Why runners get hurt
Almost every running injury is a load problem: the tissue was asked to do more than it had adapted to. A jump in weekly miles, a new hill route, a change to speed work, or coming back too fast after a break. The tissue that gives way first depends on you, which is why one runner gets a sore Achilles and another gets pain at the front of the knee doing the same training. Fixing the injury means treating the tissue, but keeping it fixed means understanding the load that caused it.
We see the whole list: patellofemoral pain, often called runner’s knee, iliotibial band pain at the outside of the knee, shin splints and stress reactions, Achilles tendinopathy, plantar fasciitis, hip and gluteal tendon pain, and hamstring problems. Both of our physical therapists are runners, which helps when you would rather not be told to take up swimming.
Gait analysis
For most running injuries we film you on the treadmill, side and rear view, and go through it with you frame by frame. We look at cadence, where your foot lands relative to your body, how much the pelvis drops and the knee falls inward, and how you absorb each step. Small changes, such as a five percent rise in cadence, can cut the load on the knee measurably and are often part of the plan. We are not chasing a perfect running form. We are looking for the one or two things that are loading the injured tissue.
The plan
- Calm it down. Hands-on treatment, taping where it helps, and a temporary reduction in running volume to a level you can tolerate. Most runners keep running at some level from the first week.
- Build the tissue. Progressive strength work aimed at the injured tissue and the muscles that protect it, particularly the calf, quad and hip. This is the part that lasts, and it takes eight to twelve weeks to change a tendon.
- Rebuild the running. A written return-to-running progression that raises volume, then intensity, at a rate the tissue can adapt to. It includes what to do when a run feels worse, so a bad day does not become a setback.
We track it all in a simple weekly log, and we adjust the plan from what the log says rather than from how you feel on the day.
Stress fractures and when to stop
Some pain does need rest. Bone stress injuries, which start as shin or foot pain that builds through a run and eventually hurts walking, need a period off running and sometimes imaging. We screen for these at the first visit, refer for imaging when the signs are there, and manage the return afterwards so it does not happen twice.
Preventing the next one
Once you are back, the strength work continues at a maintenance level, two short sessions a week. We also review how you plan training, because the runners who come back to us are almost always the ones who raised their load too fast again. A ten percent rule is a starting point; a plan built around your history is better.
Cost and insurance
Running injuries are treated as physical therapy and covered by most plans, and we check your benefits before the first visit. The gait analysis is part of the assessment, not an extra charge.
