Cardio: Running Injuries and How to Avoid Them

Feb 15, 2019

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There are very few bodybuilders or strength trainers who seriously enjoy doing cardio. It’s seen as a sideshow to the main event, lifting big lumps of iron. What’s even worse is suffering a debilitating, cardio-related injury that keeps you out of the weight room for a lengthy period.

running injuries

Pic: Ian L. Sitren @

However much you hate cardio, it’s an essential part of your training regime, not just for cutting fat and maintaining weight, but for your overall fitness. A fit and healthy cardiovascular system helps with endurance and recovery, as well as coping with carrying that extra body weight around daily.

Far too many people don’t take their cardio serious enough. They don’t give it the respect it deserves by warming up and down effectively, designing an effective program, or putting effort into finding the right equipment and clothing. This can lead to some really nasty persistent injuries  hindering or even stopping the business end of proceedings.

The most common form of cardio and the most prone to injury is running. Most gym goers run because it is an effective fat burner, can be performed almost anywhere, and in its basic form requires very little in the way of equipment. But running can be extremely harsh on the knees, as well as most other structures of the legs and back, due to the constant, repetitive impact involved.

Is Running Right For You?

Due to the harsh nature of running, it simply isn’t for everyone. For some people, the best way to avoid running injuries is to avoid running altogether.

  • If you’re carrying a lot of excess weight right now or have recently stacked on a heap of muscle, the impact may simply be too much for your unprepared joints to take. It’s not uncommon for impact forces equalling more than five times body weight to be experienced while running. Brisk walking, cycling, or swimming may be your best options.
  • If you have a history of back problems or conditions such as sciatica, you may want to consider another cardio option. Running can tighten the muscles of the lower back and hips, which may worsen your symptoms.
  • Those who have suffered serious fractures of the legs, especially joint traumas and injuries resulting in differing leg lengths should look into lower-impact forms of cardio.

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Common Injuries, Avoiding Them, and Treatment

Shin Splints



Shin splints can be extremely painful and difficult to cure. They are among the most common running injuries and are generally associated with overuse. A bruised and burning pain is felt along the length of the shins, and sometimes within the lower legs at the rear of the bone. Not to be confused with a similar problem, compartment syndrome, where the shin muscles become inflamed within their restrictive sheath, shin splints occur when the membrane surrounding the shin is damaged or inflamed.

Improper footwear can lead to shin splints, especially if your ankles turn inwards or outwards (pronation and supination) placing uneven stresses on the muscles above.

The only treatment is rest and ice, followed by light massage once any swelling has subsided. Recovery is generally slow due to the limited blood supply to the area.

Stress Fractures

Stress fractures from running most commonly occur in the feet and lower legs, especially the shin area. Like shin splints, stress fractures are generally associated with overuse, but the pain is far more localized.

Stress fractures can be largely avoided by running on soft surfaces in appropriate footwear, as well as by cutting down on mileage. Treatment is much the same as with shin splints, but if you suspect a stress fracture you should seek out medical advice and an X-ray.


A quick mention about blisters. They are not a serious injury, but can be painful and in certain climates should be treated more seriously due to the possibility of them turning septic. Blisters can be avoided by wearing good quality socks of the correct size, and well fitting footwear correctly fastened. Best treatment involves applying antiseptic cream and a blister patch. Depending on the location of your blister, it may need lancing. Severe blisters are best dealt with by a chiropodist.

Runner’s Knee

runner's knee

Pic: muscleandperformance

Patellofemoral pain syndrome, or runner’s knee, is a condition characterized by pain at the front of the knee where the kneecap rests on the thighbone. It is commonly caused by overuse, weak muscles (probably not an issue here) or muscular tightness, particularly in the hamstrings (bingo!).

It can be prevented by running on soft surfaces, and implementing a good stretching routine or yoga to keep the legs supple. Treatment involves rest and anti-inflammatories.

Pulled Muscles

Pulled muscles are not uncommon in runners, due to the repetitive nature of the activity. Common causes are overuse, dehydration, a lack of flexibility, and improper warm-up protocol. Always warm up! Gently stretch then walk before breaking into a slow jog and building up speed. If you feel any tightness building, stop to stretch and massage the area. Treatment for pulled muscles involves rest and ice, before light massage and easing back into training with appropriate strapping using tape or elastic wrap.

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Plantar Fasciitis

Down to the feet now. The arches of the feet are put under huge pressure from running, especially if you are heavy set. Plantar fasciitis involves damage to the structure at the bottom of the foot, beneath the arch, and can be extremely uncomfortable and slow to heal.

Proper footwear is a must to avoid this painful ailment, and cushioned insoles can be a great help. Treatment involves rest, ice, and strapping. This is a condition best treated by a physio or chiropodist.

Sprained Ankles

sprained ankle

Pic: youtube

Just ouch!

Sprained ankles are one of those things that can happen to the best and most diligent among us. Running on even surfaces in decent footwear helps prevent this nasty little injury, and treatment involves a visit to the hospital to check for any serious underlying damage. Be prepared to hobble for a while or even be on crutches.

Achilles Tendonitis

As with all tendonitis problems, this is more often than not caused by overuse. Again, proper footwear is essential, and not going crazy on steep hillclimbs lowers the risk. Keeping your calves supple helps alleviate pressure from the Achilles area.

Blood flow to the lower legs and foot isn’t great so recovery can be a lengthy process involving plenty of rest, ice, anti-inflammatories, and tape.

Piriformis Syndrome

The piriformis is a little muscle buried deep in your butt cheeks. It can become seriously tight and inflamed due to the repetitive nature of running. Piriformis syndrome is characterized by a dull ache or pain, as well as possible tingling and numbness in your backside. Stretching your glutes and hips well before and after running helps prevent it, and treatment involves taking it easy, anti-inflammatories, and a good sports massage. You can massage it yourself by lying on the ground with a tennis ball under your butt and moving the ball around with your butt and hip muscles.

General Tips to Avoid Injury

Know Your Limit

Assuming you’re only running to maintain a good level of cardiovascular fitness and shed a little weight, you don’t need to go crazy, putting in dozens of miles. Know your limit and never increase mileage by more than 10% per week.


  • Rest
  • Ice
  • Compression
  • Elevation

If you feel any niggles after a run, employ the tried and tested RICE method and monitor the area closely. Bringing us to our next tip.

Listen to Your Body

Listen to what your body tells you. If something doesn’t feel right, assess the area, rest it, and seek professional advice if necessary. Ignoring pain can lead to serious injury and layoffs.




Using a treadmill is a great way to avoid injury, as well as easing yourself back in after a layoff. Treadmills absorb much of the impact of running and don’t contain any hidden lumps or holes to send you tumbling. If you’re especially heavy, treadmills are probably a must to avoid impact injuries.


An excellent way to cut down the impact of running is to shorten your stride length. Don’t lift your feet too high and concentrate on placing your feet on the ground rather than stomping. Your knees will thank you!

Stretch, Stretch, Stretch

Stretching and warming up is essential for all forms of exercise. Never overstretch cold muscles, just go through a thorough but gentle routine. Once you have the blood flowing, you may give them a more intense version of stretching.

Proper Footwear

Take a look at the way different people walk and run. Some land with flat feet, some stamp with their heels, others run on their toes. Similarly, ankle biomechanics varies massively, as well as arch height, and a multitude of other factors. The best way to ensure you have the right footwear is to visit a specialist running store and have your gait analyzed by an expert. It is also recommended you replace your running shoes every 400-500 miles as the shock absorbers become worn and ineffective, especially if you’re on the heavy side.

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Jonathan Warren is a national level physique competitor and personal trainer with multiple certifications including NASM, NCCPT, and IKFF. His specializations include mobility training and corrective exercise as well as contest preparation.

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