UNC Health Care
graphic of runner with knee pain

Cross the Finish Line: How to Prevent Common Running Injuries

We know exercise is good for you, and running in particular has several health benefits. Studies have shown that running can help prevent chronic illnesses such as obesity, type 2 diabetes, heart disease, high blood pressure, stroke and some cancers. It’s good for your mental health, too: Running puts us in a better mood and can even help with anxiety and depression.

The only downside: Running injuries are common. Runner’s knee (all-over knee pain), stress fractures, shin splints, tendinitis and plantar fasciitis (inflammation of the tissue that connects the heel to toes) can happen to anyone, regardless of pace or run length. And whether you’re training for your first 5K or you’re an ultramarathoner, being sidelined can be physically and emotionally defeating.

The best way to avoid injury is to prevent it. UNC Medical Center sports medicine specialist Lauren Porras, MD, suggests these seven tips to prevent running injuries.

1. Warm up and cool down.

All runs should start with a warmup and end with a cool-down. Warming up with a brisk walk or light jog for 10 to 15 minutes helps get your blood flowing and ensures your muscles get the oxygen they need before your workout. It also raises your body temperature, which helps with flexibility. Warm body temperature helps your muscles contract, while colder temperature causes them to stiffen.

Ending your workout with a 10-minute cool-down, such as slowing to a walk or jog, will help your breathing and heart rate return to normal gradually. Stopping suddenly can make you feel lightheaded.

2. Wear the right shoes.

Running shoes should be replaced about every 500 miles, Dr. Porras says.

“If you’re doing a lot of running up and down hills or you tend to do heavy planting of your feet while you run, you may need to replace your shoes every 300 miles,” she says.

And make sure the shoes fit properly and feel comfortable when you run. Visit a running store to be fitted for appropriate supportive footwear.

3. Watch your terrain.

Dr. Porras says flat, smooth surfaces tend to be more forgiving on your joints, which is why she suggests them for beginners. Avoiding roads that have a lot of hills or unstable surfaces—trails with roots, rocks or potholes in the way, for example—can minimize injuries and accidents.

“I recommend running on a treadmill, grass, at a local park or a track when you first start,” Dr. Porras says.

4. Cross-train.

Give your running muscles a break with cross-training. This allows you to spend time building other muscles in your body, making it stronger overall. By balancing your weaker muscles with your stronger ones, you’ll also help reduce your chance of injury.

Dr. Porras recommends swimming and biking as good cross-training options for runners. “These don’t have as much of an impact on the legs and are also a great option if you are trying to heal from a stress fracture,” she says.

She also recommends resistance training on days when you are not running, to build up muscle and strengthen bones.

5. Pay attention to your diet.

Because you use more energy when you run, you need to increase the calories you are eating. But remember, the quality of food is just as important as the quantity.

“A deficiency in calories can predispose you to a bone injury,” Dr. Porras says. “It’s really important you watch what you’re eating and make sure you’re eating a nutritious diet with all the food groups, including dairy, as calcium and vitamin D can help prevent fractures.”

6. Get help.

Dr. Porras says if you are doing all of these things and are still struggling with an injury, seek assistance from a medical professional or physical therapist.

“I find getting a physical therapist involved can be very helpful because they can help evaluate the mechanics of the runner and work on any deficits that they have,” Dr. Porras says. “Otherwise, there are different braces that I sometimes prescribe, which can be helpful, depending on the injury.”

7. Don’t quit.

If you enjoy running, don’t quit, even if you get injured.

Dr. Porras says, “With modifications and changes in training—and maybe some physical therapy—you can really have a prolonged and successful running career.”


If you have a running injury, talk to your doctor. If you need a doctor, find one near you.