On the list of "things that suck," getting injured while exercising (a supposedly healthy activity) ranks pretty high—somewhere above missing a flight to Jamaica and below losing your life savings in a high-stakes poker game. Think about it this way: The more miles you run, the more stress on your joints, muscles, and cartilage. And as good as you might feel pounding the pavement with the wind in your hair, the reality is that your body is made of tissue.
There is some consolation in knowing that you’re not alone. Running injury statistics vary greatly, but the 2017 National Runner Survey estimates that 75 percent of runners have had some sort of sport-related injury over the past 12 months, and 50 percent of those injured have had to put a halt on their training for more than a four-day period.
We tapped Luke Greenberg, DPT, movement coach, and co-founder of MotivNY, to give us the rundown of the most common running injuries and how to treat them. Anxious to get back to 100 ASAP, Drake-style? We’ve got the download on how to keep on keeping on and what to do if you need to bench it for a while.
1. Runner’s Knee
This is somewhat of an umbrella term for "pain at the front of your knee." To get a handle on what specific structure is the source of pain, have a therapist or doctor palpate (that’s a fancy word meaning “touch”) specific structures and see what hurts. Another way to feel it out? Reference the pain as you try to run, and try to identify a specific location or reproduce a sensation. “This is important, because your knee is generally a symptom area but rarely the cause of the actual issue,” says Greenberg.
How bad is it? Don’t run through the pain—especially as a novice. “Generally, these types of issues are due to a weakness in hips or feet, or by increasing volume (mileage) too quickly, which can happen often if you join a local running group and fall into peer pressure with your friends running, and jump into things that your body is trying to shy you away from.”
How to make it better: Eccentric strength training, or the lowering phase of a movement, is often the best intervention for this type of pain, says Greenberg. Take a squat, for example. The lowering phase, when your butt is headed toward the floor, is the eccentric portion. “It has specific benefits to tendons and making that tissue stronger. Lack of ability to absorb load is often where we see pain onset occur, and eccentric training helps with that as well.”
2. Hamstring Pull
If you’re feeling excessive tightness on the back of your thigh, that’s a pretty solid indication that excess load has been placed on the hamstring, which can be caused by running too fast, running under fatigue, or the failure of other muscles. A hamstring pull can happen at a few different points of the muscle: The tendons near the knee joint, the attachment by your "sit bones," and in the middle of the muscle belly (read: midway between the hip and knee).
How bad is it? In the acute phase: It’s not a great idea to keep running, especially if there's sprinting or speed work involved. While there is a range of severity, you can expect six to eight weeks of healing for average hamstring pulls to regain full confidence. Just as when you take antibiotics and go through that “I’m feeling better—I don’t need these anymore!” phase, you need to be careful progressing post–hamstring injury. “These injuries are easily re-aggravated by running, squatting, or deadlifting, so it's wise to stay out of full range of motion until guided by a therapist to return to larger ranges.”
How to make it better: Start with gentle isometrics (pushing against something without any movement). “This is important because it guides the healing process of the strain and minimizes the buildup of erratically placed scar tissue,” says Greenberg.
And again: Before you go back to your regularly scheduled programming, make sure to start slow. Introduce exercises, including some plyometrics (think squat jumps, skaters), before returning to distance running. “Often, people don't realize how weak or easily fatigued the muscle is and skip this phase. That puts you at high risk to re-injure.”
3. Shin Splints
Generally speaking, shin splints are pain along the shin bone on the front lower portion of your leg. This may present itself as a shooting pain on the shin toward the midline of your body that shoots down toward the arch or on the front of the shin, more toward the outside, which then tends to radiate upward to the knee. “These vary greatly in severity and are quite common in new runners whose legs aren't accustomed to the stress, or have poor choice of footwear.”
Can you keep running? That’s a no, according to the expert. If this type of injury becomes inflamed, even just standing or walking can keep it from healing properly. “These injuries are among the most common to lead to stress fractures, and are signs of poor mechanics and overall technique or strength.”
How to make it better: Rest up! Give the inflammation time to go down, and seek out a physical therapist or running coach ASAP to get a gait analysis (this is a fancy term for having someone check out your running form and how your feet come into contact with the ground during your stride). The good news? “Most of the time, shin splints are a result of technique errors, which a person can correct to avoid future issues.
4. Piriformis Syndrome
This is a burning pain near the middle of the butt cheek, caused when the piriformis muscle compresses the sciatic nerve. The syndrome itself refers to an excessive muscle spasm in the piriformis, which is a deep hip-stabilizing muscle that is located on top of that pesky sciatic nerve. Because of its location, it can often be confused with sciatica or lower-back problems. “A good doctor or therapist will be able to determine if the issue is local to the piriformis or if there are bigger issues going on.”
How bad is it? Not terrible. “This usually gets better when you warm up, and in some respects exercise will help to get the tension to go away. If the pain goes away immediately when warming up and doesn't return until many hours after the run, it's okay to do moderate amounts of exercise as long as recovery and rehab are integrated in that game plan.” If it worsens? Definitely go seek out the opinion of a physical therapist.
How to make it better: A whole lot of strengthening work targeted at the hips and core can help take pressure off the nerve, ranging from hip-joint mobilizations and glute work. In addition, try the best you can to reduce sitting time and do some local soft-tissue release using a lacrosse ball, foam roller, Theragun, or other massage device.
5. Achilles Tendonitis
Ever wake up in the morning, step on the floor for the first time, and feel a sharp pain in your calf? It could be a sign of Achilles tendonitis, which presents itself when the ankle hasn’t been moving enough. Generally speaking, this is soreness at the back of the ankle on the cord-like portion of the Achilles. “It's associated with either an inflammation or degenerative wearing on the tendon from poor usage, and generally occurs on one limb only.”
How bad is it? Same sort of guidelines as the runner’s knee advice: Don’t push through it, especially if you’re new to your specific sport or training cycle. The good news? It's an easy injury to do other strength training with, because it typically isn't irritated by squatting, lunging, deadlifting, or general weightlifting. Plus, those strength inputs can be very helpful in creating a better surrounding structure so that the Achilles doesn't get as much stress placed upon it.
How to make it better: “I'd always recommend getting it assessed by a physical therapist, because there are a lot of things that can stunt the healing process and cause the issues, such as lack of ankle-joint mobility, lack of hip extension on the same side, excessive body lean, or favoring of one leg due to other body imbalance.”
Greenberg says that heavy-loaded eccentric exercises are known to be the best and most effective strategy here. Think single-leg squats, lowering yourself at first on one leg for a count of 5 seconds without loss of balance. Then focus on that slow descent with a progressing weight. If you're not sure, start light and see how it responds.
Originally Appeared on GQ