Sport and training

Running injuries: why niggles appear and how training load fits in

Written by Lance Peterson, GOsC-registered osteopath · Last reviewed October 2026

Why runners pick up niggles, what research says about previous injury and training load, and how to adjust before a niggle becomes a layoff.

Running is one of the most popular ways to keep fit, and also a common source of niggles, particularly in the knee, shin, heel and hip. Most running injuries are overuse injuries, where the tissues are asked to do more than they are currently ready for. Research gives some useful pointers, though it is honest to say that the evidence on exactly how much training change is too much is limited.

When to get urgent help

Go to A&E or call 999 if you have any of these. They can be signs of a fracture, infection, blood clot or other emergency.

A limb that looks deformed, or a joint that you cannot move or put weight on after an injury
A cold, pale or numb foot or hand after injury
A hot, red, swollen joint with a high temperature
A painful, swollen, warm calf, with or without breathlessness or chest pain

What it can feel like

An ache that builds during a run, or eases as you warm up then returns afterwards
Pain in one area, such as the knee, shin, heel, Achilles or outer hip, that returns with each run
Stiffness or soreness the morning after a run that does not clear within a day or two
A niggle that is gradually getting earlier in your runs or lasting longer afterwards

Common contributors

A 2026 systematic review of risk factors for knee injuries in endurance runners found the strongest and most repeated ones were a history of previous injury, higher training load or volume, and structural alignment differences
A 2018 systematic review found limited evidence overall, but three of the four studies it included linked sudden increases in running load with a higher risk of injury
Changes in shoes, surfaces or routine, and doing too much while tired or under-recovered, are commonly cited contributors
Weak hips, calves and thighs can leave the tissues less able to cope with the load

General self-care

These are general comfort measures many people find reasonable. They are not a treatment plan, and what suits one person may not suit another.

Do not ignore a niggle that is building. Reduce the load that sets it off, such as distance, speed, hills or frequency, rather than stopping everything
Cross-train with cycling, swimming or the cross-trainer to keep fitness while a niggle settles
Add strength work for the calves, thighs, hips and trunk to your week
Make changes one at a time (shoes, surface, mileage), and build up gradually
If you use over-the-counter pain relief, follow the packet instructions or ask a pharmacist

When to see your GP

See your GP promptly, or call NHS 111, if you have any of the following:

Pain after a significant injury, fall or twist
Pain that is constant, severe or getting worse, or wakes you at night
Unexplained weight loss, fever or feeling generally unwell with limb pain

Consider seeing your GP if:

Pain that is sharp, in one spot on a bone that is tender to press, and gets worse with every run. This can suggest a stress fracture and should be assessed
Pain after a fall or a sudden injury, swelling you cannot explain, or being unable to put weight on the leg
Pain that is constant, wakes you at night, or has not improved after a few weeks of adjusting your running
A painful, swollen, warm calf, or breathlessness or chest pain. Seek urgent medical advice

How osteopathy may help

Osteopaths regularly see people with minor running injuries and training niggles. After taking a full history and examining you, treatment typically combines hands-on techniques (such as soft-tissue work, joint mobilisation and, where suitable, manipulation) with advice and exercises you can do yourself. For some people this may help ease pain and stiffness and make movement more comfortable.

Research on hands-on treatment for running injuries is limited. The best-supported approach is sensible load management and graded strengthening, and an osteopath can help work out where a niggle is coming from, ease tension and plan training around it.

Results vary from person to person, some people feel a little sore for a day or two afterwards, and osteopathic care is not right for everyone. It sits alongside, not instead of, medical care, and staying active and doing your exercises remain central.

If you would like your symptoms assessed, you are welcome to book an appointment. Osteopathic care is not right for everyone, and if something needs medical attention first, I will tell you.

Book an appointment

Common questions

Why do I keep getting injured when I run?

A 2026 systematic review of knee injuries in runners found that having had an injury before was the most frequent risk factor, followed by increases in training load or volume. Returning too quickly after an injury, or building mileage too fast, are common patterns.

Is the 10% rule for increasing mileage proven?

Not strongly. A 2018 systematic review found very limited evidence on changes in training load and running injuries, and one included study found no difference in injury risk between a 10% and a 24% average weekly increase. A gradual build with rest weeks is sensible, but there is no magic number.

Should I stop running with a niggle?

Not necessarily. Reducing the load that provokes it and keeping fit with cross-training is often enough. Stop and get it assessed if the pain is sharp, localised to a bone, worsening with every run or changing how you run.

Free 5-minute exercise sheet

A simple, printable sheet of gentle exercises and stretches, about five minutes a day, based on NHS physiotherapy leaflets. It is general information, not a personal treatment plan, and it is not suitable if you have any of the urgent signs listed above.

Download the exercise sheet (PDF)

Sources and further reading

Links open in a new tab. Sources were checked in October 2026.

Related guides

This page is general information to help you understand common aches and pains. It is not medical advice and cannot diagnose your problem. If you are worried about your symptoms, please speak to your GP or call NHS 111.