Rise of running injuries: What recreational runners should know

In this interview, sports physiotherapist Nguyen Quyet Thang, Head of Physiotherapy at Vinmec Healthcare System and Guest Lecturer at VinUniversity, shares key insights into common injury patterns, training mistakes, and how runners can train more safely and effectively.

Reporter: Thank you very much, Mr. Thang, for taking the time to speak with us. Recreational running is growing rapidly. From your clinical experience, what changes have you noticed in injury patterns among non-professional runners?

Mr. Thang: In my clinical practice, one clear change I have noticed is that running injuries are no longer seen only in competitive athletes. We are now seeing many injuries in recreational runners—people who have office jobs, sit for long hours during the day, and then suddenly start training quite seriously for 5K, 10K, half-marathon, or even full-marathon events. The most common pattern I see is not a sudden traumatic injury but an overuse injury. In other words, runners do not get injured because of one single bad step. The problem usually builds up gradually when the body is exposed to more running load than it is ready to handle. So the key message is that most recreational running injuries are not simply due to bad luck. Very often, they are related to training-load management—doing too much too soon or not allowing enough recovery. The good news is that many of these injuries can be prevented if runners progress gradually, listen to their bodies, and combine running with strength training, mobility work, and proper recovery.

Reporter: Which running-related injuries do you see most often in recreational runners?

Mr. Thang: The first common injury is knee pain, especially what many people call “runner’s knee” or patellofemoral pain syndrome. Runners often feel pain around or behind the kneecap, particularly when going down stairs, running downhill, or increasing their training load too quickly. The second common problem is shin pain, often known as shin splints or medial tibial stress syndrome. This usually happens when runners increase distance, speed, or training frequency faster than their legs can adapt. I also frequently see Achilles tendon and calf overload. This is common among new runners, runners who suddenly add speed sessions or hill running, or those who return to training too quickly after a break. Another common condition is plantar heel pain, often described as a sharp pain under the heel, especially during the first few steps in the morning. It is often linked to excessive loading of the foot, calf tightness, or a sudden increase in training volume.

We also see IT band-related pain, which usually presents as pain on the outside of the knee, especially during longer runs or downhill running. It is often associated with training overload or poor control around the hip and pelvis. More serious, but also important, are bone stress injuries such as stress reactions or stress fractures in the tibia or foot. These usually cause persistent, localized pain that worsens with running and does not improve adequately with rest.

Reporter: What do many recreational runners misunderstand about training volume and progression?

Mr. Thang: One of the biggest misunderstandings is that many recreational runners think progress should be quick and linear. When they feel good for one or two weeks, they often increase their distance, speed, hill running, or training frequency quite aggressively. However, the body does not adapt at the same rate across all systems. Another common misunderstanding is that training load refers only to weekly mileage. In reality, total training load is much broader. It includes distance, speed, hill running, running surface, recovery, sleep patterns, previous injury history, and whether the runner is doing enough strength training. So the message I usually give runners is: Don't just ask, “How many kilometres did I run this week?” Also ask, “How hard were those runs?”, “How well did I recover?”, and “Is my body adapting well?” Progress is not simply about doing more. It is about doing the right amount at the right time.

Reporter: What does running smarter mean from a medical point of view?

Mr. Thang: From a medical point of view, running smarter means training according to the body's current capacity. It is not simply about running faster, longer, or harder. Muscles, tendons, bones, and joints all need time to adapt to running loads. In practice, this means increasing volume gradually, allowing enough time for recovery, and keeping easy running as the foundation of training. Speed work and hill running can be very useful, but they also place greater stress on the calves, knees, and hips. Therefore, they should only be introduced when a solid base of training volume has already been established. Running smarter also means listening to pain signals. Pain that keeps returning, worsens during running, or increases week by week should be considered a warning sign.

Reporter: What are the key principles of proper load management for recreational runners?

Mr. Thang: I usually recommend a few key principles. First, consistency is more important than intensity. Running regularly at a manageable level is better than doing one very hard session and then needing several days to recover. I also use the 24-hour response rule. If stiffness, swelling, soreness, or fatigue is clearly worse the next day, the session may have exceeded the runner's current capacity. In simple terms, good load management means progressing gradually, training consistently, monitoring the body's response, and respecting recovery.

Reporter: What simple practical advice would you give to help recreational runners stay injury-free?

Mr. Thang: My advice for recreational runners is simple: do not focus only on running more. Instead, prepare your body to tolerate running better. First, keep most of your running easy. A useful guide is the conversation pace, you should still be able to speak in short sentences while running. Second, do strength training at least twice a week, even if it is only 20 to 30 minutes per session. Exercises such as calf raises, split squats, hip hinges, step-downs, and single-leg balance exercises can help the calves, knees, hips, and feet handle running much better. Third, warm up properly before faster sessions. Start with an easy jog, add some dynamic movements, and finish with a few short strides before speed work, hill training, or interval sessions. Finally, respect warning signs. Pain that changes your running form, becomes sharper, increases during a run, or keeps returning should not be ignored. Run consistently, build gradually, keep most of your running easy, strengthen your body, and pay attention to early warning signs. These are some of the most important steps you can take to stay injury-free.

Reporter: That’s all for today’s conversation. Thank you to Mr. Nguyen Quyet Thang for sharing his insights, and thank you for listening to Doctor at Home.