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Top 5 Questions Runners Ask About Injuries (Answered by a Running Physical Therapist)
- Kate Mihevc Edwards PT, DPT
- Mar 16
- 4 min read
I love running. I hate telling people they can't run. Running is great exercise and it is so beneficial for both mental and physical health. But if you run long enough, chances are you will deal with pain or injury at some point.
As a physical therapist who works with runners every day, these are the five most common questions runners ask about running injuries and answers that can help you to stay healthy and keep running.
1. "Why do my knees hurt when I run?"
Knee pain is cited as the most common running injury. Nearly 50% of running injuries occur at the knee. This is because the knee is trapped between the hip and the foot so what is happening above and below impact the knee with every foot strike.
The two most common causes of knee pain are:
Patellofemoral Pain Syndrome – pain in the front of the knee
IT Band Syndrome – pain on the outside of the knee
Most runners assume knee pain means something is “wrong” with the knee. In reality, the knee joint is typically fine. Knee pain is often the result of training errors, strength deficits, or mobility limitations elsewhere in the body.
Rapid mileage increases, a spike in training load, poor hip strength, and limited ankle mobility can all increase stress on the knee joint.
Most likely you don't need to stop running completely. Instead we focus on:
Adjusting training load
Strengthening hips and core
Improving mobility through the ankle and hip
2. "Should I stop running if something hurts??
Not necessarily.
Pain during running does not always mean you have to stop completely. Here is another blog I wrote about running through pain. Here is another one if you aren't sure if what you are feeling is pain or just muscle soreness. What matters is how the pain behaves.
You can often continue running if:
Pain is mild, (1-4/10)
It does not worsen during the run or with standing on it
It settles quickly afterward (within the 24 hour window)
You should stop or modify training if:
Pain is sharp or worsening
You are limping
Pain continues to increase after running
The only time I really tell my runners to completely stop running is if I suspect or there is a bone stress injury. Otherwise most runners benefit from temporary training modifications, not complete rest. This may include reducing mileage, slowing pace, or adding cross training while the irritated tissue calms down.
3. "What causes Achilles pain when running?"
The Achilles tendon absorbs huge loads every time your foot hits the ground - more than 3.5-5x your bodyweight. Running places repeated tensile stress on the tendon, which can lead to overuse injuries if recovery is insufficient.
Achilles pain commonly develops when runners:
Increase mileage too quickly
Have a major spike in their training load
Add hills or speed workouts suddenly
Change shoes or running surfaces
Have limited ankle mobility or calf strength
Rehabilitation usually focuses on progressive, eccentric calf strengthening, load management, and improving running mechanics so the tendon can tolerate the forces of running again.
Here is a great podcast episode I recently did with two of the other RUNsource experts about Achilles pain. We talk through what to do with Achillies injuries from an MD, dietitian and PT perspective.
4. "How do I prevent running injuries?"
This is the million dollar questions. Most running injuries happen when training load exceeds the body’s ability to recover.
That means injury prevention isn’t just about stretching or foam rolling. It involves the entire system:
Training progression
Strength training
Sleep and nutrition
Stress management
Recovery
Runners take roughly 1500 steps per mile, depending on their speed. Slower runners take more steps and with each step you take forces several times your body weight travel up through the legs.
Strength training helps the body tolerate those repetitive forces. For most runners, strength training 2–3 times per week combined with consistent mileage is one of the best ways to stay injury free. If you are already strength training dial in some of your basic needs. Make sure you are sleeping enough (7-9 hours), eating enough calories to support the amount of training you are doing and have a stress management plan.
5. "Do I need a running gait analysis?"
Everyone wants to blame their running form for their injury, but most of the time it is only a part of the picture. A running gait analysis can be helpful to dial in your form when you are trying to improve speed or come back from injury. We do them all the time at Precision. However a run gait analysis is not a magic bullet.
Running form affects how forces move through the body, but many injuries occur because of training mistakes or strength deficits, not just biomechanics.
Small adjustments like increasing cadence slightly or improving hip extension can sometimes reduce stress on irritated tissues. However, these changes work best when combined with strength training and proper training progression.
Most Running Injuries Are Preventable
Running injuries are rarely random. They usually occur when training load, nutrition, stress, recovery, and biomechanics fall out of balance.
The good news is that most injuries respond well to:
Smart training adjustments
Strength training
Addressing mobility limitations
Early treatment from a running specialist
If something feels off, don’t ignore it. Small changes early can prevent months of frustration later.
Your goal should not just be running more miles it should be running strong for years. The RUNsource app can help you reach your goals with information from experts, injury recovery plans and in the next few weeks you will even be able to ask it questions about running injuries, running information and more - all based on a curated running research library and expert knowledge.
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