How to Prevent Running Injuries – Calgary Physiotherapist’s Opinion

Introduction

Exercise science, equipment, technology, nutrition, rehabilitation, strength & conditioning, and sport psychology are all fascinating and seemingly unending depths of knowledge. Each have undoubtedly contributed to our optimization of running performance at some level. However, simply put: running is a never ending challenge against yourself with some clothes and a pair of shoes. It is in this beautiful simplicity that I found myself hooked. But sure… I’m also a bit of a nerd for this stuff.

As a Physiotherapist and runner myself, I know the aches, pains, frustration, and greyness of it all, and am here to provide some insight into basic principles of running injuries. 

After reading, if you still need help, you can book an assessment with me HERE.

 

Why Do Running Injuries Happen?

Barring slips, falls, etc., running injuries most often happen through a mismatch of your load and your capacity. Training load, ‘how much did you do?’ can be an individual training session, weeks,  or even months and beyond. Capacity, ‘what can my tissues tolerate?’, can be multifactorial and difficult to manage or predict. 

The forces of running are high. Some tissues will see 4+ times your body weight with each stride, while forces between your foot and the ground will take on multiple orders of body weight as well1,2. Load is the more easy variable to account for as we can modulate it through amount, intensity, and frequency of runs, as well as technique.

Capacity on the other hand, is a doozy. How much you sleep, stress, nutrition, technique, footwear, training load, and so on can all contribute to how much your body can handle. 

Any changes to the many factors affecting these two variables can lead to injury. These injuries can happen slowly too, just to complicate things more. Metaphorically speaking, think about when you tend to get sick. It’s generally after your busiest work weeks with poor sleep, travel, nutrition, and higher stress that we find ourselves getting sick. Similarly, it’s these times where our capacity is diminished where running injuries occur. Except in this case, the sick coworker you blame is an activity you enjoy that a small part of one tissue wasn’t quite ready for.

Preventing Running Injuries

Due to the many contributing variables, it is very difficult to predict or prevent injuries. However, here are some best practices in staving off injury:

Building slowly

Just because you’ve done it before, doesn’t mean it will be the same this time. Take the extra time to ease into training and add mileage carefully. Personally, I take the first 6 weeks or so of a training block with no speed work or running workouts. Everything is fairly low intensity as I re-build my base. This will depend on your experience and where you are starting from. 

Introduce changes gradually

Novelty is a very reliable way to injure yourself. Introduce changes slowly including new distances, intensities, footwear, exercises, etc. You are far better off taking a couple of weeks to add something than to be setback a couple of weeks because you didn’t.

Control what you can

Optimizing nutrition, sleep, training, and other lifestyle variables can all cumulatively make you more resistant to injury. Furthermore, we can’t control things like weather, road conditions, or the big hill you need to go up and down by your house. Different conditions will create different stresses. Control the factors that you have power over as best you can, but…

Allow others to help

Friends, running groups, coaches, trainers, medical professionals etc. all have their expertise and can serve as excellent resources. Hiring a coach for programming and a trainer to keep strong is a great strategy for accountability & can aid in injury prevention5. In the context of running injuries at Vital, we are here to help assess, treat, and provide as much knowledge and insight as we can to get you back to training and prevent recurrence.

Meet yourself where you’re at

Not every run will go well and not every training block will lead to a personal best. It is the accumulation of training that leads to success, and more importantly it is consistency that will build your tissue tolerance. Some evidence would suggest it is the extremes of both training years and volumes where runners get hurt3. Sometimes you need to let your foot off the gas due to life circumstances, and be honest with yourself and where you’re at. If running is a major outlet and aids with your mental health, losing it is not worth running the extra 2km in pain or ignoring the symptoms you already have.

My _____ Hurts, What Do I Do Now?

The often immensely frustrating aspect of running injuries is they tend to happen insidiously. Runners may even report little to no symptoms prior to sustaining an injury5. What this means is there frequently isn’t an obvious mechanism or onset. It may be what you did (or didn’t do) days or weeks prior that led to the pain you’re feeling now. However, some recent research points to more significance of single training sessions leading to injury than once thought3. Worsening or persistent pain is worth investigating, but not all pain represents an injury. As above, running forces are high, and it won’t always feel good. If pain is lasting days after a run, getting worse, or impeding daily life function, this is where seeking professional help kicks in.

Don’t panic, it’s most likely a well travelled path back to training. The Running Clinic (a Canadian organization for running education) breaks the most common running injuries into a continuum of 3 main variables: load, repetition, and range of motion. In this context, load can be a bit more specific to the actual tissues responsible for injury and not so much an all encompassing ‘how much am I doing?’. Repetition is self-explanatory, every time we go out to run we are doing thousands of the same thing repeatedly. Pretty good way to hurt yourself. Range of motion isn’t always as intuitive, but simply is looking at what ranges are required and whether they affect symptoms. This will depend on the type of running you do and even your technique. Analyzing/modifying these variables is step one in treating a running injury.

Classifying the nature of the problem and what tissues are involved is an important part of how we as rehab professionals will go about managing the injury. Like going out in the sun with a sunburn, ignoring it probably won’t help. But that doesn’t mean you need to stop running altogether, which my experience would suggest is most runners’ fear. That being said, running less doesn’t always resolve the problem either. I’m probably not going to tell you to stop running… but I will probably tell you something needs to be stronger. Running injuries can be recurrent and nagging once training load increases again if the root cause is not dealt with and it is not done carefully6,7. 

This is where the knowledge and experience of treating running injuries really takes over. Furthermore, at Vital Performance Care we are well equipped with many tools and toys to objectively measure & aid in speeding up the rehab process. These tools include force plates, dynamometers, needling, shockwave, blood flow restriction training, a pool, a track, etc. Many of us are runners too, and strive to help keep you moving.

References

1. Dorn TW, Schache AG, Pandy MG. Muscular strategy shift in human running: dependence of running speed on hip and ankle muscle performance. J Exp Biol. 2012 Jun 1;215(Pt 11):1944-56. doi: 10.1242/jeb.064527. Erratum in: J Exp Biol. 2012 Jul 1;215(Pt 13):2347. PMID: 22573774.
2. Nilsson J, Thorstensson A. Ground reaction forces at different speeds of human walking and running. Acta Physiol Scand. 1989 Jun;136(2):217-27. doi: 10.1111/j.1748-1716.1989.tb08655.x. PMID: 2782094.
3. Abrahamson J, Lindman I, Eriksen MB, Kibsgaard A, Nielsen RO. Using Self-Reported Training Characteristics to Better Understand Who Is More Likely to Sustain Running-Related Injuries Than Others: The Garmin-RUNSAFE Running Health Study. Scand J Med Sci Sports. 2025 Jan;35(1):e70004. doi: 10.1111/sms.70004. PMID: 39713859; PMCID: PMC11664494.
4. Schuster Brandt Frandsen J, Hulme A, Parner ET, et alHow much running is too much? Identifying high-risk running sessions in a 5200-person cohort studyBritish Journal of Sports Medicine 2025;59:1203-1210.
5. Brandt Frandsen, Jesper Schuster, Simonsen, Nina Sjoerup, Hulme, Adam, Jacobsen, Julie Sandell, and Nielsen, Rasmus Østergaard (2024). A paradigm shift in understanding overuse running-related injuries: findings from the Garmin-RUNSAFE Study Point to a Sudden Not Gradual Onset. JOSPT Open 3 (1) 1-8.
6. Saragiotto BT, Yamato TP, Hespanhol Junior LC, Rainbow MJ, Davis IS, Lopes AD. What are the main risk factors for running-related injuries? Sports Med. 2014 Aug;44(8):1153-63. doi: 10.1007/s40279-014-0194-6. PMID: 24809248.
7. Fokkema T, Varkevisser N, de Vos RJ, Bierma-Zeinstra SMA, van Middelkoop M. Factors Associated With Running-Related Injuries in Recreational Runners With a History of Running Injuries. Clin J Sport Med. 2023 Jan 1;33(1):61-66. doi: 10.1097/JSM.0000000000001076. Epub 2022 Nov 11. PMID: 36599361; PMCID: PMC10503541.