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Running Injuries

As many of you begin to prepare for the season of running events, first being HBF Run For A Reason, I wish to talk about running injuries and what we, as physiotherapists, generally observe in our injured running clients. If you have been plagued or hindered by numerous injuries or pains with your running, this post is for you.

We all know that each individual is built differently and each has their own unique running style. Historically, physiotherapists have managed runner injuries by treating the painful body part and not consider the body mechanics as a whole. More recent research indicates that the static body structure is not the cause of ongoing running injuries but instead arises from the individual’s running biomechanics and poor management of training loads.

The predominant training mistakes that physiotherapists hear in clinic, are:

  • Returning to high load too soon
  • Overloading
  • Not cross- or strength training
Amy Zappavigna - Running Injuries

Assessment of the amateur runner’s technique can stray far from “perfect”. Analysis of our technique can not only identify the mechanical cause of injury but can also identify areas that we can optimise for greater body efficiency. Our analysis of running technique is mainly focused on these areas:

  • Pelvic / hip movement – stance hip drop or  hip internal rotation
  • Knee valgus / varus – knocking knees or bow-legged
  • Heel strike (ground contact) – contact too far forward of body
  • Cadence – steps per minute, target average 175 – 182spm

These areas and more contribute to the overall load occurring at each of the joints in the lower limb as we run, therefore imbalances at any point can result in injury.

Runners can present with all types of symptoms occurring at various sites, ranging from the lumbar spine all the way down to the fifth toe. The most commonly reported pain site in runners occurs at the knee, accounting for up to 50% of all running injuries followed by pain in the lower leg. Injuries that physiotherapists frequently diagnose include:

  • Patellofemoral pain
  • Iliotibial Band Syndrome
  • Achilles Tendinopathy
  • Tibial Stress (“shin splints”)

It is important to know that different injuries can be driven from predominantly the mechanics or the training load. For example, Achilles pain is more likely to arise with sudden increases in load and/or intensity, whereas iliotibial band pain will likely arise as result of running mechanics. Each injury will have elements of both mechanical and loading imbalance but with full assessment and analysis of your running we will pinpoint the causes of your pain. 


Amy Zappavigna - Running Injuries
Amy Zappavigna - Running Injuries

This process involves discussion of your current training regime, including recent changes you have made, then followed by video analysis of your running technique. Our role then as a physiotherapist is to help you either manage your training better, help find cues to alter running technique or a combination of both. Often changes to running technique will require some strengthening of muscles and lengthening of other muscles, so expect a few exercises to accompany your new training regime.

So, before you go smashing out your training for the 4km run or half marathon, consider your need to discuss your regime and review of running technique with your physiotherapist. Call today to book an appointment 9274 1482 or book online.


Amy Zappavigna

Amy Zappavigna

Pilates Physiotherapist

Amy has integrated her clinical skills and Pilates knowledge into treating and managing her client’s injuries. She enjoys getting people active and on the right path to achieving their fitness and functional goals.

In her spare time, Amy is training for her next triathlon or running around the field umpiring amateur football.

Special Interests

  • Treating Running Injuries
  • Rehabilitating Spinal Pain.