17 Common Running injuries (Prevention & Treatment)

The running injuries that stop most runners: runner’s knee, plantar fasciitis, IT band syndrome, shin and foot stress fractures and ankle sprains.

Mileage jumps also bring hamstring, calf, quad and groin strains, hip bursitis, runner’s toe and blisters, and every entry explains the cause and how runners reduce the risk.

Injury Rates and Numbers

The figures below come from injury surveillance data and peer reviewed studies. Each row names the population it was measured in, because rates from elite athletes and from recreational players are not comparable.

Finding	Measured in	Source
A systematic review found running injury incidence across included studies ranged from 20.6% to 79.3%, reflecting wide variation in definitions and populations.	adult runners (multiple study populations pooled), published 2015	van der Worp MP et al., “Injuries in Runners; A Systematic Review on Risk Factors and Sex Differences,” PLOS ONE
A systematic review found a mean incidence of 37% for running related injuries to the lower extremity.	adult runners across pooled studies, published 2021	Dempster J, Dutheil F, Ugbolue UC, “The Prevalence of Lower Extremity Injuries in Running and Associated Risk Factors: A Systematic Review,” Physical Activity and Health
The knee was the most commonly injured body region in runners, accounting for 24.3% of running related injuries.	adult runners across pooled studies, published 2021	Dempster J, Dutheil F, Ugbolue UC, “The Prevalence of Lower Extremity Injuries in Running and Associated Risk Factors: A Systematic Review,” Physical Activity and Health

Overview

Injury	Body area	Typical time out
Knee injuries (runner’s knee, patellar tendinitis)	Knee	2 to 6 weeks, months if long standing
Ankle sprains	Ankle	1 to 3 weeks, up to 4 months grade 3
Plantar fasciitis	Foot	3 to 12 months to full volume
IT band syndrome	Outer knee and hip	2 to 6 weeks, longer if chronic
Stress fractures (shins, feet)	Shin and foot	6 to 8 weeks, 3 to 6 months high risk
Hamstring strains	Back of thigh	2 to 6 weeks, 3 months plus if severe
Calf strains	Lower leg	1 to 3 weeks, up to 8 weeks grade 2
Runner’s toe (black toenail)	Toe	No time off, nail 6 to 12 months
Quad strains	Front of thigh	2 to 4 weeks, 3 months plus if torn
Hip injuries (bursitis, strains)	Hip	4 to 12 weeks, months if tendinopathy
Dehydration	Whole body	Hours to a day, days after heat illness
Heat exhaustion/heat stroke	Whole body	Days, weeks to months after heat stroke
Sunburn	Skin	Usually none, days if blistered
Blister formation	Foot	None to a few days
Groin strains	Groin	2 to 4 weeks, 3 months plus if torn

Knee injuries (runner’s knee, patellar tendinitis)

Runner’s knee, known clinically as patellofemoral pain, comes from the cartilage and soft tissue around the back of the kneecap being loaded more than it can handle as the kneecap glides in its groove on the thigh bone. Patellar tendinopathy is a different problem in the same area: the tendon that runs from the lower edge of the kneecap to the shin bone becomes irritated and thickened. Downhill running, long strides that land the foot well ahead of the body, and hills or stairs push the load on both structures up sharply.

Symptoms

• A dull ache around or behind the kneecap that builds during a run
• Pain going down stairs or hills, often worse than going up
• Stiffness and a deep ache after sitting with the knee bent for a long time
• A grinding or clicking feeling when you bend the knee
• With patellar tendinopathy, a sharp point of pain right at the lower edge of the kneecap

How serious it is: The mild form hurts only late in a run and settles within a day. The stubborn form hurts from the first minute, stays sore on stairs during normal daily life, and takes months rather than weeks to turn around.

Typical time out: Two to six weeks of modified running for a mild case that responds quickly to load reduction and strength work, and three to six months for a long standing patellar tendinopathy, because tendon tissue adapts slowly and the pain often outlasts the tissue change.

See a doctor if: See a clinician if the knee locks, gives way, swells noticeably within hours, or hurts at night while you lie still.

What helps

• Keep running at a distance and pace that stays below a mild, quickly settling pain rather than stopping completely
• Load the quadriceps and hip abductors progressively, since strength deficits there are the most consistent finding
• For patellar tendinopathy, slow heavy work such as decline squats, done with a controlled lowering phase, several times a week
• Raise your step rate slightly and shorten your stride, which lowers the force on the kneecap joint per step
• See a physical therapist if pain is unchanged after four to six weeks of self managed load control; imaging is rarely needed early and often shows changes that do not explain the pain

Ankle sprains

A sprain tears fibers in the ligaments on the outside of the ankle, most often the anterior talofibular ligament, when the foot rolls inward under body weight. Trail running, curbs, potholes, and tired legs late in a run are the usual settings. A far less common but more serious version tears the high ligaments between shin and calf bone above the joint.

Symptoms

• A sudden give or pop at the moment the foot rolls
• Swelling on the outside of the ankle within minutes to hours
• Bruising that spreads toward the toes over the next days
• Pain when you push off or turn on the foot
• A wobbly, unreliable feeling on uneven ground afterward

How serious it is: Grade 1 stretches the ligament with little laxity, grade 2 partially tears it with some looseness and marked swelling, grade 3 tears it fully and leaves the joint clearly unstable. High ankle sprains between shin and calf bone heal considerably slower than the common outer sprain.

Typical time out: One to three weeks back to easy running for grade 1, four to eight weeks for grade 2, and two to four months for grade 3 or a high ankle sprain, since the ligament needs to regain both length and the sense of joint position.

See a doctor if: Get it checked if you cannot take four steps on it, if there is bone tenderness on the back edge of either ankle knob or on the outer midfoot, or if the foot looks crooked or feels numb.

What helps

• Start walking and loading the ankle within pain limits in the first days rather than immobilizing it
• Balance and hopping work on one leg, progressing to unstable surfaces, which is the single measure with the best evidence for preventing the next sprain
• A brace or taping for the first months back on trails and in sport, especially after a grade 2 or 3
• Short cooling in the first hours if it helps the pain, but do not build the whole plan around it
• Physical therapy if the ankle still feels unstable after six weeks, since repeat sprains are the main long term risk

Plantar fasciitis

The plantar fascia is a thick sheet of connective tissue running from the heel bone to the base of the toes, and it tightens like a bowstring every time you push off. Overloading it causes degenerative change and irritation at its attachment on the inner heel. The current term is plantar fasciopathy, because the tissue shows wear rather than classic inflammation.

Symptoms

• Sharp heel pain with the first steps in the morning or after sitting
• Pain that eases after a few minutes of walking, then returns later in the day
• A tender spot on the inner front edge of the heel when you press it
• Worse pain barefoot on hard floors
• Tightness in the calf and the arch when you pull the toes upward

How serious it is: The mild form is limited to the first steps of the day and settles quickly. The severe form hurts throughout the day, limits standing at work, and has usually been present for many months before treatment starts.

Typical time out: You can often keep running in some form throughout, but a full return to normal volume takes three to twelve months, and the wide range reflects how long the problem was present before it was addressed.

See a doctor if: See a clinician if the heel pain came on suddenly with a snap, if the heel is numb or tingling, or if there is swelling with warmth and fever.

What helps

• High load calf and foot strengthening, for example heel raises done with the toes propped on a rolled towel, with slow lowering
• A soft heel cup or a supportive insole to lower the tension on the attachment during work and daily life
• Cut mileage and speed work to the level that keeps morning pain manageable rather than stopping entirely
• Calf and plantar fascia stretching before the first steps of the day
• Physical therapy or a foot specialist after three months without progress; a corticosteroid injection can relieve pain briefly but is an exception, because it does nothing for the tissue and carries a risk of rupture

IT band syndrome

The iliotibial band is a thick strip of connective tissue running down the outside of the thigh from the hip to just below the knee. Pain arises where it compresses the fat pad and tissue against the outer knuckle of the thigh bone, mainly at around thirty degrees of knee bend, which is the position of early stance in running. Downhill running, cambered roads, and a narrow foot placement increase that compression.

Symptoms

• A sharp or burning pain on the outside of the knee that appears at a fairly predictable point in every run
• Pain that eases when you stop running and returns quickly when you start again
• Worse going downhill or slowing down, sometimes fine at faster paces
• Tenderness when you press the outer knee just above the joint line
• Occasionally pain higher up on the outer hip instead

How serious it is: The mild form only appears late in long runs and stops when you stop. The stubborn form appears within a few minutes of any run and hurts on stairs and downhill walking too.

Typical time out: Two to six weeks for a case caught early after a training spike, and two to three months if it has been running through pain for a long time, because the irritated tissue needs a genuine drop in compression to settle.

See a doctor if: Get it looked at if the outer knee swells, if the joint catches or locks, or if the pain persists at rest and at night.

What helps

• Cut hills, downhills, and long runs for a few weeks, and avoid running on a strongly cambered road surface
• Strengthen the hip abductors and external rotators, for example side lying leg raises and single leg squats with attention to the knee not falling inward
• Run with a slightly wider foot placement and a higher step rate to reduce the compression at the outer knee
• Use a foam roller on the outer thigh muscles for symptom relief if it feels good, understanding that the band itself cannot be stretched long
• Physical therapy if the same point of pain returns at the same distance after three or four weeks of adjusted training

Stress fractures (shins, feet)

A stress fracture is a fine crack in bone that forms when repeated impact outpaces the bone’s ability to rebuild itself. In runners the usual sites are the shin bone, the second and third metatarsals in the forefoot, and the navicular in the midfoot. Sudden jumps in weekly mileage, a switch to harder surfaces or new shoes, and too little energy intake relative to training all shift the balance toward damage.

Symptoms

• Pain you can point to with one fingertip, rather than a diffuse ache
• Pain that starts later in a run and over weeks appears earlier and earlier
• Pain when walking or hopping on the leg
• A tender, sometimes slightly swollen spot over the bone
• Aching at rest or at night in the more advanced stage

How serious it is: Early bone stress reaction hurts only with impact and heals with rest. A true fracture line hurts on walking. Fractures of the front edge of the shin, the navicular, and the femoral neck are high risk sites that heal poorly and are treated far more cautiously than the rest.

Typical time out: Six to eight weeks away from running for a low risk site, and three to six months, occasionally longer after surgery, for a high risk site such as the navicular or femoral neck, because the blood supply there is poor.

See a doctor if: See a doctor promptly if you cannot bear weight, if the pain wakes you at night, or if a groin or front shin pain persists, since those sites can go on to a complete break.

What helps

• Stop the impact loading and switch to cycling, swimming, or pool running to keep fitness while the bone heals
• Get imaging, since plain x rays often miss early stress fractures and MRI is the reliable test
• A walking boot or crutches for the sites and stages where a clinician advises it
• Check energy availability, iron, and vitamin D, and in women a missing menstrual period, since low energy intake is a leading driver of repeat bone injury
• Return through a structured walk to run progression under guidance, adding no more than small weekly increments

Hamstring strains

The hamstrings run from the sitting bone to below the knee and are loaded hardest in late swing, when the leg is reaching forward and the muscle is lengthening while braking. Tears usually happen in the long head of biceps femoris at the junction between muscle and tendon. A separate slow burning version, high hamstring tendinopathy, sits right at the sitting bone and hurts most when you sit.

Symptoms

• A sudden sharp pain or pull in the back of the thigh during a fast stride
• Difficulty lengthening the leg out in front when walking or running
• Bruising down the back of the thigh over the following days
• A tender, sometimes indented spot you can feel in the muscle
• With the tendon version, deep pain at the sitting bone when sitting on a hard chair or driving

How serious it is: Grade 1 involves a few fibers with near normal strength, grade 2 a partial tear with clear weakness and bruising, grade 3 a complete tear or an avulsion off the sitting bone, which may need surgery.

Typical time out: Two to six weeks for grade 1, six to twelve weeks for grade 2, and three months or more after a complete tear or surgical repair. Injuries close to the sitting bone take longer than those in the muscle belly.

See a doctor if: See a doctor if you felt a pop with immediate inability to walk, if there is a visible gap or large bruise high in the thigh, or if the back of the leg goes numb.

What helps

• Begin gentle pain free movement within the first days, then progress steadily; long rest makes the outcome worse
• Eccentric strengthening with the muscle lengthening under load, for example Nordic curls and single leg deadlifts, which lowers the reinjury rate
• Add strength work at long muscle length, since range matters as much as force
• Return to sprinting through a graded speed progression, not straight back to full pace
• Physical therapy for grade 2 and above; reinjury is common when running speed resumes too early

Calf strains

The calf consists of the two headed gastrocnemius crossing both knee and ankle and the deeper soleus, and both feed into the Achilles tendon. Runners most often tear fibers at the inner head of gastrocnemius during a fast push off or an uphill effort, while soleus injuries build up slowly over long steady runs. The calf absorbs a large share of the force at every foot strike, which is why it is loaded far beyond body weight.

Symptoms

• A sudden stab in the calf, sometimes described as feeling kicked from behind
• Pain when pushing off, going up on the toes, or climbing stairs
• Tightness and swelling in the lower leg over the following day
• Bruising tracking down toward the ankle
• With the slow soleus type, a deep dull ache that only appears in the later miles

How serious it is: Grade 1 leaves you able to walk with a slight limp, grade 2 makes a single leg heel raise painful or impossible, grade 3 is a complete tear with a visible defect and marked loss of push off.

Typical time out: One to three weeks for a mild gastrocnemius strain, four to eight weeks for a grade 2, and longer for soleus injuries, which are notorious for coming back if running resumes before the muscle tolerates repeated heel raises.

See a doctor if: Get urgent care if the calf is swollen, warm, and painful without a clear injury, or if you are short of breath, since a blood clot can mimic a strain.

What helps

• Walk and load within pain limits early, then build to double and single leg heel raises with high repetitions
• Train the soleus specifically with bent knee heel raises, which the standard straight leg version misses
• Return to running through a walk run progression, adding speed and hills last
• A temporary heel lift in the shoe can take tension off during the first weeks
• Physical therapy if the calf tightens up at the same distance repeatedly, which usually means the load capacity is still short

Runner’s toe (black toenail)

Repeated impact of the toe against the front or top of the shoe causes bleeding under the nail plate, a subungual hematoma. The trapped blood turns the nail dark and lifts it from the nail bed. Long downhill sections, swollen feet late in long runs, and shoes with too little length or a low toe box are the usual causes.

Symptoms

• A dark red, purple, or black patch under the nail
• Throbbing pressure under the nail in the first day or two
• Tenderness when the nail is pressed or the shoe presses on it
• The nail loosening and eventually falling off weeks later
• A new nail growing in underneath, sometimes ridged

How serious it is: A small patch under part of the nail is a cosmetic nuisance. Bleeding under most of the nail with strong pressure pain is the form worth having drained, and a dark nail that appeared without any impact needs a medical opinion.

Typical time out: Usually no time off running at all. The nail itself takes six to twelve months to grow out fully, and toenails grow more slowly than fingernails.

See a doctor if: See a doctor if the toe is deformed or was crushed, if pus or spreading redness appears, or if a dark streak in a nail developed without any injury.

What helps

• Leave the nail in place as a natural dressing and let it detach on its own
• Have a painful, tense hematoma drained by a clinician within the first day or two if the pressure is severe
• Buy running shoes about a thumb width longer than your foot and lace them so the heel does not slide forward
• Keep toenails cut short and straight across
• Keep the toe clean and covered if the nail has partly lifted, and watch for signs of infection

Quad strains

The quadriceps group straightens the knee, and rectus femoris also crosses the hip, which makes it the head that tears most often because it is stretched at both ends during a sprint stride. Fibers give way during acceleration, uphill sprinting, or a hard downhill where the muscle brakes under lengthening load. A direct blow to the thigh causes a different injury, a contusion, which bleeds into the muscle.

Symptoms

• Sudden pain in the front of the thigh during a fast or uphill effort
• Pain when lifting the knee or straightening it against resistance
• Difficulty going down stairs or braking downhill
• Swelling and later bruising in the front of the thigh
• A tight, guarded feeling that limits how far you can bend the knee

How serious it is: Grade 1 leaves strength largely intact with local pain, grade 2 causes clear weakness and a limp, grade 3 is a complete tear with a palpable gap and marked loss of knee extension.

Typical time out: Two to four weeks for grade 1, six to ten weeks for grade 2, and three months or more for a complete tear, with injuries at the top of rectus femoris near the hip taking longer than those lower down.

See a doctor if: Seek care if the thigh becomes very swollen and hard, if you cannot straighten the knee actively, or if the thigh feels numb.

What helps

• Restore pain free knee bend early with gentle movement rather than immobilizing the leg
• Progressive strengthening including lowering phases, such as slow step downs and split squats
• Add hip flexor strength work at long range, since rectus femoris also works across the hip
• Build back to sprinting and downhill running in stages, since these are the loads that caused it
• See a clinician if the thigh gets tighter and more swollen over days instead of easing, which can point to bleeding in the muscle

Hip injuries (bursitis, strains)

Pain on the outer hip is usually gluteal tendinopathy, wear in the tendons of gluteus medius and minimus where they attach to the bony point of the hip, often with irritation of the bursa that sits over them. Pain in the groin more often comes from the hip flexors or adductors, or from the joint itself. Compression of the outer tendons against the bone when the hip crosses the midline, in narrow running, in side lying, and in standing with the weight on one leg, is what keeps the problem going.

Symptoms

• Pain on the bony point of the outer hip, worse lying on that side at night
• Pain when standing on one leg, climbing stairs, or crossing the legs
• Deep groin pain with a hip flexor or joint problem instead
• Pain in the first minutes of a run that may ease, then return afterward
• Stiffness in the hip after sitting a long time

How serious it is: The mild form is painful only with direct pressure and long runs. The severe form disturbs sleep every night and limits walking, and it is the tendon rather than the bursa that determines how long recovery takes.

Typical time out: Four to twelve weeks for a hip flexor or adductor strain depending on grade, and three to six months for gluteal tendinopathy, because tendon changes at the attachment respond slowly and are easily aggravated.

See a doctor if: See a doctor if groin pain gets worse week by week and hurts on walking, if you cannot bear weight, or if the hip pain came with a fall in someone with thin bones, since a femoral neck stress fracture must be ruled out.

What helps

• Avoid positions that compress the tendon: sleeping directly on the side without a pillow between the knees, sitting cross legged, and standing hanging on one hip
• Isometric then progressive hip abductor strengthening, kept clear of positions where the leg crosses the midline
• Run with a slightly wider foot placement so the hip is not repeatedly pushed into that compressed position
• Keep running at reduced volume and flat terrain rather than stopping, unless every run flares the night pain
• Physical therapy early, since gluteal tendinopathy managed with rest alone often drags on for a year; a corticosteroid injection helps for weeks but does worse than exercise in the longer term

Dehydration

Running generates heat that the body sheds mainly by sweating, and on hot or long efforts the fluid and sodium lost in sweat exceed what you take in. Blood volume falls, the heart rate climbs at the same pace, and the body sheds heat less efficiently. Drinking far too much plain water is the opposite error and can dilute blood sodium, which is dangerous in its own right.

Symptoms

• Thirst and a dry mouth during and after the run
• Heart rate higher than usual at a pace that normally feels easy
• Headache, light headedness on standing, and unusual fatigue
• Dark yellow urine and little of it
• Skin that feels hot with less sweating than expected on a hot day

How serious it is: Mild fluid loss causes thirst and a heavier feeling at pace and corrects itself with normal drinking and a meal. The serious form comes with confusion, fainting, or heat illness and is a medical emergency.

Typical time out: Hours to a day for the mild form once you have drunk and eaten normally, and several days or more if it accompanied heat illness, since the body’s heat tolerance stays reduced for a while afterward.

See a doctor if: Get medical help if someone becomes confused, faints, stops sweating in the heat, or is vomiting and cannot keep fluids down.

What helps

• Drink to thirst during the run rather than to a fixed schedule, and do not force large volumes of plain water
• Add sodium on runs over about an hour and in the heat, through a sports drink, electrolyte tablets, or salty food
• Weigh yourself before and after long runs in the heat to learn your own sweat rate
• Start hot runs already well hydrated and shift long efforts to the cooler hours
• Rehydrate afterward with fluid plus salt and a meal, not water alone

Heat exhaustion/heat stroke

When heat production during running outpaces what the body can shed through the skin, core temperature climbs. Heat exhaustion is the stage where circulation struggles and performance collapses but the brain still works normally. Exertional heat stroke is the stage where core temperature is high enough to disturb the brain, and it damages organs within minutes if the body is not cooled.

Symptoms

• Heavy sweating with weakness, dizziness, and nausea
• Headache and muscle cramps
• Skin flushed and hot, sometimes clammy
• Pace collapsing and legs feeling like they will not respond
• With heat stroke, confusion, slurred speech, aggression, staggering, or collapse

How serious it is: Heat exhaustion means a clear head and recovery on cooling and rest. Any change in behavior, speech, coordination, or consciousness means heat stroke until proven otherwise, and that is a life threatening emergency.

Typical time out: One to several days after heat exhaustion, and several weeks to months after heat stroke with medical clearance and a staged return, because heat tolerance stays impaired long after the person feels fine.

See a doctor if: Call emergency services immediately for anyone who is confused, collapses, or behaves oddly in the heat, and start cooling before transport rather than after.

What helps

• Stop, get into shade, and cool aggressively: cold water immersion is the fastest method, otherwise cold wet towels changed constantly plus ice at the neck, armpits, and groin
• Cool first, then transport, in a suspected heat stroke; every minute above a dangerous core temperature counts
• Give cool fluids only to someone fully alert and able to swallow
• Acclimatize over one to two weeks before racing in the heat, with short easy sessions at first
• Move hard sessions to early morning, cut the pace on hot days, and wear light, loose, light colored clothing

Sunburn

Ultraviolet B radiation damages DNA in the outer skin layer, and the redness and pain that follow hours later are the inflammatory response to that damage. Runners are exposed for long stretches at midday, and sweat plus water reflection off snow, sand, or open water increase the dose. Repeated burns are a leading risk factor for skin cancer later on.

Symptoms

• Redness and warmth that appear a few hours after the run and peak the next day
• Skin that stings when touched or when clothing rubs
• Tightness and later peeling
• Blisters in a severe burn
• Chills, headache, or nausea when a large area is burned

How serious it is: A first degree burn is red and sore and settles in a few days. Blistering marks a deeper burn, and widespread burns with fever, chills, or feeling faint need medical attention.

Typical time out: Usually none for running, though blistered or chafing areas may need a few days of covered skin and looser clothing before you go out again.

See a doctor if: See a doctor for extensive blistering, fever and chills after a burn, or signs of infection such as spreading redness and pus.

What helps

• Apply a broad spectrum sunscreen of SPF 30 or higher before the run and reapply on runs longer than two hours
• Use a sweat resistant formula and cover the easily forgotten spots: ears, back of the neck, the part in the hair, and the lips
• Wear a cap and a light long sleeved shirt with UV protection instead of relying on sunscreen alone on long days
• Cool the skin and use a bland moisturizer or aloe once burned; avoid alcohol based and fragranced products
• Shift long runs out of the late morning and midday hours when UV is strongest

Blister formation

Repeated shearing between the outer and deeper skin layers separates them, and fluid fills the gap. Heat and moisture make skin softer and more prone to shear, which is why blisters cluster on long runs, in wet shoes, and on hot days. The usual sites are the heel, the ball of the foot, and the sides of the toes.

Symptoms

• A hot spot, a burning point of friction, before anything is visible
• A raised bubble filled with clear fluid
• Pain with each step in that spot
• A blood filled blister when the shear reached deeper vessels
• Redness spreading around the blister if it becomes infected

How serious it is: A small intact blister is a nuisance you can run through with a dressing. Large, torn, or blood filled blisters expose raw skin and can become infected, and blisters in people with diabetes or poor circulation are treated with much more caution.

Typical time out: None to a few days. A torn or infected blister may keep you off running for up to a week until the skin has closed.

See a doctor if: See a doctor if the area becomes red, warm, and increasingly painful, if pus appears, or if you have diabetes or reduced sensation in the feet.

What helps

• Leave a small blister intact and cover it with a hydrocolloid dressing or blister pad
• For a large painful blister, drain it at the edge with a sterile needle and leave the roof of skin in place as a cover
• Treat hot spots as they happen by stopping to tape or pad the spot rather than pushing through
• Use moisture wicking socks, change them on very long runs, and consider a thin liner sock under a thicker one
• Fix the cause: shoes with enough length and width, laces that stop the heel sliding, and lubricant or tape on known problem spots

Groin strains

The adductor muscles run from the pubic bone down the inner thigh and pull the leg toward the midline while also helping to stabilize the pelvis with every stride. Adductor longus is torn most often, usually near its tendon at the pubic bone, during a change of direction, a slip, or an abrupt acceleration. Slow onset groin pain in runners can also come from the pubic bone itself or from the hip joint, which is why persistent cases need a proper assessment.

Symptoms

• Pain in the inner thigh or at the pubic bone when squeezing the legs together
• A pulling sensation when you stride out or push off sideways
• Pain on getting out of a car or turning over in bed
• Tenderness along the inner thigh close to the groin
• Bruising on the inner thigh after a larger tear

How serious it is: Grade 1 hurts on resisted squeezing but leaves strength close to normal, grade 2 causes clear weakness and often bruising, grade 3 is a complete tear at the attachment. Groin pain that builds up over months without a single moment of injury is a different problem and needs assessment.

Typical time out: Two to four weeks for grade 1, six to twelve weeks for grade 2, and three months or more for a complete tear or a long standing groin problem, since pain at the pubic attachment settles slowly.

See a doctor if: See a doctor if you cannot bear weight, if there is a bulge in the groin that changes with coughing, or if groin pain has been getting worse for months without an injury.

What helps

• Start with isometric adductor squeezes on a ball within pain limits in the first days
• Progress to the Copenhagen adduction exercise, which has the best evidence for building adductor strength and lowering the risk of recurrence
• Add hip abductor and trunk strength, since the two sides of the pelvis work as a pair
• Return to strides and direction changes last, after full pain free strength has come back
• Get imaging or a specialist opinion for groin pain lasting beyond six to eight weeks, since hip joint and bone causes are easy to miss

First Aid for Soft Tissue Injuries: PEACE and LOVE

Sports medicine has moved on from RICE. The current guidance, published in the British Journal of Sports Medicine in 2019, splits care into the first days after the injury and everything that follows.

PEACE, the first two to three days

• Protect: unload the area and limit movement that hurts, but only briefly.
• Elevate: keep the limb above heart level when you can.
• Avoid anti-inflammatories: they may blunt the healing you need.
• Compress: a bandage or taping limits swelling.
• Educate: your body heals this on its own; passive treatments rarely speed it up.

LOVE, from day three onward

• Load: return to movement as pain allows, early loading builds tissue.
• Optimism: expectations shape recovery more than most people assume.
• Vascularization: easy cardio that does not hurt brings blood to the area.
• Exercise: restore strength, mobility and balance before returning to play.

Ice still helps with pain in the first hours. What changed is the evidence that long icing and routine anti-inflammatory drugs slow tissue repair.

How to Lower Your Risk in Running

• Raise weekly mileage in small steps and hold each new level for a couple of weeks before going up again, since most running injuries follow a sharp jump in load rather than a single bad step.
• Strength train twice a week with heavy, slow work for calves, hamstrings, quadriceps, and hip abductors, which are the tissues that absorb the impact of each stride.
• Keep the majority of weekly running easy and put hard sessions, hills, and long runs on separate days so tissue has time to rebuild between them.
• Increase your step rate slightly if you are a heavy heel striker with a long stride; a shorter stride lowers the load on the kneecap joint and the hip.
• Rotate between two pairs of shoes that fit with about a thumb width of room in front of the toes, and replace them when the midsole feels flat rather than at a fixed mileage.
• Eat enough to cover the training you are doing, since running on a chronic energy deficit is one of the strongest drivers of bone stress injuries, especially alongside missing menstrual periods in women.

When to Stop and Get Medical Help

Most of the injuries on this page are treated at home. These signs are not.

• You cannot put weight on the leg or cannot take four steps after an injury.
• A limb looks crooked, a joint sits out of place, or you saw or felt a bone give way.
• Numbness, pins and needles, a cold or pale foot, or a leg that will not respond to you.
• Confusion, slurred speech, staggering, or collapse in the heat, which means possible heat stroke.
• Chest pain, fainting, or breathlessness far out of proportion to your effort.
• A joint that swells rapidly within an hour, locks, or cannot be moved at all.

Sources

• van der Worp MP et al., “Injuries in Runners; A Systematic Review on Risk Factors and Sex Differences,” PLOS ONE
• Dempster J, Dutheil F, Ugbolue UC, “The Prevalence of Lower Extremity Injuries in Running and Associated Risk Factors: A Systematic Review,” Physical Activity and Health

This article is general information, not medical advice. If you are hurt, a doctor or physiotherapist who can examine you is worth more than any web page. Last reviewed: August 2026.

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