Why Half of All Runners Get Hurt Every Year (And How to Make Sure You’re Not One of Them)

Spring is here. The weather is warming up, the trails are calling, and you’re lacing up those shoes after a long winter of telling yourself you’d “start running again soon.” We’ve all been there. Whether you’re brand new to running, returning after a break, or gearing up for a race this season, there’s one thing the research is very clear about: running is one of the best things you can do for your health, and also one of the most reliable ways to hurt yourself if you’re not prepared.

Here’s the number that usually gets people’s attention: studies show that more than 50% of recreational runners sustain a musculoskeletal injury each year. That’s not elite marathoners or ultra-runners pushing the limits of human endurance. That’s everyday people going for their morning jog, training for their first 5K, or just trying to stay active.

The good news? Most of those injuries are predictable, and a significant number of them are preventable. You just need to know what you’re actually dealing with.

Let’s break it down.

The Injuries You’ll Likely Meet This Season

Running is a repetitive sport. Every single stride, your body absorbs a force roughly two to three times your body weight through your joints, muscles, and tendons. Over miles and miles, that adds up fast. The most common injuries runners face are what we call overuse injuries — damage that builds quietly over time, not from one dramatic moment, but from accumulated stress on tissues that weren’t quite ready for the load being placed on them.

The usual suspects:

• Patella femoral pain syndrome (runner’s knee)

• IT band syndrome (that nagging outer knee pain)

• Plantar fasciitis (the heel pain that greets you first thing in the morning like an unwanted alarm clock)

• Medial tibial stress syndrome (shin splints)

• Achilles tendinopathy

  
  

These are some of the injuries that sideline runners every spring, and they all share a common theme: they don’t just happen because you ran. They happen because your body wasn’t moving as well as it needed to in order to handle the demands of running. Your gait (form) is another contributor. Overpronation/supination leads to adverse effect up the kinetic chain.

The Real Culprit Is Usually Not Where the Pain Is

This is probably the most important thing you’ll read today, so let’s sit with it for a moment.

When runners come in with knee pain, the first instinct is to focus on the knee. When there’s heel pain, the conversation immediately jumps to the foot. But in sports medicine and chiropractic care, we’re trained to look upstream. Pain is often just the messenger. The actual problem is usually coming from somewhere else entirely.

Here’s what the science says: a 2024 randomized controlled trial published in the British Journal of Sports Medicine studied 325 novice recreational runners over 24 weeks and divided them into three groups.

• One group did hip and core exercises before their runs.

• One group did ankle and foot exercises.

• The third group just did static stretching.

The results were striking:

The hip and core group had 39% lower average weekly prevalence of overuse injuries, and 52% lower prevalence of substantial overuse injuries compared to the stretching group.

The ankle and foot group? No meaningful benefit, and they actually had a higher rate of acute injuries.

What this tells us is that your hips and your core are doing far more work to protect your knees, shins, and feet than most people realize. When the glutes, hip abductors, and deep core muscles are weak or poorly coordinated, the entire chain below them is forced to compensate. Your knee starts caving in slightly with every step. Your shin absorbs more rotational stress. Your plantar fascia is fighting battles it was never designed to fight. The pain shows up at the weakest link, but the fault line often runs through your hips.

This is a big deal for IT band syndrome specifically. The IT band is the most common cause of lateral knee pain in runners, responsible for roughly 10 to 16% of all running-related injuries. Biomechanical research consistently shows that when the lateral gluteal muscles don’t fire properly during the support phase of running, the pelvis loses stability, the femur drops inward, and the IT band gets repeatedly compressed and irritated. The pain is at the knee. The problem started at the hip.

The Gait Pattern Nobody Talks About

One of the sneaky biomechanical faults we see all the time in clinical practice is what’s called a crossover gait, sometimes described as a “scissoring pattern.” This happens when a runner’s feet land too close to — or crossing over; the midline of their body, rather than landing in two parallel lanes roughly hip-width apart.

It looks subtle. Most runners have no idea they do it. But the downstream effects are significant. A narrow base of support during running has been linked to tibial stress fractures, IT band syndrome, and kinematic patterns associated with multiple types of running injury, including excessive hip adduction and overpronation.

When your foot strikes too close to center with each step, your entire kinetic chain is thrown off: the hip drops, the knee caves, and the forces that should be distributed across a wide stable base are instead funneling through a compromised one.

The fix isn’t complicated, but it does require awareness and, ideally, a professional eye to catch. Slightly widening your foot strike, improving hip abductor strength, and increasing your step rate (cadence) slightly are all strategies that research supports for correcting this pattern.

What Actually Works: Evidence-Based Recommendations

So what should you actually do to run this season without ending up on the injured list? Here’s what the evidence supports.

Build your hip and core foundation before you increase your mileage.

Not after you start feeling pain. Before. Think single-leg deadlifts, glute bridges, lateral band walks, side planks, and single-leg squats. These don’t need to be complicated or time-consuming. Ten to fifteen minutes of targeted hip and core work three to four times per week, done consistently, can meaningfully reduce your injury risk. The key word there is consistently.

Respect the 10% rule, and then go slower than that.

The traditional guideline is not to increase your weekly mileage by more than 10% per week. For newer runners, being even more conservative than that is wise. Your cardiovascular system adapts to running stress much faster than your tendons, ligaments, and bones. You might feel fine aerobically and be silently accumulating load in your tissues that hasn’t yet become symptomatic.

Don’t skip the strength work.

Stretching before your run is not a proven injury prevention strategy, the research on static stretching for runners is consistently underwhelming. Strength training, on the other hand, has a strong evidence base for reducing overuse injury risk. Calf raises, hip strengthening, single-leg work, and basic core stability exercises are your best pre-season investment.

Warm up dynamically, not statically.

Save long static holds for after your run. Before you run, do leg swings, hip circles, glute activation work, and some light plyometrics to wake your nervous system up and get your movement patterns firing properly before you ask them to carry you for several kilometers.

Address plantar fasciitis and heel pain early.

The 2023 Clinical Practice Guidelines from the Academy of Orthopaedic Physical Therapy are unambiguous: manual therapy directed at the joints and soft tissue structures of the lower extremity, combined with therapeutic exercise and neuromuscular re-education, is the recommended first-line approach for plantar fasciitis. This is exactly what conservative chiropractic and sports medicine care provides. The people who wait six months before seeking care are usually the ones who have a much longer recovery ahead of them.

Get a movement assessment before the season starts.

Not because something hurts, but because knowing how you move is information you can actually use. At Active Living Chiropractic in Hillsboro and Beaverton trained clinician can identify asymmetries, weaknesses, and biomechanical patterns — like that crossover gait — before they become the injury that sidelines your summer plans.

Take care of your body

If you’ve been dealing with nagging running-related pain, or if you want to start this season on the right foot (literally), our team at Active Living Chiropractic in Beaverton and Hillsboro specializes in evidence-based sports medicine and chiropractic care for runners and active individuals. We do thorough movement assessments, build personalized prehab and rehab programs, and treat the cause — not just the symptom.

Spring is a great time to run. Let’s make sure you’re still running by summer.

Reference:

Leppänen et al. (2024), British Journal of Sports Medicine Run RCT; Wu et al. (2024),

Sports Medicine Exercise Prevention Meta-Analysis; Riazati et al. (2022),

Frontiers in Sports and Active Living Neuromuscular Fatigue; Sanchez-Alvarado et al. (2024),

Frontiers in Sports and Active Living IT Band Syndrome Review; Koc et al. (2023),

Journal of Orthopaedic & Sports Physical Therapy Plantar Fasciitis CPG.