Why Do I keep Having the Same Running Injury?

When you got injured did you treat your injury or just ignore it? Did you look up what you should do on social media, chat GPT, Claude or ask a friend what to do? Did you go to PT for a couple sessions then decide you were good enough then move on? Did you make it all the way through treatment until the pain was gone then stop?

When you get injured there is more to getting better than rest or even making then pain stop. Of course I no longer want you to be in pain - but as a physical therapist I also want to make sure you build up your tissue tolerance, improve your movement patterns and learn why it happened in the first place so it doesn't reoccur. Feeling better and being ready to load your body during a long run or a tough workout are two totally different things.

Your muscles, bones, ligaments and tendons have to have enough capacity to tolerate load during repetitive running. The average recreational runner takes between 1,400-1,800 steps per mile. Each time your foot hits the ground your body must accommodate for the ground reaction force of 2.5-5x your body weight.

Just resting or doing basic "rehab" exercises like bridges, clam shells and heel raises will not cut it. You have to load your body with progressive exercises, weight and plyometrics so that it can tolerate the forces of running. You may also need to slowly add things like sprinting or hills depending on your type of injury.

I always talk about the importance of loading your tendons. So think about an achilles or hamstring tendon injury.

Imagine you are running and your hamstring starts to bother you so you take a few days off, maybe modify your running or do a few nerve glides and it starts to feel better. The next time you run you go out on an easy run and it feels "okay", but then you challenge it by finishing your run on a hill. The next day you find the hamstring is a little worse and you are annoyed because you thought it was better. Why did you think that? Because the pain was gone? What did you do in that scenario to change how your hamstring handles the training load?

Absolutely nothing.

Running injuries are complicated.

My patients, the shear number of running injuries and research tells us how complicated running injuries are,

In the 2024 Garmin-RUNSAFE Running Health Study, 7,765 adult runners from 87 countries were followed; more than half self-reported a running-related injury after 1,000 km of running. The authors describe running-related injury as a prominent barrier to continued running and report that runners identify injury as the most common reason for quitting running.

In a study by Warne et. all 325 runners across four different countries found that 68.3% reported having an injury in the previous year. The study identified associations between injury and several factors - age, running surface, strength, training history, sleep, nutrition, running experience and every day life.

What Can I do Differently?

When you are retuning from an injury think about more than if you still have pain.

1. First focus on rebuilding strength tissue load capacity. That means do your rehab exercises and then progressively load the tissues with more weight or reps, by adding dynamic movements like plyometrics or depending on your injury short sprints.

   
   

2. You don't have to stop running with every injury, but you might have to modify it. Modify it but then when you start to feel better slowly add back different variable like speed in short bursts, hills, intensity or duration. Don't add it all back at once.

   
   

3. Pay attention to how your body responds and adjust. If you feel great after your run then next time you go out repeat the same workout or increase one factor. If you have pain during the workout but it decreases back to baseline in 24 hours you might be okay depending on the injury. If you are limping around you did to much. DOn't be afraid to adjust.

   
   

4. Lastly look at your life not just your running. You want your training to match your life. How is your work, school or life stress? Are you sleeping enough? Are you fueling enough?

I want my athletes get back to what they love doing, but I also want them to stay there. So next time you are injured focus on the goal ahead. Make sure you are eating enough, sleeping enough and rebuilding your tissue capacity. There are not shortcuts to getting stronger and building more resilience, if you stop rehab early, only do the basics and focus entirely on pain your injury may come back sooner rather than later.