Running doesn't always feel good, whether you're dealing with running injuries or just the run-of-the-mill running aches and pains. Sure, those of us who run regularly say that it gives us life and makes us feel wonderful. But at the end of the day, running is a high-impact exercise, meaning your entire body take a bit of a beating when you pound pavement for a prolonged amount of time.
If you're a beginner runner, your body isn't use to the repetitive motion, and you're likely to end up with some aches and pains. That doesn't always mean you're injured, Reed Ferber, Ph.D., researcher at the University of Calgary and director of the Running Injury Clinic, tells SELF. "Running hurts, you need to prepare yourself for that," he says. "But if the pain gets better, or goes away as the run goes on, that’s a good thing. That’s not really an injury." It takes your body some time (maybe even a few months) to adapt to the new stress you're exposing it to.
But if the pain persists, gets worse throughout your run, or goes away while you're running but comes back with a vengeance when you stop, those are signs you could have an actual injury. Ferber says the best thing to do is stop running, and go see a professional to figure out what's going on before you cause any permanent damage from your running injuries.
There are a lot of ways you can sprain, strain, tweak, and tear yourself when you run, but below, we've laid out the four most common overuse injuries that physical therapists see in beginner runners, and how they typically suggest treating them. These types of injuries occur when you train too hard too fast and your body doesn't have time to adapt. Most of them start out minor, but will get worse if you keep pushing too hard.
1. Runners knee
What it is: "Patellofemoral pain syndrome, more commonly referred to as runner’s knee, is a dull, achy pain that originates underneath your kneecap and is typically felt during running, especially up hill, walking down stairs, or when moving from a sitting position to a standing position," John Gallucci, Jr., M.S., D.P.T., president and CEO of JAG Physical Therapy, tells SELF.
This is the most common running injury, especially for new runners, Ferber says. He notes that for some people, the pain may start at the beginning of the run, subside throughout, and then pick up again as soon as you stop running.
What causes it: "It's a grinding injury," Ferber says. There's cartilage under your kneecap and also along your thigh bone, and a layer of fluid in between the two works as cushioning, Ferber explains. He says to think of the knee cap as a train and the thigh bone (femur) as the train track. When the hips are weak, the thigh bone loses its stability and moves underneath the kneecap. "The railroad track starts moving. Those pieces of cartilage start to rub together, and that’s what causes the pain," Ferber explains.
How to fix it: This is something most runners can deal with and will attempt to run through, Gallucci says. But (surprise!) that's not a good idea. "If not properly managed, patellofemoral syndrome can progress into a more severe injury that would require surgical intervention, such as a fissuring or fracturing of the patella," he says.
Initially, you should stop running and try to limit inflammation—taking anti-inflammatory mediations such as ibuprofen can help. Then, work on strengthening your hips, says Ferber, who co-authored a study on the benefits of treating runner's knee with hip and core exercises. Here are the specific exercises he recommends.
2. Shin splints
What it is: Medial tibial stress syndrome, more commonly known as dreaded shin splints, cause pain on the inside surface of the shin, "especially when walking, running, and pulling the foot upward or stretching it downward," Licameli says. The pain can occur on the inner or outer side of the shins.
What causes it: "There’s a muscle that attaches to the back of the shin bone and that muscle wraps around the inside of the ankle bone and helps to control the foot when it pronates [rotates inward and downward], and also helps during push-off to propel you forward," Ferber explains. Shin splints happen when there's repetitive trauma to the connective tissue that attaches this muscle to the tibia bone, says Gallucci. The tissue breaks down, becomes inflamed, and sometimes, scar tissue forms during the healing process, "which produces pain and tightness."
How to fix it: Getting running sneakers with more cushioning is a good start, but shoe choice is just a minor part of this, Ferber says. "The true fix is strengthening." He tells patients to follow a heel raises program (check it out here) to strengthen the calves and ankles.
3. Plantar fasciitis
What it is: Plantar fasciitis causes a stabbing pain on the bottom of the foot near the heel. "It's usually a little bit stiff at the beginning of a run and then the pain goes away. Then, it's a little stiff when you finish," says Ferber. "But it hurts first thing in the morning. That first step out of bed is excruciating at the heel. It can take 15 to 30 steps to get it warmed up and to go away, and then you kind of forget about it."
What causes it: The plantar fascia is a thick band of connective tissue that runs along the sole of the foot from the toes to the heel. Its job is to support your arch, Ferber says. "It gets stretched every time the foot comes down, and rung back out as the foot pronates," he explains. It's designed to be thick enough to withstand these forces, but too much repeated tension on the fascia can cause irritation and inflammation.
Since the fascia is connected to so many parts of your foot and leg, there are many things that can contribute to plantar fasciitis. "Poor running mechanics, flat feet, weakness of the hips, weakness of the core, poor control of pelvic positioning, and nerve irritation in the lower back," can all contribute to this inflammation and pain, Licameli says. Tight calf muscles or even inflexible toes can strain this connective tissue, too, adds Ferber.
How to fix it: "We say to stretch and do heel raises to make sure the muscles crossing underneath the foot are good and strong. That takes the load off the plantar fascia," Ferber says. "Plus, a good arch support (just an over-the-counter orthotic) will take some stress off." Licameli also suggests strengthening the hips and the core (try this core workout for runners). "And always warm up properly," he says.
4. Achilles tentonitis
What it is: This type of tendon injury causes inflammation and pain in the Achilles tendon, "especially when walking, running, raising up on toes, and stretching the calf muscles," Licameli says. It's an aching, dull pain, "usually right where the muscle transitions to tendon," Ferber says. The pain can also be deeper in the thickest part of your tendon, which is more common as you age. Why? "As you age, you lose blood supply in the mid part of the Achilles tendon and it becomes brittle. It starts happening in about your 40s," Ferber explains.
What causes it: Any weakness or tightness in the calves, glutes, or hamstrings can impact the Achilles tendon. We use our calf muscles and glutes to propel us forward, and if they're not their doing jobs, smaller things like tendons have to kind of take over, which can end up causing a lot of strain. Licameli adds that having weak hips or core or flat feet can all impact how much strain is on the Achilles tendon.
How to fix it: Again, strengthening and stretching the muscles at play is key here. Often it's the hips or calves that need to be strengthened, but issues with the feet are core are common, too. Ferber adds that since there can be so many different causes, you need to figure out the main one in order to properly treat it—that's why it's so important to see a professional to help you get to the bottom of it.
This story originally appeared on Self.
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