The injuries runners get most often, and the habits that help avoid them

Most common

Knee, shin, Achilles tendon, sole of the foot and sprained ankles

Usual cause

Adding volume or intensity faster than the body can adapt

Prevention

Gradual progression, strength work, rest and a warm-up

Warning sign

Pain that changes how you run or will not settle

Important

Pulse is not a medical service: for pain or injury, see a professional

Pulse is not a medical service. This article is general information to help you understand what runners mean when they talk about "runner’s knee" or "shin splints"; it cannot diagnose or treat anything.

If you are in pain, have a niggle that will not go away or think you are injured, book an appointment with a doctor or a physiotherapist. Only a professional assessment can tell you what is wrong and what to do about it.

Nearly all of them are overuse injuries: there is no single knock or bad step, just tissue asked to handle more work than it can absorb for a while. These are the ones you hear about in any running club:

• Runner’s knee: an ache around or behind the kneecap, often worse on downhills and stairs.
• Pain along the inner edge of the shin, usually called shin splints.
• Achilles tendon trouble at the back of the ankle.
• Plantar fasciitis: pain under the foot, often most noticeable with the first steps in the morning.
• Iliotibial band irritation: pain on the outside of the knee.
• Sprained ankles, more frequent on trails and obstacle courses because of uneven ground.

A Spartan or a DEKA is not just running. There are jumps, carries, drags, climbs and constant changes of pace, so shoulders, wrists, lower back and hands join the usual list of running complaints.

Mud, rocks and technical descents mean many more unstable landings. That is why ankles and knees benefit from training off the road too, and from rehearsing obstacle movements before race day.

There is rarely just one cause. More often several things pile up over a few weeks:

• Too much, too soon: a sudden jump in distance, pace or climbing, for example when cramming for a race.
• Not enough rest: hard days back to back with no time to recover, or a spell of poor sleep.
• Footwear: badly worn shoes, or an abrupt switch to a very different model without easing in.
• Too little strength: legs, hips and core that struggle to absorb the repeated load of every stride.
• Coming back after a break at the same volume you were running before it.

No formula guarantees injury-free running, but some habits stack the odds in your favour. None of them is complicated; the hard part is sticking with them.

• Build up gradually: increase volume or intensity step by step and include easier weeks.
• Do strength work a couple of times a week, especially legs, glutes, calves and core.
• Respect rest: easy days and sleep are part of training too.
• Warm up before running hard: a few minutes of easy jogging and mobility get the body ready.
• Check your shoes and make any change of footwear progressively.
• Vary the terrain and, if you are heading to an obstacle race, practise the obstacles as well.

Heavy legs after a hard session are normal. What you should not ignore is pain that forces you to change how you run, gets worse as you go, always shows up in the same spot or does not improve after a few days of rest.

Do not wait either if there is swelling, if you cannot put weight on your foot properly or if the pain wakes you at night. In those cases stop running and book in with a doctor or a physiotherapist: they are the ones who should decide what to do and when you can return.

• Does this article replace a doctor’s opinion?

  No. Pulse is not a medical service and this article is general information: it does not diagnose or treat any injury. If you are in pain or think you are injured, see a doctor or a physiotherapist.

• What is the most typical running injury?

  Knee complaints such as runner’s knee are among the most talked about, along with shin, Achilles and foot problems. Which one affects you depends on many factors, and naming it is a job for a professional.

• Can I keep running with a mild niggle?

  It depends on what it is, and an article cannot tell you that. If the niggle changes how you run, gets worse or will not go away, stop and get it checked. Running through pain tends to drag the problem out.

• Do running shoes prevent injuries?

  Shoes in good condition that feel comfortable help, but they are not magic. How you build up your training, your strength and your rest matter just as much, if not more.

• Is strength training useful for runners?

  Yes, it is one of the habits most often recommended to runners, and even more so for obstacle racing. If you are unsure where to start, a coach or a physiotherapist can point you in the right direction.