The beginner’s guide to running

But as a beginner, it can be easy to overdo things or to run with incorrect technique. This can cause running injuries that may impede your progress and motivation, and may discourage you from running again.

In this article, Ella Moffat, Senior Physiotherapist at King Edward VII’s Hospital gives some top tips to avoid injuries when you start out running or jogging, and explains what treatments are available should you injure yourself.

The most common running injuries

When we begin any new exercise, it’s normal to feel some aches and pains. Our muscles may not be used to working in this new way, meaning that they’ll ache for a few days as they repair.

But an injury that causes intense or long-term pain can scupper your fitness plans and goals. Unsurprisingly, the vast majority of  running injuries affect the legs and lower body. Some common running injuries include:

Runner’s knee

Runner’s knee (also known as patellofemoral pain syndrome) causes pain under the kneecap, as the cartilage that cushions the underneath of the kneecap and the top of the thigh bone rubs together. It can feel worse when running uphill, moving from sitting to standing or walking down a set of stairs.

What does it feel like?

As mentioned, the pain is situated in the kneecap – however, it can manifest either as a dull pain or a sharp, sudden pain.

What causes it?

Causes include:

• Your knee cap maltracking (when the knee cap does not sit in the middle of its groove)
• Muscle imbalance, including weakness in thigh and bottom muscles
• Worn down cartilage under the kneecap
• Issues with your feet (including hypermobile feet, fallen arches or overpronation (more on this below)

How to avoid it

The best way to avoid this type of injury is to perform stretches and strength exercises prior to your run.

Shin splints

Perhaps the most common beginners’ running injury, shin splints causes pain on the inner or outer side of the shinbone.

What do they feel like?

If you get shin splints, you will feel soreness or a dull pain along your shinbone. You may see some swelling in your lower leg as well. The pain might get worse during exercise and you could feel numbness in your feet.

What causes them?

Repetitive strain on the muscle that attaches the inner side of the shin bone to the inner side of the ankle bone when running.

Shin splints can be caused by:

•       Wearing poorly fitted shoes
•       Extended period of running on hard surfaces or downhill
•       Poor running technique
•       Returning to or starting to do too much too soon
•        Overpronation (similarly to runners knee)
•       Muscle weakness or imbalance
•       Over training- not allowing yourself enough time to rest

How to avoid them

It’s important you find the right pair of running trainers that provide you with adequate support. You may need to consult a running expert and take a gait analysis (more on this below). Similarly to runner’s knee, it’s vital you stretch properly when warming up for a run and cooling down afterwards.

Plantar fasciitis

Plantar fasciitis is an inflammation of the tissue that runs along the bottom of the foot supporting the arch.

What does it feel like?

Plantar fasciitis can cause a short, sharp stabbing pain on the underneath of the foot close to the heel. It can feel worse in the morning, as you place your feet on the floor when getting out of bed. It is often described as similar to standing on a golf ball and can be very uncomfortable.

What causes it?

It’s caused when the plantar fascia (a thick band of tissue that runs along the bottom of the foot supporting the arch) becomes inflamed through overstretching.

There isn’t always a clear cause but some common causes include:

•       Natural foot position
•       Unsupportive or poorly cushioned shoes
•       Over training
•       Tightness in the calf muscles
•       Overstretching the sole of your feet when running

How to avoid it

Similarly to the other injuries above, performing the right, gentle stretches such as calf and forefoot stretches  before and after runs really helps. You should also avoid running on hard surfaces where you can and ensure you wear well-fitting running shoes.

Examples of static stretches

Achilles tendonitis 

The Achilles tendon is located in the back of the heel and can become inflamed through regular running.

What does it feel like?

At first, it may feel like a small ache above your heel or in the back of your leg after running.

The pain of Achilles tendonitis is usually worse when running, walking or standing on your tiptoes.

Especially in the morning, you may also feel stiffness or tenderness above your heel or in the back of your leg.

What causes it?

If you’ve recently increased the intensity of your runs, you are more liable to get Achilles tendonitis. Other causes include:

•       Running in old, worn-out shoes
•       Fallen arches in your feet
•       Going for a run without stretching first
•       Calf muscle tightness and/or weakness 

How to avoid it

In addition to stretching, it’s crucial you don’t push yourself too much on your runs – start slowly and build up the intensity gradually. If you strengthen your calf muscles and undertake other lower-impact forms of exercise, such as swimming or cycling, this can also help.

If the pain persists, you may have severe Achilles tendonitis or even a torn Achilles tendon. In this instance, it’s best you consult a physio. 

What can you do to prevent running injuries?

As we’ve touched on, one of the best ways to  prevent a running injury is to wear the right footwear. There are a number of factors that determine the type of shoe you should choose, including the height of your arch, the width of your foot, and your natural running style. If you are serious about running and choosing the right footwear, you should consider a ‘gait analysis’.

A gait analysis involves you running briefly on a treadmill with a camera attached to film your feet and lower legs as you run. They’re often offered for free in specialist running apparel shops and some regular sportswear shops.

A trained professional will then look at the footage and, using some software, will tell you which running shoes are best suited to you. Running shoes vary in terms of cushioning and support, and the right pair for you will be determined by the way your foot strikes the ground when you run.

Some runners have an ‘overpronation’ which means the ankle rolls inwards when the foot hits the ground, whilst others have an ‘underpronation’, where the ankle rolls outwards. Some runners have neutral pronation, where ankles roll slightly inwards with each step, with a natural side to side movement of the foot.

Having an overpronation or an underpronation doesn’t mean that your running ability will be impaired, and you may not even realise you have one. But it is important to wear the right running shoes for your feet if you intend to run regularly. You can try to determine your own pronation using this wet foot test.

Here are some more tips to help prevent the risk of injury when you start running:

•       Always warm up properly, with 10 minutes of stretching exercises before you run
•       When first starting, run for short intervals, interspersed with walking – the ‘Couch to 5k’ app will encourage this.
•       Don’t run too fast. Keep to a slow and sustained pace 
•       Try not to run every day. It is important to give your muscles time to rest and recover before running again. As you become more experienced, you can begin to run on consecutive days, but always remember to listen to your body.
•       Try to relax when you run, with your shoulders down.
•       Aim to mix up your running surfaces too – run on a mix of roads and grassy surfaces where possible to help cushion the joints.
•       Don’t run on a full stomach – leave at least two hours between finishing a meal and going for a run to avoid getting a stitch.

 Treatment for running injuries

Using an ice pack over the affected area (for up to 20 minutes) and taking non-steroidal anti-inflammatory painkillers such as ibuprofen can help to ease the pain and inflammation of a running injury. You should also rest and avoid running whilst your pain is at its worst.

Some long lasting, niggling running injuries can be caused by a weak point in the body, and there are certain exercises you can perform that will help target these weak points. Working with a sports therapist or physiotherapist will help you understand which exercises are best for you, your running style and any injuries you may have.

As a general rule, performing weight bearing and cross training exercises will help to strengthen the whole body, which will minimise any pressure on your legs, knees or hips.

If you’re still in any doubt as to how best to avoid running injuries, the one golden rule that we can’t stress enough is: stretch before and after your run! Before running it is recommended that you do dynamic stretches to warm up the muscles and joints, followed by static stretches after you run to try and reduce muscle stiffness and maintain muscle length.

Examples of dynamic stretches

Many runners find that regular yoga sessions (there are apps you can download that teach the basics and beyond) will also help with stretching and keeping supple. The more supple your muscles, the less risk you’ll face of injury.

Also of importance is making sure your running shoes are fit for purpose. It helps a lot if you’re aware of any potential issues in your feet and other parts of your body pre-run as well.

Pace yourself and don’t push yourself too hard as you start running – trying to do too much, too soon is the sure-fire way to sustain injuries. Follow this guidance and you’ll be set up to make the most of your runs and enjoy them in as pain-free a way as possible.

More information

•   If you’ve experienced a running injury that’s causing you pain and preventing you from running, even after rest, then speak to your GP about treatment. (Don’t have a GP?)
•   Our Sports and Exercise Medicine Department is fully equipped and staffed by professionals to help you get back to fitness.