As new year resolutions kick in, we see more running injuries in clinic. Often these affect the knee, but the hip, ankle, and lower back can also be involved.

Structures in the knee that can develop running injuries

Meniscus Injury

The menisci are two C-shaped pieces of cartilage within the knee joint. Their job is to improve the relationship between the bones that make up the hinge joint. They also provide some shock absorption. Torn menisci can be painful and unpredictable.

Weightbearing while twisting through the knee is the textbook way to injure a meniscus. You might not expect this kind of movement while running, but it might happen when changing direction or avoiding an obstacle. A tear might immediately be felt as a sharp pain, followed by swelling around the knee.

A tear might go along the length of a meniscus, or come in from the side. Longitudinal tears may form a “bucket handle” where the inner part becomes displaced. This can lead to that unpredictable pain as the flap moves around.

Running Injuries and The ITB

The Iliotibial band (ITB) is often blamed unfairly for problems among runners. This often leads to painful foam-rolling in an attempt to loosen the band. However, the ITB is not a muscle- it’s more of a ligament, and ligaments are meant to be tight for support.


The ITB supports the knee, so excessive tightness through the ITB may be in response to a knee problem. It also acts over the hip joint, so problems there can have an effect too. Likewise, this may manifest as a hip problem if the tissues flick over bone. Achiness and feeling or hearing a “pop” from the hip can result.

Tension in the ITB is controlled by a muscle at the top of the band that blends into it: the TFL. If the ITB does need loosening, rolling through the muscle will be more effective than the band itself. The real question is why the TFL tightened in the first place. Let your osteopath know if you have any hip or knee problems alongside this discomfort.

The Quadriceps and knee pain

The quadriceps are the strong muscle group on the front of the thigh, responsible for straightening the knee and bending the hip. If they become tight, they pull on the patella (knee cap). This puts a strain through the joint between the knee cap and the rest of the knee. Excess pressure through the back of the knee cap affects the cartilage, and can lead to osteoarthritis over time.

Management for tight quads might involve strengthening of the hamstrings and glutes, or relaxing the quads themselves. Foam rolling can be useful here, as the large muscle group can take the pressure and respond quickly. Your osteopath can help identify more subtle factors in the development of this muscle imbalance.

Osteopathy for Running Injuries

It is worth noting that although injuries do develop in runners, overall running does make the body more resilient. Long distance runners have thicker intervertebral discs than non-exercisers. Exercise improves bone density, and is recognised as an important management strategy for osteoporosis. Our aim is to help you manage and prevent your injuries, and get back to exercise.

Treatment for minor running injuries may involve local work to the injury to reduce inflammation and improve circulation. Longer term, the goal is to prevent the injury returning. We aim to do this by looking at how your body functions as a whole: finding any areas that are overworking or underperforming. This holistic approach allows us to identify other pre-symptomatic areas and nip future problems in the bud too.

If you’re suffering from running injuries, or you’ve just started running and want a check-up, book in with us now.