Understanding Overuse Injuries: Signs You Shouldn’t Ignore

Are you training for a fall marathon, new to running, building up a base or just enjoying an easy run to clear the mind? Running can be so rewarding in so many ways. But as rewarding as it can be it can also create some unexpected risks, especially overuse injuries. 

Unlike sudden injuries caused by a fall or twist, overuse injuries develop gradually. That is what makes them tricky, they sneak up slowly, but left unaddressed, they can sideline your training for weeks (or longer). So how do you catch them early? We will discuss things to keep in mind on how to prevent common overuse injuries and what you should do.

So what are overuse injuries? Overuse injuries occur when repetitive stress is placed on muscles, joints, or bones without adequate time for rest and recovery. In runners, they are often caused by:

• Rapid increases in mileage or intensity

• Poor running mechanics

• Inadequate recovery time

• Muscle imbalances or weakness

• Worn-out footwear

  
  

The most common overuse injuries we see in runners are:

• Shin splints

• Runner’s knee (patellofemoral pain syndrome)

• Achilles tendinitis

• Stress fractures

• Plantar fasciitis

• IT band syndrome

It’s important to know the signs of overuse injuries and what to be aware of to prevent getting one yourself! Many runners are conditioned to "push through" discomfort, but that mentality can do more harm than good. These are warning signs that your body may be developing an overuse injury:

1. Pain That Comes Earlier in Your Run

If pain used to start after 5 miles and now it starts at mile 2, your body is telling you something. Worsening symptoms over time, rather than improving with warm-up, is something that should be a warning light!

2. Swelling or Tenderness in a Specific Area

Localized tenderness (e.g., around the shin or heel) is a classic early sign. Swelling, even if minor, usually indicates inflammation or tissue stress.

3. Persistent Aches at Rest

Soreness that lingers even after a rest day, or pain that wakes you up at night, is not just typical training fatigue. That is your body signaling that recovery is not happening properly or enough.

4. Changes in Running Form

Do you notice you are limping slightly? Favoring one leg? Shortening your stride? These are compensations your body makes when something is not functioning right, and they often lead to more problems if ignored.

5. Performance Decline

If you are feeling slower, more fatigued, or struggling with runs that used to feel easy, it may not be just mental. Overuse injuries can drain efficiency and affect performance.

What to do?

So what should you do if you are noticing these signs, take action early. Rest, a short break from running can prevent a long layoff later. Seek professional help. Go see a physical therapist who specializes in running medicine and that can assess your gait, strength, and mobility to identify the root cause, not just treat the symptoms. Modifying your training, dialing back intensity or mileage temporarily often allows tissue to recover. Focus on recovery and healing; foam rolling, stretching, sleep, nutrition and hydration matter just as much as your miles. Strength training and mobility can go a long way. Having weakness in your hips, tight calves, or poor core stability are often contributors. A physical therapist can help build a tailored plan.

You do not have to wait until you are injured to get help! One of the biggest things that you can do, that not many people realize, is preventative care. Take action SOONER rather than LATER. Most people wait until they are sidelined from their injury before they get the help that they need. Once you start to feel a slight discomfort that you are not able to fix on your own or notice a change in how you are running, seek help. Find a running medicine provider near you and get to the bottom of it before it becomes a bigger issue. 

The best way to manage overuse injuries is to prevent them in the first place. Take care of the little things to ensure that you are able to enjoy running or any kind of exercise. 

I hope this helps! Happy Running!

Dr. Noelle O’Hara, DPT