While many injuries come out of the blue and are impossible to predict, there are some parts of the body that are particularly vulnerable and prone to damage, says Brian Soo, physical therapist at Kaiser Permanente San Francisco. “The knee is number one, that’s for sure,” says Soo. “And knee injuries tend to be related to hip alignment problems, which are also common.”
Here are the injuries Soo says he and other physical therapists see most frequently in those training for marathons and other races.
Patellofemoral pain syndrome (PFPS) or “Runners Knee”
The most common running injury of all, PFPS occurs when the kneecap, or patella, doesn’t track correctly in the groove at the top of the thighbone, irritating the cartilage under the kneecap.
The large tendon that runs down the back of the heel, known as the Achilles tendon, can become overstretched and inflamed.
Plantar means foot, and the plantar fascia is the ligament that runs along the bottom of your foot, supporting your arch. When it becomes irritated and inflamed, the result is plantar fasciitis.
Iliotibial Band Syndrome (ITBS)
The iliotibial band is the ligament that runs down the outside of your thigh, connecting the hip to the knee. The bending of your knee during running can cause this band to rub on the top of the femur, causing irritation.
Shin Splints or Medial Tibial Stress Syndrome
The stress of training can lead to minute tears in the muscles that surround your tibia, or shin bone, causing pain down the sides of your calves.
All of these injuries tend to happen when you train too hard and too fast, or as the result of biomechanics and gait issues, Soo says. A secondary factor is runners’ tendency to ignore pain, thinking it will go away. “If you start with a nagging pain but keep trying to run through it, then the damage can progress until you have a significant injury,” says Soo. “If something hurts, it’s a sign you need to cut back, or figure out how to run in a different way. You may need to make modifications to your gait or build up strength in supporting muscles.”
Minor pain isn’t a signal to give up, it’s just a sign that you need to make adjustments, Soo says. “I don’t like telling people to stop running, because that can be debilitating in other ways. But it’s important for runners to understand a little bit about anatomy and biomechanics and pay attention to what’s happening in their bodies.” A physical therapist can analyze the source of pain and recommend stretches and strengthening exercises to counterbalance areas of weakness.