Why you're getting injured when you return to running (and how to prevent it)
- Flora Muijzer
- Jun 2
- 6 min read
By Flora Muijzer | Physiotherapist & Sports Performance Specialist
Reading time: approx. 9 minutes
Spring is here, the days are longer, and suddenly everyone is lacing up their trainers again. After months of cold, dark mornings that made the couch far more appealing than the pavement, returning to outdoor running feels exciting — maybe even urgent. But this time of year is also when I see a surge of new clients in my clinic, all dealing with the same thing: injuries that didn't have to happen.
Whether it's a grumbling Achilles, achy knees, or shin pain that won't quit, most spring running injuries share one root cause: doing too much, too soon, after doing too little for too long. The good news is that with a bit of awareness and a few simple strategies, they're almost entirely preventable.
The problem: your body forgot what running feels like
Running is a high-impact sport. Even at a comfortable pace, each foot strike sends a force equivalent to roughly two to three times your body weight through your joints and tissues. Your tendons, bones, and muscles adapt to handle this load — but only if you give them consistent exposure to it.
During winter, most people's running volume drops significantly. Some stop altogether. That's completely fine. But when spring arrives and the motivation spikes, the temptation is to jump straight back to the mileage and intensity you were managing in autumn. Your cardiovascular fitness may recover relatively quickly, but your tendons, ligaments, and bones need significantly longer — often weeks to months — to rebuild their load tolerance.
This mismatch between what your heart and lungs can handle and what your tissues can handle is where injuries are born.
The most common spring running injuries
1. Shin Splints (Medial Tibial Stress Syndrome)
One of the most common complaints I see in returning runners. You'll feel a dull ache along the inner edge of your shinbone during or after a run. It often feels fine when you warm up, only to return worse the next morning.
Why it happens: Bone responds to load more slowly than muscle. When running volume increases faster than your tibia can adapt, the bone's outer layer (periosteum) becomes inflamed.
2. Achilles Tendinopathy
A stiff, achy Achilles — especially that first step out of bed in the morning — is a classic sign of tendon overload. The Achilles is remarkably strong but notoriously slow to heal once irritated.
Why it happens: Tendons thrive on gradual, progressive loading. A sudden spike in mileage or intensity (including adding hills or speed work too early) is the most common trigger.
3. Runner's Knee (Patellofemoral Pain Syndrome)
That vague ache around or behind the kneecap, often worse when going downstairs or after sitting for long periods. This one is especially common in people who've spent a lot of winter sitting at a desk.
Why it happens: Prolonged sitting often leads to weakened glutes and tight hip flexors, which alter how your kneecap tracks in its groove. Add running load on top and the joint surface becomes irritated.
4. Plantar Fasciitis
A sharp, stabbing pain under the heel — particularly excruciating on that first step in the morning. More common in runners returning after a long break.
Why it happens: The plantar fascia (the thick band of tissue supporting the arch) loses its load tolerance after a period of inactivity. A sudden return to impact loading over-stresses it before it has time to adapt.
The 10% Rule — and why it's not quite enough
You've probably heard of the 10% rule: don't increase your weekly mileage by more than 10% per week. It's a reasonable starting point, but it's not the whole picture.
The 10% rule addresses volume, but it doesn't account for:
Intensity — adding speed sessions on top of more miles is a double load spike
Your starting point — 10% of zero is still zero; returning runners need an absolute floor
Recovery capacity — stress, poor sleep, and nutrition all affect how well your body adapts
Terrain — going from flat pavements to hilly trails counts as an intensity jump
A more useful framework is managing your acute-to-chronic workload ratio: the idea that your body handles load well when this week's training isn't dramatically higher than your average over the past four weeks. If you've been doing very little, your chronic load is low — which means your safe acute ceiling is also low, even if it feels easy in the moment.
How to return to running without getting hurt
Start Slower Than You Think You Need To
The most common mistake is letting your fitness level dictate your starting volume when it should be your tissue tolerance. If you've had a break of more than four to six weeks, treat yourself as a relative beginner again, regardless of your previous fitness.
A run-walk approach is genuinely excellent — not just for beginners — and allows your body to accumulate training stimulus while managing tissue load.
Prioritise Strength Work
Runners are often reluctant to spend time not running, but strength training is one of the most powerful injury-prevention tools available. Strong glutes, calves, and hip stabilisers reduce the mechanical stress on your knees, Achilles, and feet with every stride.
Two sessions a week of targeted lower limb strength work — single-leg calf raises, Romanian deadlifts, hip thrusts, and lateral band walks — can make a significant difference. These don't need to be long sessions; thirty minutes is enough.
Don't Skip the Warm-Up
I know, I know. You've heard it a thousand times. But a proper warm-up isn't just about preventing muscle strains — it's about priming your neuromuscular system for the demands of running. Five to ten minutes of dynamic movement (leg swings, hip circles, walking lunges, light jogging) prepares your tissues to absorb load more effectively.
Static stretching before a run, on the other hand, has limited evidence behind it. Save the deep stretching for after.
Listen to Your Body — But Know the Difference
There's a difference between the discomfort of exertion (normal) and the discomfort of tissue strain (a signal to stop). As a rough guide:
Discomfort that eases as you warm up and doesn't persist after your run — usually fine to continue, monitor closely
Pain that gets worse during the run, or that's still there the next morning — reduce load and seek assessment if it persists more than a week or two
Sharp or sudden pain — stop immediately
Pushing through genuine pain almost never works out. Your body is very good at compensating in the short term, but compensation patterns create secondary problems elsewhere.
Get Your Footwear Sorted
Running shoes have a lifespan of roughly 500–800 km, after which the midsole cushioning degrades significantly even if the upper looks fine. If your shoes have been sitting in a cupboard for six months, they may be well past their best. It's worth getting a proper gait assessment at a specialist running store before ramping up your training.
This isn't about finding a "corrective" shoe — the evidence for heavily corrective footwear is less clear than the marketing suggests. It's simply about having a shoe that hasn't broken down.
When to see a physiotherapist
Not every ache needs professional input, but there are times when it's worth getting eyes on:
Pain that persists for more than two weeks despite reducing your load
Swelling around a joint or tendon
Pain that stops you from completing a run
Any sudden, sharp, or severe pain
Symptoms that keep coming back every time you try to return to running
Early intervention almost always means faster recovery. Tendons and stress fractures, in particular, respond much better to treatment when caught early. Waiting to "run through it" often means a much longer time off down the line.
The bottom line
Returning to running in spring should feel good. It can feel good — the physical benefits, the mental lift, the satisfaction of covering ground under your own power. But your body is a biological system that responds to load gradually, and it doesn't care how motivated you feel.
Give your tissues the time they need to adapt, build strength alongside your mileage, and you'll be running consistently through summer and beyond — instead of spending it recovering from an injury that didn't have to happen.
If you're dealing with a running-related injury or want personalised guidance on returning to sport, get in touch to book an assessment.
Physio Flora is based in Riviera del Sol & Marbella, serving patients across Marbella, Mijas, Fuengirola, Estepona, Benalmádena, and the wider Costa del Sol.
📞 +34 711 059 592
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📍 Riviera del Sol & Marbella (Costa del Sol)
Movement is medicine — and expert physiotherapy is how you get the most from it.
Physio Flora · English-Dutch-German-Spanish-speaking physiotherapy on the Costa del Sol · Specialising in orthopaedic & spinal conditions, sports injury, chronic pain management, and post-surgical rehabilitation.
Flora Muijzer is an expert physiotherapist and sports performance specialist. She has worked with the Chinese Olympic Windsurf Team, Porsche Carrera Cup Asia, Shanghai Women's Football League, the Dutch National Ballet, Netherlands Dance Theater, Ironman triathletes and other amateur and professional athletes. She now has 2 clinic locations along the Costa del Sol (Riviera del Sol and Marbella) and helps both athletes and non-athletes.
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