As someone who's completed over ten marathons, an ultramarathon, and an Ironman triathlon, I know the frustration of a running injury derailing your training. And as a physical therapist, I know that most running injuries are preventable with the right approach.
A 2025 scoping review published in Translational Sports Medicine highlighted a surprising fact: runners have not benefited from the same reduction in injury rates seen in other sports. Despite advances in shoes, watches, and training plans, runners keep getting hurt at roughly the same rates.
The reason? Most injury prevention strategies are too generic. The research points to a better way.
Why One-Size-Fits-All Prevention Fails
The 2025 research found that runners benefit most from a multifactorial approach - one that considers their individual biomechanics, training history, muscle imbalances, and personal goals. A generic "stretch before you run" recommendation doesn't cut it.
Here's what matters according to the latest evidence:
Individual Risk Assessment
Every runner has a unique profile of strengths and weaknesses. A physical therapist can assess your:
- Hip and glute strength - weakness here is the single biggest predictor of knee, IT band, and shin injuries
- Ankle mobility - restricted dorsiflexion changes your entire running chain
- Single-leg stability - running is a series of single-leg hops; if you can't balance and control on one leg, you're at risk
- Running form - cadence, foot strike, and trunk position all affect injury risk
Training Load Management
The research consistently shows that rapid increases in training volume are the primary driver of running injuries. The 10% rule (don't increase weekly mileage by more than 10%) is a reasonable starting point, but individual tolerance varies significantly.
Strength Training
A growing body of evidence supports targeted strength training as the most effective injury prevention strategy for runners. This doesn't mean heavy powerlifting - it means building the specific muscular endurance and stability that running demands.
The Most Common Running Injuries (and How PT Helps)
Runner's Knee (Patellofemoral Pain)
The most common running injury, accounting for roughly 25% of all running-related complaints. Research points to hip weakness and poor patellar tracking as primary contributors. Treatment includes hip and quad strengthening, along with manual therapy to address tissue restrictions.
IT Band Syndrome
That sharp pain on the outside of your knee typically stems from weak glutes and tight hip flexors - not a "tight IT band" (you can't meaningfully stretch the IT band). Dry needling of the glute and TFL trigger points combined with hip strengthening is highly effective.
Plantar Fasciitis
That stabbing heel pain with your first steps in the morning responds well to a combination of calf strengthening, intrinsic foot muscle work, and dry needling of the calf and plantar foot muscles.
Achilles Tendinopathy
Heavy slow resistance training (eccentric loading) remains the gold standard for Achilles tendon issues. A physical therapist can design a progressive loading program that builds tendon resilience without aggravating symptoms.
Shin Splints (Medial Tibial Stress Syndrome)
Often caused by too much, too soon, combined with calf weakness and poor ankle mobility. Addressing these factors with targeted exercise prevents recurrence.
A Runner's Prehab Routine
Based on the current evidence, here are the essential exercises every runner should incorporate:
Hip Strength (3x/week)
- Single-leg bridges - 3 sets of 12 each side
- Side-lying hip abduction - 3 sets of 15 each side
- Single-leg deadlifts - 3 sets of 10 each side
Calf and Ankle (3x/week)
- Single-leg calf raises - 3 sets of 15 each side
- Ankle dorsiflexion mobilization - 2 minutes each side
Stability (2-3x/week)
- Single-leg balance - 3 sets of 30 seconds each side
- Step-downs - 3 sets of 10 each side
Why Mobile PT Makes Sense for Runners
Most running injuries don't happen in a gym - they happen on trails, roads, and sidewalks. At Rebound Motion, I can meet you at your home, your trailhead, or your track. I can watch you run in your actual environment, assess your form with your own shoes, and treat you right where you train.
Every session includes a comprehensive assessment plus treatment using whatever tools your body needs - manual therapy, dry needling, cupping, and a customized exercise program.
Don't Wait Until You're Injured
The best time to see a physical therapist isn't when you're already hurt - it's before the injury happens. A single assessment can identify the weak links in your chain and give you a targeted plan to address them.
Whether you're training for your first 5K or your next ultra, I'd love to help you stay on the road.
Call or text (435) 227-5233 to schedule your running assessment.