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3 Common Injuries For Distance Runners And How To Avoid Them

About the Author: Sylvie Turner is an experienced medical writer and editor with a specialty in orthopedic conditions and sports injuries. She has researched and written extensively on hip, shoulder, knee, and foot conditions. She holds a master’s degree in Health Communication from DePaul University and writes for one of the most visited patient education platforms on the internet. (Note: Consult a physician when running injuries occur to avoid serious, long-term damage.)

Running, whether for pleasure or for a race, can be hard on the body. Distance running, which is generally defined as continuous running over 3 kilometers (1.8 miles), is particularly grueling, especially when you get into double digit mileage. The more you run, the more strain it puts on your joints, muscles, and bones. Injury is likely one of the biggest concerns for distance runners, since being sidelined can affect training schedule and cause endurance issues.

Here are some of the most common running injuries, including prevention tips.


Runner’s knee, also known as patellofemoral pain syndrome (PFPS), is the most common running injury and is due to increased stress between the patella (kneecap) and femur (thigh bone).

If you have runner’s knee you likely feel pain in the front or sides of the knee. The pain may be dull or aching while at rest and become sharp when the knee is flexed or extended. You may also notice swelling around the kneecap, stiffness, and a grinding or crunching sound during movement.

Why does runner’s knee occur?

Runner’s knee is often the result of overtraining or overusing the knee. Increasing the intensity of running too quickly, even for seasoned athletes, is often the perfect storm to cause this particular injury. Beyond overuse, unusual biomechanics, excessive body weight, and a lack of flexibility in the hamstrings or quadriceps may increase the likelihood of developing runner’s knee.

How do you prevent runner’s knee?

While some people are predisposed to runner’s knee, it can often be prevented.

  • Strengthen the knee’s support muscles, such as the quadriceps, hip flexors, and glutes
  • Shorten stride length while running
  • Land with a slightly bent knee, which can reduce the load

You can still run with PFPS, however, rest more frequently and avoid running downhill. You may want to add cross-training, such as cycling, to your routine.


Tiny cracks in bone are called stress fractures and are a huge concern for most runners. Stress fractures commonly occur in the foot and ankle, but can also happen in the two bones of the leg, the tibia (shin bone) and fibula. Stress fractures are often painful to the touch and you may feel an aching or burning sensation around the injury.

Why do stress fractures occur?

Stress fractures occur when a bone is unable to bear the weight placed on it. While bones become stronger and can adapt to new stress, they do so over a few months, which means that suddenly increasing the amount you run can result in a stress fracture. Stress fractures can also happen because of improper footwear or changing your running surface, such as going from an indoor running track to a sidewalk. If you suspect you have a stress fracture, it’s a good idea to take a break.

How do you prevent stress fractures?

Stress fractures are often preventable if an athlete follows certain guidelines.

  • Increase intensity and mileage gradually
  • Wear appropriate and well-fitting footwear
  • Maintain proper nutrition, including taking a daily calcium or vitamin D supplement for bone strength

Continuing to run might only make the injury worse, and could impact your long-term performance.


The Achilles tendon connects the calf to the heel and is essential to running, which makes it quite susceptible to injury. While there are many different tendon conditions, runners typically experience tendonitis. Achilles tendonitis is inflammation of the tendon; the root cause of the inflammation is damage to the tendon from continuous and strenuous physical activity. Symptoms generally appear gradually over time and may include pain, swelling, and tightness in the back of your heel or in the lower section of the calf.

Why does Achilles tendonitis occur?

The more strain that is placed on the Achilles tendon—such as from distance or uphill running—the more susceptible it is to injury. Weak or tight calf muscles and ankle instability may also attribute to an Achilles tendon injury. As with stress fractures, a sudden increase in activity or wearing improper and unsupportive footwear also increases the likelihood of injuring the Achilles.

How do you prevent Achilles tendonitis?

Injury to the Achilles tendon is often preventable by:

  • Easing into a new routine. If you are training for a race, gradually increase miles and don’t overdo it.
  • Participating in cross training. Since running is a high-impact activity, try swimming or cycling on your rest days.
  • Stretching your leg muscles. Before exercising, be sure to properly stretch the calf, ankle, and Achilles tendon.

While you may be able to run with Achilles tendonitis, it’s important to stop and take a few days off if it becomes painful.

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