Marathon season is underway, and with weekly mileage building up, many runners begin to experience persistent niggles, especially in the knee or shin. When not addressed, these minor pains can escalate into injuries that hinder training and compromise race-day performance.
How Common Are Running Injuries?
A recent systematic review of running-related musculoskeletal injuries (RRMIs) across runner populations revealed how frequent, and where, these issues occur:
- High overall risk: Runners face an injury incidence of ~40% per season and prevalence of ~44% at any given time.
- Most common sites: The knee, ankle, and lower leg account for most injuries in non-ultramarathoners.
- Patellofemoral pain syndrome (PFPS): Pain around or behind the kneecap, triggered by running, squatting, or stairs, affects 16.7% of non-ultramarathon runners.
- Medial tibial stress syndrome (MTSS): Shin pain related to repetitive stress shows an incidence of 9.4% in non-ultramarathon runners.
- Ultramarathoners: PFPS and MTSS remain common, but anterior compartment tendinopathy is the leading concern, followed by PFPS and Achilles tendinopathy.
- Other notable injuries: Achilles tendinopathy (~10.3%), plantar fasciitis, and iliotibial band syndrome, each affecting 6–8% of runners.
These numbers underscore that niggles are not rare, PFPS alone impacts nearly 1 in 6 runners, while shin pain affects nearly 1 in 10. Ignoring these warning signs can disrupt training, slow progress, and even lead to race withdrawal.
An Evidence-Based Approach to Injury Prevention:
Working with a physiotherapist can help identify issues early and keep you running strong. Key strategies include:
1. Strength & Functional Testing
- Field tests: 25 single-leg calf raises and 10 single-leg squats can screen for muscle endurance and control deficits.
- In-room testing: Comprehensive lower limb strength screening can highlight imbalances or asymmetries.
2. Comprehensive Running Assessment
- Gait and running analysis to detect biomechanical strain or inefficient movement patterns.
3. Individualised Strength & Movement Programming
- Targeting deficits in quadriceps control, hip stabilisers, calf endurance, and trunk stability.
4. Load Management Planning
- Structuring training volume and progression to avoid sudden spikes that overload tissues.
5. Collaboration with Coaches
- Aligning rehabilitation and training goals to optimise pace, mileage, and recovery.
Addressing niggles early leads to tangible benefits:
- More consistent training with fewer setbacks
- Reduced pain through improved biomechanics and muscle strength
- Greater endurance and efficiency on long runs
- A higher chance of not just finishing, but exceeding your marathon goals
Reference
Videbæk S, Bueno AM, Nielsen RO, Rasmussen S. Incidence of Running-Related Injuries Per 1000 h of Running in Different Types of Runners: A Systematic Review and Meta-Analysis. J Sport Health Sci. 2021 Nov;10(6):531-541. doi:10.1016/j.jshs.2021.03.005. PMID: 34646651; PMCID: PMC8500811.
Available here: https://pmc.ncbi.nlm.nih.gov/articles/PMC8500811/
