Running and MSK injury prevention

Running continues to grow in popularity. Its appeal is easy to understand: it’s low cost, accessible and offers wide-ranging benefits, including improved cardiovascular health, bone density, joint health and mental wellbeing.

However, as participation increases, so does the risk of injury. Research suggests that 50% of runners experience an injury each year that prevents them from running for a period of time. While frustrating, many of these injuries are preventable with the right approach to training, recovery and support.

Understanding how running injuries develop, and what helps to reduce risk, can help runners stay active and injury free for longer.

Common running-related injuries
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Most running injuries develop gradually, often as a result of repeated load on the same tissues without adequate recovery. The most frequently reported injuries include:

• Achils tendinopathy: pain and stiffness at the back of the heel
• Medial tibial stress syndrome: often referred to as shin splints
• Patellofemoral pain syndrome: pain around or behind the kneecap
• Plantar fasciitis: pain at the bottom of the heel
• Ankle sprains: often linked to uneven surfaces or fatigue

Without appropriate management, these injuries can progress from mild discomfort to persistent pain that limits training and confidence.

Five ways to reduce injury risk

1. Progress training gradually

Sudden increases in running distance, frequency or intensity place additional stress on muscles, tendons and joints. When this load increases faster than the body can adapt, the risk of injury rises.

Research shows that avoiding sudden spikes in training volume significantly reduces lower-limb injury risk. Gradual progression – ramping up running time slowly and steadily – allows tissues time to strengthen and adapt. Many runners find that increasing weekly training load by around 10% is a helpful starting point.

2. Include strength and balance training

Running places repeated demands on the same bodily structures, primarily the hips, knees, ankles and feet. Strength, balance and coordination training all help improve tissue resilience, joint stability and control, reducing the risk of overload.

It’s widely discussed that strength-based programmes can significantly reduce the risk of overuse injuries. Incorporating a small number of targeted exercises into your routine can make a meaningful difference over time.

Here are some examples of strength and balance training exercises to enhance muscle resilience and joint stability:

• Heel Raises: Complete on one leg (with or without support for balance) to progress this exercise.

• Reverse Lunge: Put your hand on a nearby wall for balance if needed or add a bit of weight to challenge yourself.

• Bridges: Complete on one leg, or challenge your hamstrings more by moving your feet further away from your bottom.

• Side Plank: Rather than lifting from your knees, fully straighten your leg so you’re liftig up from your feet.

• Pendulum Balance: For additional support, lightly touch a wall with your finger tips when carrying out the exercise. Alternatively move your foot forwards, backwards, out to the side and even across your body for more of a challenge!

3. Choose appropriate footwear and support

Footwear plays an important role in comfort and load management. While there is no single “best” running shoe, poorly fitting and suited footwear can contribute to injury risk. In practice, the most suitable shoe is often one that feels comfortable during running and does not cause rubbing, pressure or pain. Trying several options and paying attention to how they feel on the foot can be more helpful than focusing on brand or design alone.

Some runners may also benefit from additional support, such as orthotics – particularly if they have a history of injury or specific biomechanical factors. Advice from a clinician can help determine what is appropriate for you. 

4. Prioritise rest and recovery

Recovery is just as important as training. Inadequate rest, particularly poor sleep, increases the risk of injury and slows tissue repair.

Building rest days into training plans and aiming for regular, good-quality sleep allows the body time to adapt and reduces cumulative fatigue. 

5. Support training with adequate nutrition

Running increases energy demands. When calorie intake consistently falls short of energy expenditure, the risk of injury rises and recovery slows.

Sustained energy deficits have been linked to increased injury risk, impaired healing and reduced performance. Ensuring nutrition supports training load, particularly during periods of increased activity, helps maintain resilience and recovery.

Staying consistent, not perfect

Running injuries are frustrating, especially when they interrupt progress. However, many overuse injuries develop gradually and can often be prevented with small, consistent adjustments to training and recovery.

By progressing training load sensibly, supporting running with strength work, prioritising recovery and fueling appropriately, runners can reduce injury risk and improve long-term consistency.

‍Need additional support?

Digital MSK tools can help runners access timely guidance when pain or discomfort appears. Platforms like Phio support early triage, guided exercises and escalation to clinical input when needed, helping runners address issues early and avoid unnecessary time away from activity.

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