7 Things Physical Therapists Want You to Know About Running Injuries

Molly Hurford
by Molly Hurford
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7 Things Physical Therapists Want You to Know About Running Injuries

Running isn’t a sport that’s necessarily gentle on the body — and runners are pretty well-known for ignoring a nagging pain until it becomes a full-blown injury. Sports doctor Kelby Bethards is quick to note that of all endurance athletes, runners are the most likely to end up injured out of sheer stubbornness and chronic injury and pain, while a sport like cycling lends itself to more abrupt, acute injury.

So, while you’re less likely to break a bone on the running track, you are at a higher risk for overuse injuries. The good news is most of these injuries are preventable or easily treatable if you get help early in the game.

Kaci Lickteig, former Western States 100-miler winner and ultra-running physical therapist, has a few insights she’d like to share with runners:


You know that tiny click you feel in your knee when you go uphill or that slight catch in your ankle on long descents? Pay close attention to how your legs (and body as a whole) are feeling on each and every run. Take notes using an app like MapMyRun, where you can record your pace and mileage but also record little memos about that side stitch that got you at mile 3, or the ankle roll that happened halfway through your trail run. That way, you’ll be more aware of how you’re feeling, and if a nagging pain in your calf turns into a ‘pain in every step’ kind of feeling, you can trace it back and see it wasn’t just hurting for one run, it’s been a slow build. The more info you can provide a physical therapist, the better.


No matter who you are or what your running background is, you’re likely going to deal with some type of injury at some point in your running career. That doesn’t mean you should hang up your running shoes, that just means you’re human. “Your body isn’t a perfect machine. It’s going to break down,” says Lickteig. “It’s what you do when it breaks down that matters.” And that might mean simply taking a few days off at first, before heading to a physical therapist — but if that doesn’t help, it’s time to seek pro help.


For runners, Lickteig says the most common injuries by far are knee problems but IT band tightness and injury is a close second. Plantar fasciitis — foot pain — is common as well. “Those repetitive overuse injuries are the most common,” she adds. The tricky thing about overuse injuries is they happen gradually, which can make knowing when to take time off difficult. Lickteig says a good indicator of needing help — in addition to pain — is if you notice your gait pattern changing over a few days. “That means you need to come in, because you’ll end up causing other problems if we don’t address it,” she adds. Physical therapy isn’t always inexpensive, so she suggests trying a few days off before resorting to booking an appointment, but notes that the longer you put off an appointment when dealing with persistent pain, the more it might cost in the long run.


It’s frustrating to be told to take time off from running. But consider it part of training: You’ll return and be able to be faster, better, stronger. “You’re going to live, even if you have to take four months off,” says Lickteig. “You’ll be a better runner if you actually heal.” (If you’re frustrated, try activities like deep water running to get your fix.)


“We know when athletes haven’t been following the recommendations for rest or certain exercises,” says Lickteig. The ones who follow a therapist’s advice see faster results and get back to running more quickly than those who ignore exercises and stretches or try to sneak in miles. “I can always tell!” laughs Lickteig. “And really, it only takes 5–10 minutes to follow our exercise recommendations. It’s not hard!” This is one situation where you really want to be a model patient.


“So many injuries would be avoided if people just wore shoes that fit properly,” says Lickteig. If you’ve been having pain but haven’t considered swapping shoes, it might be time to go shopping. Most running stores can offer recommendations or even have periods where you can exchange the shoes if you’re not loving them, so take advantage of that and find a pair that actually fits well and suits your running style.



When you are sidelined from running, take this time to recover properly and when you are back on the trails, make sure you remember that feeling of not being able to run. It makes your ability to run feel that much sweeter, says Lickteig. Once you’ve been away from running, coming back should feel like a huge win, even if you’re not as fast right away. Enjoy the run and be grateful for your ability to come back from injury.

About the Author

Molly Hurford
Molly Hurford

Molly is an outdoor adventurer and professional nomad obsessed with all things running, nutrition, cycling and movement-related. When not outside, she’s writing and podcasting about being outside, training and health. You can follow along with her adventures on Instagram at @mollyjhurford.


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