- Common running injuries include runner’s knee, IT band pain, shin splints, Achilles and other tendinitis, and stress-related pain.
- They are usually driven by training load and running mechanics — so rest alone tends to let them return.
- Physical therapy combines a loading program, running analysis, and strength work to fix the cause, not just the symptom.
- Our program is led in part by Chad Smurthwaite, DPT, OCS, a board-certified Orthopedic Clinical Specialist and former collegiate distance runner.
- No referral is needed in most cases. We see new patients within a few days at Cedar Mill, Tigard, and Milwaukie.
What are running injuries?
Running injuries are overwhelmingly overuse injuries — the cumulative result of training load outpacing what the body is prepared for. Runner’s knee, IT band syndrome, shin splints, Achilles and other tendinopathies, and stress-related bone pain all tend to build gradually rather than strike suddenly. Because they come from accumulated load and mechanics, simply resting and then returning to the same training usually brings them right back.
Two things drive most running injuries: how much load you ask the body to absorb (mileage, pace, hills, surface, and how quickly you ramp up) and how you distribute that load (your strength and running mechanics). Effective treatment has to address both. Calming the injured tissue is just the start — the lasting fix is building capacity and improving how you move.
At Creekside Physical Therapy, we treat the current injury and then go after the cause. That includes a running and movement analysis to find the mechanics behind the problem, a progressive loading program for the injured tissue, and strength work up the chain. The program is led in part by Chad Smurthwaite, DPT, OCS, a board-certified Orthopedic Clinical Specialist and former collegiate distance runner. You work one-on-one with the same therapist throughout.
Running sends roughly two to three times your body weight through each leg with every stride, thousands of times per run — so small inefficiencies in mechanics or small gaps in strength add up fast. Force travels from the foot and ankle up through the knee, hip, and trunk, and weakness or poor control anywhere in that chain shifts extra load onto a specific tissue. That is why running injuries that look local — the knee, the shin, the Achilles — so often trace back to load management and to strength and control farther up the chain.
What it feels like
Running injuries present in recognizable patterns. Common symptoms include:
- Pain around the kneecap with running, stairs, or sitting (runner’s knee)
- Pain on the outside of the knee that builds during a run (IT band syndrome)
- Aching along the shin with running (shin splints)
- Pain and stiffness in the Achilles, worst with the first steps of the day
- Heel pain with the first steps in the morning (plantar fasciitis)
- Pain that builds at a predictable point in a run and eases with rest
- Symptoms that return as soon as you resume your previous training
Why it develops
Running injuries are driven by load and mechanics, usually in combination:
- Too much, too soon — a rapid jump in mileage, pace, or hills
- Insufficient strength to handle training load
- Running mechanics that concentrate load on a specific tissue
- Worn-out shoes or an abrupt change in footwear
- Hard surfaces or a sudden change in terrain
- Inadequate recovery, sleep, or load management
- Returning to full training too soon after a previous injury
How we evaluate a running injury
Your first visit is a running-focused one-on-one evaluation. Your therapist takes a detailed history — your training load, recent changes, prior injuries, and goals — then assesses strength, mobility, and how you move, often including a running or gait analysis. We do not perform imaging; if your history or exam raises concern for a stress fracture or another problem that needs imaging, we coordinate with your physician before loaded progression. You leave the same day with a clear diagnosis and a written, phased return-to-running plan.
How physical therapy treats it
Running injuries respond well to physical therapy that addresses both the injured tissue and the cause. Your one-on-one plan typically includes:
- A running and movement analysis to identify the mechanics behind the injury
- A progressive loading program for the injured tissue, advanced as you tolerate
- Strength work up the chain — foot, calf, hip, and core — to better distribute load
- Manual therapy and IASTM to restore mobility and tissue quality
- Training-load and footwear guidance to fix the "too much, too soon" pattern
- Gait retraining where mechanics are driving the problem
- Blood flow restriction (BFR) training when heavier loading isn’t yet tolerated
- A phased return-to-running plan and a maintenance program so the injury doesn’t come back
When to seek care
- Running pain that has lasted more than a week or that returns every time you run
- Pain that builds at a predictable point in your runs and limits your training
- Sharp, point-tender pain over a bone — get evaluated to rule out a stress fracture
- Recurring injuries that keep interrupting your training
- You want to run more efficiently and prevent the next injury, not just fix this one
Running injuries are treated by Creekside’s physical therapists at all three clinics. Chad Smurthwaite, DPT, OCS, a board-certified Orthopedic Clinical Specialist and former collegiate distance runner, leads our running rehab and gait-analysis program. If a running injury involves a stress fracture or another problem that needs medical care, we coordinate with your physician and guide your return to running afterward.