Top 5 Common Issues/Injuries Seen In Runners

Talking with and treating runners, I typically see similar injuries time after time.  Here are the top 5 common areas of pain that I find in runners that I see.

Pain on the bottom of the foot

I frequently speak with or see runners in my office with pain on the bottom of the foot.  The common issue most people know is Plantar Fasciitis, but there are a number of other things that can be causing that pain.

Plantar Fasciitis is when the plantar fascia is inflamed.  With true Plantar Fasciitis, you will have sharp pain immediately when standing up from sleeping or prolonged sitting and then after a couple steps calms down.  I do see this occasionally, but not as frequently as other issues.

Most times, the small muscles in the feet are over worked and tight, resulting in pain that mimics Plantar Fasciitis in regards to the pain location, which can make it difficult for you to discern where the pain is actually coming from.

This tightness in the muscles can be caused by a number of situations, including weakness in the hips and weakness in the feet, both of which can cause the arch to collapse with every step and thus irritating the tissues on the bottom of the foot.

Posterior Tibialis Tendonitis

The posterior tibialis muscle runs along the back of the bone in the lower leg, deep to your calf muscle, with the tendon running along the medial side of the ankle.

If you tend to overpronate when you run or just have poor control in your foot and ankle complex, this can cause increased tension on the tendon with every step, eventually resulting in irritation, inflammation, and pain in the posterior tibialis tendon.

The cause of the overpronation can come from a number of factors, the most common being decreased hip strength/stability or decreased foot strength.

Knee Pain

Because of the biomechanics of the knee joint, pain in the knee is a symptom of an issue above or below the joint, typically either in the hip or the foot/ankle.

Joint stiffness, muscle tightness, or weakness in in the hip, ankle, and foot can all contribute to the mechanics at the knee being faulty.  Over time, the dysfunctional mechanics results in pain.

The pain can be from a number of things.  The most common being stress on the tissues of the medial knee causing irritation and strain in the area and tightness in the quadriceps causing compression of the knee cap.

Long term, these mechanical changes cause wear and tear on the cartilage that line the joint surfaces, resulting in arthritis.

IT Band Syndrome

Pain along the lateral thigh is another common compliant.  The IT band is what always gets blamed for it, but in reality, it is not truly an IT band issue.

Pain along the lateral thigh is commonly due to restrictions developing between the IT band and the lateral quadriceps.  These restrictions do not allow the soft tissues to glide on each other as necessary, resulting in pain with movement.

Another common cause is tightness in the hip flexors, specifically the TFL, which is the muscle that is at the top of the IT band.  When the TFL becomes tight, more tension is placed on the IT band and lateral thigh.

Weakness in the hip or feet can also contribute to IT band pain.  When the hip or foot ares weak, the knee falls in easier when that leg is on the ground.  This inward rotation of your knee can cause increased tension on the IT band, which can result in pain.


To clear up misconceptions that I hear, sciatica is pain that starts in the gluteal region and goes down the back of the leg, sometimes all the way to the foot.

When this happens, a nerve is being pinched or irritated in the low back or gluteal region of your body.  The question comes down to “where and why.”  Similar to knee pain, sciatica is more of a symptom of something else not functioning properly.

Tightness in the piriformis is commonly blamed for sciatica, but then the question comes of “why is the piriformis tight?”

The hip and gluteal muscles become tight when they are weak and overworked.  This tightness can eventually cause the nerves in the area to pinch on the nerve that travels through the area.

The pelvis or sacrum not positioned or moving properly can also contribute to the symptoms.  If the pelvis and/or sacrum are not moving properly, the muscles cannot work properly.  Over time, this causes tightness in the muscles and pinching of the nerve.

Does this sound like a problem you are having?  Have more questions?  Email me at with any questions you may have about your pain issues.

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