“Just Stop Running” Is Usually Incomplete Advice
I have heard some version of this from runners for years:
“It hurts when you run? Just stop running.”
There are absolutely times when I tell a runner they cannot run. A suspected bone stress injury is an obvious example. High-impact activity may need to stop while the athlete is appropriately evaluated, followed by progressive loading and a gradual return to running.¹
But for many running injuries, “just stop running” isn't a treatment plan.
As a physical therapist, I want to know why you got hurt, what your body can currently tolerate and how we can keep you as active as possible while addressing the problem.
Running Injuries Are Usually More Complicated Than One Thing
Most running injuries don't happen because of one single factor. Training load, tissue capacity, previous injury, biomechanics, recovery and other health and lifestyle factors can all contribute.²
In the running medicine course I teach, I emphasize looking beyond the painful body part. I want to understand the physical, emotional, mental, situational, biomechanical and training factors surrounding the runner.
Was there a big change in mileage? More speed work? Hills? Poor recovery? Is the runner returning from another injury? What else is happening in their life?
Simply removing running may calm symptoms, but it doesn't necessarily address the reason the runner ended up in my clinic.
Sometimes We Modify Running Instead of Eliminating It
One of the first questions I ask is:
What CAN this runner do?
Maybe we decrease mileage. Maybe we temporarily remove speed or hills. Maybe we use run/walk intervals. Or maybe running does need to stop temporarily, but cycling, swimming or another form of cross-training can maintain fitness while the injured tissue recovers.
Then we start building capacity.
Depending on the injury and the runner, treatment may include education, strength training, mobility, plyometrics, gait retraining, footwear changes and modification of training load.
The goal isn't simply to make the pain disappear.
We want to prepare your body to handle running again.
There Is a Difference Between Too Much Load and No Load
This is where injury management can get confusing.
If running contributed to an injury, it seems logical to think that completely removing running—and therefore removing load—would help the tissue heal faster.
But more rest isn't always better.
Many of the tissues we rehabilitate need mechanical loading to maintain and rebuild their capacity. Tendons are a great example. Progressive exercise-based loading is a central component of conservative tendinopathy management.³˒⁴
Think of load as a continuum:
Too much load → the tissue can't keep up.
Appropriate load → the tissue has an opportunity to adapt.
Too little load → the tissue can lose capacity.
This is why I don't automatically tell every runner with a tendon injury to stop running. Depending on the diagnosis, irritability of the tissue and the runner's symptoms, we may be able to modify the dose instead.
Maybe we reduce mileage. Maybe hills and speed disappear temporarily. Maybe we add recovery days. At the same time, we progressively load the tendon through strength exercises.
Tendon research has helped shift rehabilitation away from prolonged protection and toward appropriately dosed, progressive loading.³⁻⁵ Complete rest may temporarily reduce symptoms, but it doesn't necessarily prepare the muscle-tendon unit for the demands it will encounter when the runner starts running again.
We have to determine what the right load is at the right time.
Running Isn't Just Exercise
There is another piece of this that I think healthcare providers sometimes underestimate.
Running may be where someone sees their friends. It may be how they manage stress. They may have trained for months for a race. For a high school or collegiate runner, the sport may be a significant part of their social life and identity.
In my course, I teach clinicians to listen to the runner's story, understand what running represents to that individual and create goals with the athlete rather than simply telling them what they can't do.
If running truly needs to stop, I want the runner to understand why, what they can do instead and what we're looking for before they can start running again.
That's very different from:
“Don't run for six weeks and come back if it still hurts.”
Sometimes Stopping IS the Right Decision
None of this means runners should push through everything.
Bone stress injuries, significant acute injuries and certain medical conditions may require us to remove running. With suspected bone stress injury, for example, part of my role as a PT is recognizing the clinical picture, stopping inappropriate loading and getting the runner to the appropriate medical provider for diagnosis and management.¹
The difference is that stopping running is one part of the plan—not the entire plan.
As a PT at Precision Performance, my job is to figure out what you can safely do today while preparing your body for what you want it to do tomorrow.
Sometimes that means running less.
Sometimes it means temporarily not running.
Sometimes continuing to run—with the appropriate modifications—is exactly what we want.
Rehabilitationis about rebuilding your capacity to handle it.
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References
Warden SJ, Davis IS, Fredericson M. Management and prevention of bone stress injuries in long-distance runners. J Orthop Sports Phys Ther. 2014;44(10):749–765. Clinical concepts incorporated into the Precision Performance Running Medicine Course.
Bertelsen ML, Hulme A, Petersen J, et al. A framework for the etiology of running-related injuries. Scand J Med Sci Sports. 2017;27(11):1170–1180.
Silbernagel KG, Hanlon S, Sprague A. Current clinical concepts: conservative management of Achilles tendinopathy. J Athl Train. 2020;55(5):438–447.
Malliaras P, Barton CJ, Reeves ND, Langberg H. Achilles and patellar tendinopathy loading programmes: a systematic review comparing clinical outcomes and identifying potential mechanisms for effectiveness. Sports Med. 2013;43(4):267–286.
Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med. 2009;43(6):409–416.
Mihevc Edwards K. Precision Performance Running Medicine Course. 2025. Clinical course materials: running-injury assessment, load management and treatment framework.
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