Medically reviewed by Dr. Tanaya Sarnaik (PT) – Updated October 2026.
Running has grown quickly in India. City marathons fill up months ahead, running groups meet before sunrise in parks and along seafronts, and plenty of people go from a desk job to half-marathon training in a matter of weeks.
Along with that has come a rise in running injuries. Some post-run discomfort is normal and settles on its own. Some of it is the early stage of a problem that gets worse if you keep training through it. Telling the two apart is what most runners actually need help with.
ReLiva Physiotherapy & Rehab is the Official Physiotherapy & Rehab Partner of the Times Internet Half Marathon, supporting runners with injury prevention, rehabilitation and guidance to help them run safely.
This article covers the common running injuries, what causes them, the warning signs worth acting on, and how physiotherapy-led rehabilitation and a graded return to running work.
What Is a Running Injury?
A running-related injury is a musculoskeletal problem associated with running that causes pain or functional limitation and leads to a reduction or modification of training. Simply put, a running injury is any pain or tissue problem that interferes with your ability to run normally.
Most fall into two groups.
- Acute injuries happen at a single moment, rolling an ankle on an uneven footpath, or a sudden pull in the calf or hamstring.
- Overuse injuries develop gradually through repeated loading, although acute traumatic injuries such as ankle sprains and muscle strains also occur. The great majority of running injuries are the second kind, which is why they are easy to dismiss early on.
Running injuries are common. A systematic review covering more than 10,000 runners, cited in a 2024 Sports Medicine review, found injury incidence and prevalence both exceeding 40%. Most are lower-limb overuse problems.
What Are the Most Common Running Injuries?
Runner’s knee (Patellofemoral pain) Pain around or behind the kneecap, typically worse on stairs, squatting, downhill running or after long periods sitting. One of the most frequently reported running injuries.
Shin splints (Medial tibial stress syndrome): Pain along the inner edge of the shin bone, often after increasing distance (changes in training load) or switching to harder surfaces (abrupt increases in running exposure). Common in newer runners.
Plantar fasciitis and heel pain: Sharp under-heel pain, classically worst with the first steps in the morning or after sitting, easing as you move.
Achilles tendinopathy: Pain and stiffness in the Achilles tendon above the heel, usually worst at the start of a run and after rest. Often linked to a jump in hill work or speed sessions.
Ankle sprain. An acute injury, common on uneven roads, kerbs and unlit early-morning routes.
Calf and hamstring muscle injuries. Range from tightness that eases to a sudden sharp strain that stops the run.
IT band pain. Pain on the outer knee, often appearing at a predictable point in a run and settling with rest.
Bone stress injuries and stress fractures: Less common but more serious. Localised bone pain that worsens through a run, persists afterwards, or is tender to press on one specific spot needs assessment rather than pushing through.
For runners experiencing persistent foot pain, the cause may need more than a change in footwear or training routine. Read our guide to foot pain in Pune runners and how physiotherapy can help prevent long-term injury.
What Causes Running Injuries?
Rarely one thing. Usually, several factors combine.
Training load errors
These are the most common. Increasing weekly distance too quickly, adding speed and distance at the same time, or going from very little running to a structured plan after signing up for an event. The pattern of jumping into half-marathon training with a few weeks’ notice is a familiar one in Indian running groups.
Inadequate recovery
Running hard on consecutive days, poor sleep, or training through the heat of an Indian summer without adjusting pace and hydration all reduce the body’s ability to adapt to the load.
Strength and mobility deficits
Weakness in the hips, glutes, calves and feet means those structures tolerate less repetitive loading. Prospective studies have linked muscular weakness to higher rates of patellofemoral pain, shin splints and Achilles problems.
Surface changes
Moving from treadmill to road, from track to trail, or running on the camber at the edge of a road changes how load is distributed.
For urban Indian runners, the transition between treadmill running, roads, footpaths and uneven surfaces can also change the load your legs experience.
Footwear changes
The relevant issue is usually abrupt change rather than shoe type. Switching to a very different shoe, or racing in something you have barely trained in, alters loading suddenly. The evidence that choosing shoes by foot type prevents injury is weak, so comfort and gradual transition matter more than a shop’s arch assessment.
Running mechanics
How you run affects where load goes, though there is no single correct running style, and altering someone’s gait is a decision that needs assessment rather than a video from the internet.
Returning too soon
Coming back to full training before the tissue and its capacity have recovered is one of the more common reasons an injury becomes recurrent.
What Are the Warning Signs of a Running Injury?
Some of these are strong signals to stop and get assessed:
- Pain that persists beyond a run, or is still there the next morning
- Pain that gets worse as a run progress rather than easing after the first kilometre
- Pain that changes how you run: limping, shortening your stride, favouring one side
- Swelling around a joint or tendon
- Pain during everyday activity: stairs, walking, standing up after sitting
- Sharply localised pain you can point to with one finger, particularly over bone
- The same pain returning each time you increase distance or speed
- A drop in performance you cannot explain by fatigue or conditions
Symptoms that ease during a run are not automatically harmless, and symptoms that persist are not automatically evidence of serious injury. A more useful guide is whether symptoms are worsening, becoming more localised, affecting walking or running mechanics, interfering with daily activities, or failing to settle with appropriate load modification.
Should You Run Through Pain?
Not all discomfort means injury, but persistent or worsening pain should not be ignored.
General muscle soreness after a hard or unfamiliar session is normal, spread across a muscle group rather than one point, and typically eases within a couple of days. That does not require stopping.
Pain that is sharp, localised, present during everyday activity, worsening week on week, or changing your gait is different.Continuing to train through persistent or worsening pain can allow the problem to become more difficult to settle. The practical response is to modify, reduce distance and intensity, drop hills or speed work, rather than choosing between running as normal and stopping entirely.
What Should You Do for a Running Injury?
Temporarily reduce or stop the activity that clearly aggravates symptoms, depending on severity. Avoid testing it every morning to see whether it still hurts. Reintroduce activity gradually as symptoms and function allow. Significant pain, inability to bear weight, marked swelling, deformity or focal bone pain warrants clinical assessment.
For an acute injury, the older RICE approach has been revised. A more recent approach to acute soft-tissue injury management is PEACE and LOVE guidance in the British Journal of Sports Medicine, emphasises protecting the area briefly rather than resting for long periods, then reintroducing loading and movement early, because prolonged rest can compromise tissue quality. Ice and anti-inflammatories are no longer treated as automatic steps for every injury.
In practice: protect it for the first day or two, keep moving within comfortable limits, monitor how symptoms behave over the following week, and seek assessment if pain is not settling, is severe, or you cannot walk normally.
How Are Running Injuries Treated?
Physiotherapy-led management for running injuries generally follows a sequence.
Assessment first, identifying the affected tissue, and just as importantly, why it became overloaded. Training history matters as much as the physical examination.
Load modification next. Rather than stopping running entirely, this usually means adjusting distance, intensity, frequency and terrain to a level the tissue tolerates, while keeping fitness through cross-training.
Pain management where appropriate, as a support to rehabilitation rather than the treatment itself.
Mobility and strength work targeted at the deficits found, progressively loaded so the tissue builds capacity rather than simply being rested.
Movement and running retraining where the assessment indicates it would help.
Graded return to running, built around progressive increases with monitoring of symptoms, rather than a jump back to previous volume.
How Can Physiotherapy Help With Running Injuries?
A physiotherapist assesses training load and recent changes to it, running mechanics, joint range of motion, strength, muscle control, and footwear or training factors where relevant.
A 2024 systematic review and meta-analysis found no significant overall reduction in running-related injury risk or injury rate from exercise-based prevention programmes. An analysis of supervised programmes found a lower injury risk, although the authors noted important limitations and low quality in many included studies. Supervision and adherence may therefore be important.
That is worth knowing before downloading a generic strength routine. The programme itself matters less than whether it is appropriate for you and whether you actually do it consistently.
How Long Does a Running Injury Take to Heal?
There is no single timeline, and any specific figure should be treated with suspicion.
Recovery depends on the tissue involved, how severe the problem is, how long it has been present, your training load, and how consistently rehabilitation is followed. A mild muscle strain and a bone stress injury are on entirely different scales.
One point matters more than the timeline: pain disappearing is not the same as the tissue being ready. Pain often settles before capacity is restored, which is why so many runners reinjure themselves in the first weeks back. Return should be based on graded loading and how symptoms respond, not on the day the pain stopped.
When Should You See a Physiotherapist for a Running Injury?
- Pain lasting more than a week or two despite reduced running
- Pain that keeps coming back each time you build up again
- Any change in how you walk or run
- Swelling around a joint or tendon
- Inability to run normally, or to complete usual distances
- Pain affecting daily activities, not just running
- A history of repeated injuries in the same area
- An event coming up with symptoms that have not resolved
That last one is worth taking seriously. Assessment several weeks before a race gives room to modify training. Assessment in the final week usually leaves only the choice of running injured or not running.
Recurring pain or unable to increase your running distance? A sports physiotherapy assessment can help identify what is limiting your running and guide your return.
How Can You Prevent Running Injuries?
- Progress training load gradually, and avoid increasing distance and intensity in the same week
- Include strength training, particularly for hips, calves and feet
- Allow recovery — easy days genuinely easy, and adequate sleep
- Warm up before harder sessions rather than starting at pace
- Choose footwear for comfort and change shoes gradually rather than abruptly
- Vary your training with cross-training to build fitness without repetitive impact
- Adjust for conditions — Indian summer heat and humidity warrant slower paces and more attention to hydration
- Address previous injuries properly, since a past injury is among the stronger predictors of a future one
Tips to Help Prevent Running Injuries
Follow these running injury prevention tips to build training load gradually, recover adequately and reduce avoidable injury risks.
FAQs About Running Injuries
What are the most common running injuries?
Runner’s knee (patellofemoral pain), shin splints, plantar fasciitis, Achilles tendon problems, IT band pain, and calf or hamstring strains. Most are lower-limb overuse injuries that develop gradually rather than from a single incident.
How do I know if running pain is an injury?
Normal soreness is spread across a muscle group and settles within a day or two. Pain that is sharp, localised to one point, worsens during a run, persists afterwards, or changes how you run is more likely an injury.
Should I stop running if my knee or foot hurts?
Not necessarily. Some running-related conditions can be managed with modified, symptom-guided running, while others require temporary cessation of impact activity. Whether running is appropriate depends on the diagnosis, severity, symptoms and functional response to loading. Seek assessment if symptoms are severe or affecting daily activities.
Can a physiotherapist treat running injuries?
Yes. Physiotherapy assessment identifies the affected tissue and why it became overloaded, then guides load modification, progressive strengthening, running retraining where appropriate, and a graded return to running.
How long does it take to recover from a running injury?
It varies considerably with the tissue involved, severity and how long symptoms have been present. Recovery should be assessed by symptoms, function and the ability to tolerate loading.
Can I run while recovering from an injury?
Often yes, at a modified level. Many injuries respond better to reduced, controlled running than complete rest. What is appropriate depends on the diagnosis, severity, symptoms and functional response to loading, which is why this is worth deciding with a clinician rather than guessing.
How can I prevent running injuries?
Build training load gradually, include appropriate strength work for hips, calves and feet, allow proper recovery, change footwear and surfaces progressively. Previous injuries should be rehabilitated appropriately. . Evidence suggests supervised programmes work better than unsupervised ones, mainly through better adherence.
Book a Running Injury Assessment
If pain is limiting your running, keeps returning when you build up your distance, or has not settled with rest, an assessment can identify what is happening and why and set out how to get back to running without repeating the cycle.
Sports physiotherapy at ReLiva — book an assessment or find your nearest clinic.
This article has been reviewed by Dr. Tanaya Sarnaik (PT).
Dr. Tanaya Sarnaik is a sports and musculoskeletal physiotherapist at ReLiva Physiotherapy & Rehab, with over 11 years of clinical experience. Certified in Maitland manual therapy, kinesiology taping, and myofascial release, she is skilled in McKenzie therapy, neurodynamics, Mulligan’s, and gait training. Her multidisciplinary expertise spans sports injuries, orthopedic pain, women’s health, pregnancy care, and post‑operative recovery. Known for her compassionate approach, Dr. Tanaya has helped countless patients achieve lasting relief and fitness, including guiding expectant mothers through safe prenatal fitness programs.
