in training volume to be a significant factor. This advice is intended for athletes and is not specifically aimed at people who are just starting to run⁴.
• Alternating between walking and running helps spread out the effort. We recommend this approach: start with short periods of running and gradually increase them as your tolerance allows.
• We recommend several short workouts spread out over the week. Adjust the frequency if you start to feel tired or experience pain, and make sure to set aside time to recover.
• Tendons and bones adapt to repeated stress over time. Your ability to tolerate this stress also depends on your overall health and^{recovery5, 6}

To choose your shoes, check out our guide to running shoes.

How can I start running without getting injured?

A gradual start with short runs and alternating between walking and running allows you to adjust the intensity to your abilities. This gradual approach makes the first few sessions less difficult, but it does not guarantee that you will avoid injury. The risk of injury does not depend solely on the amount of training. Stress, fatigue, and recovery also play a role.⁴

How do you adjust the difficulty level at the beginning?

Your progress depends on your experience, the duration of your runs, and how you feel after exercising. Avoid suddenly increasing several factors at once, such as duration and speed. Progressing too quickly may exceed what you can currently handle.

We recommend starting with short runs that alternate between walking and running. Gradually increase the total duration once you’re comfortable with the sessions. If pain increases as you run, changes your running form, or persists after exercise, cut your run short and have the situation evaluated if necessary.

Running shoes and running form can also be examined:

• Choose a shoe that feels comfortable. A Cochrane review found little or no difference in injury risk among various types of running shoes, with evidence ranging from low to very low certainty. Comfort remains a practical criterion for choosing shoes, but it does not guarantee that they will prevent injuries⁷. (See the blog post on running shoes, Link to Blog #13)
• The way you run can affect the stress placed on certain body structures. Two studies suggest that gait retraining could reduce injuries, but the evidence is still too limited to conclude that any particular technique reliably prevents injuries. This is an adjustment to explore with a physical therapist—not a guarantee⁸. (See the blog post on running technique, Link to Blog #12).

For more information on this topic, see our guide to the best running technique.

The programs from La Clinique Du Coureur can serve as a starting point. Choose the program that matches your goal, then adapt it to your fitness level, recovery time, and any pain you may experience.

Where can I learn more about running?

The podcast "Parle-moi de santé, " hosted by our physical therapist Alexis Gougeon, explores running in its first episode, featuring Blaise Dubois.

Episode #1: Prevention and treatment of running injuries.

Watch the episode on YouTube.

The podcast is also available on Apple Podcasts.

Source:

Links open in a new tab.

1. Kluitenberg B, van Middelkoop M, Smits DW, Verhagen E, Hartgens F, Diercks R, et al. The NLstart2run study: Incidence and risk factors of running-related injuries in novice runners. Scand J Med Sci Sports. 2015;25(5):e515-23. (Back to section: 1)
2. Williams, P.T. Effects of running and walking on the risk of osteoarthritis and hip replacement. Med Sci Sports Exerc. 2013;45(7):1292-7. (Back to sections: 1, 2)
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 sections: 1, 2)
4. Soligard T, Schwellnus M, Alonso JM, Bahr R, Clarsen B, Dijkstra HP, et al. How much is too much? (Part 1) International Olympic Committee consensus statement on training load in sport and risk of injury. Br J Sports Med. 2016;50(17):1030-41. (Back to sections: 1, 2)
5. Bohm S, Mersmann F, Arampatzis A. Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies in healthy adults. Sports Med Open. 2015;1(1):7. (Back to section: 1)
6. Hamstra-Wright KL, Huxel Bliven KC, Napier C. Training Load Capacity, Cumulative Risk, and Bone Stress Injuries: A Narrative Review of a Holistic Approach. Frontiers in Sports and Active Living. 2021;3:665683. (Back to section: 1)
7. Relph N, Greaves H, Armstrong R, Prior TD, Spencer S, Griffiths IB, et al. Running shoes for preventing lower-limb running injuries in adults. Cochrane Database Syst Rev. 2022;8(8):CD013368. (Back to section: 1)
8. Doyle E, Doyle TLA, Bonacci J, Fuller JT. The Effectiveness of Gait Retraining on Running Kinematics, Kinetics, Performance, Pain, and Injury in Distance Runners: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2022;52(4):192-A5. (Back to section: 1)