Staying Ahead of Injuries: What Runners Should Watch For
Katherine Caldwell, MD – Orthopedic Physician
Medical Director, Greater St. Louis Marathon
Training for a race is exciting. You build mileage, you feel stronger, and you start picturing yourself crossing that finish line. But one of the biggest setbacks we see in sports medicine is runners ignoring small warning signs until they become bigger injuries.
The good news is that many common running injuries are preventable. The key is recognizing them early and making smart adjustments.
Pay Attention to Pain That Changes Your Form
Soreness is normal. Sharp pain is not.
If you notice pain that makes you limp, change your stride, or avoid putting weight on one side, that is a red flag. Pain that worsens during a run instead of easing up after a warm-up should not be ignored. Running through it rarely fixes the issue. It usually makes it worse.
Watch for Gradual, Increasing Discomfort
Many overuse injuries build slowly. Common ones include:
- Shin pain that lingers after runs
- Knee pain, especially going down stairs
- Heel pain first thing in the morning
- Tightness along the outside of the hip or thigh
If discomfort is increasing week to week, your body is asking for a change.
Follow the 10 Percent Rule
One of the simplest ways to prevent injury is to increase mileage gradually. A good general guideline is not increasing your weekly mileage by more than about 10 percent at a time. Sudden jumps in distance, speed, or intensity are common triggers for stress injuries.
Prioritize Strength Training
Running is repetitive. Strength training builds the support system that keeps your joints stable. Focus on hips, glutes, core, and lower legs. Strong hips and glutes reduce stress on the knees. Strong calves and ankles support better mechanics and can help reduce shin and foot issues. Two short strength sessions per week can make a big difference.
Do Not Skip Recovery
Rest is part of training, not a break from it. Sleep, proper fueling, hydration, and at least one rest or cross-training day per week allow your body to repair and adapt. If you constantly feel fatigued, that increases injury risk.
Replace Worn-Out Shoes
Most running shoes last about 300 to 500 miles. If your shoes feel flat, uneven, or less supportive, it may be time for a new pair. Old shoes can subtly change your mechanics and increase stress on joints and soft tissues.
When to Get Checked Out
If pain lasts more than a week despite cutting back, or if it interferes with daily activities, it is worth getting evaluated. Early treatment often means a faster return to training.
The goal is not just getting to race day. It is getting there healthy. Training for the Greater St. Louis Marathon should feel challenging, but it should not feel damaging. Listen to your body, build gradually, and take small warning signs seriously. Doing that now helps ensure you are strong and confident when you step to the starting line in April.