Preventing Running Injuries: Part 2


With Preventing Running Injuries: Part 1 discussing the extrinsic factors that contribute to running injuries, in part 2 we are going to look in detail at all of the intrinsic risk factors associated with running.

Intrinsic Factors

These are factors that relate to the individual runner, and for the most part are within the runner’s control. If you are able to get all of these factors right, you have an excellent chance of running injury free and even achieving some personal bests!  These include:

  • Running technique / posture
  • History of Previous Injury
  • Musculoskeletal dysfunction / Imbalance
  • Number of years running

We will now look at each of these factors in depth and what key elements you need to consider to give you the best chance of remaining injury free. 

Running Technique / Posture

Correct running technique and posture play an integral role in helping to maximise efficiency with forward propulsion and to prevent overload and strain on the body with running. We have outlined in detail all of the optimal technique and postural elements associated with running gait, which can be found in our biomechanics of running report.  Essentailly, these elements include:

  1. Head straight and shoulders relaxed
  2. Elbows bent between 60-90 degrees, kept compact by your side, with arms straight forward and back (not across body)
  3. Pelvis tilted forward slightly, helping to facilitate a forward lean from the ankles.
  4. Foot strike occurring between rear and midfoot, with the ankle sitting directly below the knee when you land
  5. Approximately 25 degrees of knee flexion in stance phase for ideal balance between spring and stiffness/stability in leg.

Running is an activity that places load through a lot of joints and muscles in our body.  Adopting postures that are less than ideal is going to increase the strain placed on these structures, in turn increasing our risk of injury. There are many common postural and biomechanical issues that we see with running gait, and these along with their specific implications have been outlined in the biomechanics of running report.

Tip: It is often difficult to know yourself if you are adopting each of these optimal postures when running. Get someone to video your running and look to see if you are incorporating the general principles above. If not, try to add in one element at a time.  Be patient as it will take time for any change in technique to feel natural. If you are still unsure, further analysis with our detailed running assessment can provide valuable insight into any biomechanical issues and how best to address these. 

History of Previous Injury

While this may appear obvious to some, it is worthwhile to clarify the key reasons for this. If you have suffered an injury in the past, particularly to a lower limb muscle, joint, ligament or tendon, this can increase your risk of developing a running injury, as outlined in the research.

This is especially relevant if you have not had the injury treated or undertaken the appropriate rehabilitation. There may be residual muscle weakness, tension or shortening, joint stiffness, neural tension, proprioceptive loss (loss of joint position sense), scarring or motor control deficits.  These will often only come into play when the body is placed under increased load with running. Most of these dysfunctions may not be detected by the individual, as they are often not causing any symptoms, until increased load is placed through them (such as running). They will affect the way the body moves, which can include running posture and technique and also affect recovery from running.

Upper body injuries can also affect running, as the arms and shoulders move, and the torso rotates as you run. It is not uncommon to see hip pain that is being triggered by shoulder dysfunctions, and foot pain that can be linked to dysfunctions in the thoracic spine. This is because the body is largely interconnected, and one region will affect another at some level. This concept is called Regional Interdependence, and there is a growing body of research to support it.

Tip: Make sure you get all injuries checked out by a qualified health professional, and follow through with your rehabilitation as prescribed by the practitioner. If you are just starting out, or wanting to increase your volume or intensity, it may be worthwhile having a thorough musculoskeletal assessment by a trained health professional.  This will help to detect any imbalances/dysfunctions before they become a problem…as we know, prevention is better  cure!

Sprain hamstring or cramps – Running sports injury with female runner.

Musculoskeletal Dysfunction / Imbalance

While a history of previous injury can place you at increased risk of muscle imbalances and dysfunction, it is important to remember that you do not need to have had a past injury to have a musculoskeletal dysfunction.

All of us have some dysfunctions throughout our body, in varying degrees. These commonly include muscle tension/knots/guarding, joint stiffness, neural tension, reduced muscle flexibility and/or strength and decreased muscle control/activation. They usually result from prolonged postures, repetitive movements, poor postural habits and altered movement patterns.  It is a particualrly likely if there are a combination of these factors present. 

Common daily activities such as prolonged sitting or driving, bending, lifting and reaching all place some strain on the body and can lead to dysfunctions developing.  This is particularly likely if these activities are done with poor movement patterns and less than optimal postures.  This places increased strain on the body and muscle, joint and nerve dysfunctions are much more likely to develop.

These dysfunctions can build up over time and will affect how well your body moves and recovers from exercise. For example, a shoulder dysfunction will affect the rotation of the torso and shoulder movement during running, impeding free rotation, which can cause compensatory changes in the way the opposite hip and leg move. A problem may manifest as pain in the hip or knee, but the real source is the shoulder, and local treatment at the site of pain is unlikely to fix the problem.

In our clinical experience, these dysfunctions are the primary cause of most non-traumatic running injuries (those conditions that have developed slowly over time). Increases in volume, intensity or other extrinsic factors can trigger these issues, but these exist well before hand, lying dormant until the strain threshold in the body is exceeded.

Tip: see tip above!

Tired female runner sweating and breathing after running hard in countryside road.

Number of Years Running

Generally, the more experienced you are as a runner, the less likely are you to get injured. There are 2 main reasons for this:

1. Adaptation by the body to the forces experienced in running. The human body has an amazing ability to adapt to the conditions and loads placed on it, as long as it has time to adapt. Muscles and tendons become stronger with increased years of running, and joints also adapt to loads placed on them. Over time, the central nervous system (brain) also finds more efficient muscle recruitment pathways to perform the same task, thereby increasing the overall efficiency of the activity. This applies to any sport or motor skill, with running no exception. Eventually, less muscle effort and energy is required to perform the same task.

2. Increased body awareness. The more experience you have as a runner, the better able you are to read your body and watch for signs that it needs a rest. You become more attuned to those little niggles, and you have either learned ways to manage them, or are aware when your body needs a rest to recover. You are probably also more aware of the benefits of strengthening exercises to prevent injuries, good diet and stretching to aid in recovery, and have developed a stable routine for running.

Hopefully this has added further insight into the factors you need to consider to help stay injury free while you run and how best to address these. If you want any further help, please book a session with one of our physiotherapists who will be able to provide advice and recommendations specific to your circumstances. 

Happy running!


  1. Yeung EW, Yeung SS (2001). A systematic review of interventions to prevent lower limb soft tissue running injuries. British J Sports Med (35):383-389.
  2. Niemuth PE, Johnson RJ, Myers MJ, Thieman TJ (2005). Hip Muscle Weakness and Overuse Injuries in recreational Runners. Clinical J Sports Med(15) 1:14-21

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