Running Physio Sydney — Injury Treatment by Physios Who Understand Runners
Running Physio Sydney: Central Performance is home to the Sydney Running Centre — a dedicated running injury and performance facility in Surry Hills, 3 minutes from Central Station. Our running physios are also certified World Athletics and Australian Athletics certified running coaches, and our clinic includes video treadmill gait analysis, VALD ForceDecks strength testing and a full rehab gym. That means you get a diagnosis, a training plan and a route back to running from one team, under one roof. No referral needed; appointments within 24–48 hours.
What makes a running physio different from a general physio?
Any physiotherapist can treat a sore knee. A running physio treats the runner attached to it. The difference shows up in three places:
- We assess your running, not just your injury. Most running injuries are training load problems wearing an injury costume. Alongside the physical assessment, we review your training history, recent changes in volume or intensity, your goals and your race calendar — because the right plan for someone building to a marathon in ten weeks is different from the right plan for a casual parkrunner.
- We rarely tell you to just stop running. For most running injuries, the evidence supports modified running over complete rest. Our job is to find the level of running your body can currently tolerate and build from there — protecting your fitness and your sanity while the injury settles.
- We can see what’s causing the problem. Video gait analysis and objective strength testing let us identify the technique and strength factors that overloaded the injured tissue in the first place — so the injury doesn’t come straight back when you rebuild.
The Eight Most Common Running Injuries We Treat
Most middle and long distance running injuries are overload/overused type injuries, as opposed to contact sports or sprinting injuries which are more sprains and strains, often related to trauma or explosive movements. Most running-related injuries are related to overload of tendons or their bony attachments (tendinopathy or enthesopathy), joints, or bones (bone stress reactions, stress fractures). The following are the seven most commonly reported injuries that our running physios see.
1. Shin Pain and Shin Splints
Shin pain begins with what is commonly known as shin splints, although it is officially called medial tibial stress syndrome. The pain is felt along the inner border of the shin bone (tibia), usually in the lower third of the shin. It is actually a range of conditions beginning with inflammation of the muscle attachment points to the bone (periostitis), and progressing through to a bone stress injury/reaction. If left to progress further it may turn into a stress fracture. For more information you can read about physio for shin pain, our blog on bone stress injuries in runners,
2. Runner’s Knee Pain
One of the most common injuries for runners is ‘Runner’s Knee’ or patellofemoral pain syndrome, characterised by pain around or behind the kneecap. Runner’s Knee is responsible for a significant portion of knee pain in runners, and for more information you can read our blogs about physio for runner’s knee and strength exercises for runners knee.
Anther common cause of knee pain in runners is patella tendinopathy, which is an over-load injury of the quadriceps tendon as it attaches to the tibia (shin bone), just below the kneecap. In patella tendinopathy the pain is felt at the bottom or just below the kneecap, compared to runners knee where the pain is more around or behind the kneecap. For more information on differentiating between the two conditions you can read our blog on runner’s knee versus jumper’s knee.
The third common condition causing knee pain in runners is ITB Syndrome. It the most frequent running-related cause of pain on the outer side of the knee, and it is caused by irritation of the ITB (and possibly other related structures) as it crosses a bony prominence on the outer edge of the femur (thigh bone) called the femoral epicondyle.
3. Achilles Tendinopathy (Achilles Tendonitis / Tendinosis)
Achilles tendinopathy involves pain and stiffness in the Achilles tendon, the band of tissue connecting the calf muscles at the back of the lower leg to the heel bone. It is caused of overloading the tendon beyond it’s capacity, usually as a result of increasing running volume or intensity too quickly. Calf weakness is another major contributor, and other factors such a foot position and running shoe choice may play a role. For more information you can read our blog on Achilles pain with running and the latest research on Achilles physio treatment and exercise research.
Even though not technically an Achilles issue, its worth noting that calf weakness (a major contributor to Achilles tendinopathy) is also a primary cause of calf strains in runners, another common running injury. The foundation of effective treatment for both conditions rests on load management and calf strengthening.
4. Heel Pain When Running – Plantar Fasciitis /Plantar Fasciopathy
The most common cause of heel pain in runners is plantar fasciitis/fasciopathy. This is caused by overloading and inflammation of the plantar fascia – the thick band of tissue that runs across the bottom of the foot and connects the heel bone to the toes. The most common area to feel pain is underneath the heel, and it is often very sore to put weight on first thing in the morning or at the start of a run, then the pain reduces as your body warms up. However, with continued overload due to too much running, the pain intensity increases, it lasts for longer (i.e. takes longer to “warm up”), and eventually it stays sore through weightbearing to the point where running becomes impossible.
5. Foot and Toe Pain When Running
Foot and toe pain can arise from metatarsalgia, an “umbrella diagnosis” that includes several conditions involving overloading and inflammation of soft tissues in the ball of the foot. However, foot pain can also be from a bone stress injury (or stress reaction) or stress fracture, due to overloading of bones within the foot. An important condition to recognise is a navicular bone stress injury or stress fracture, because early diagnosis and management is essential. Similarly, early diagnosis of other bone stress injury/reaction and stress fractures is very important because continuing to overload the bones during running can cause significant bone trauma and in some cases non-union (i.e. the broken bone fails to heal) which may require surgery.
6. Stress Fractures and Bone Stress Injuries
Early diagnosis of bone stress injuries and stress fractures in runners is critical. If picked up early most bone stress injuries respond well to physio management. However, if a bone stress injury is not diagnosed early and you continue to run it can progress to a full stress fracture requiring more intensive management, unloading using crutches or a boot, extended periods out of running, and in some cases surgery. Also, if you have had previous bone stress injuries, or if the injury is more central on your body like your pelvis or upper femur (thigh bone), further investigation to exclude other conditions like RED-S may be required.
7. Hip and Glute Pain When Running
The most common cause of hip pain when running is gluteal tendinopathy. Like other tendinopathies gluteal tendinopathy is caused by overloading the tendon, most commonly by increasing running volume or intensity too quickly. Other biomechanical factors such as a cross-over running gait can also increase your risk. Gluteal tendinopathy pain is felt on the outer side of the hip, and can also be associated with bursitis (trochanteric bursitis), where the bursa (a fluid-filled sac that sits between the tendon and the hip bone) becomes inflamed. Pain at the front of the hip can be caused by hip flexor strains or tendinopathy, or the hip joint itself.
8. Hamstring Injuries – Proximal Hamstring Tendinopathy
The most common hamstring injury in middle and long distance runners is proximal hamstring tendinopathy. Unlike hamstring strains or tears, which usually occur in sprinters or multi-directional field sports like soccer or football, proximal hamstring tendinopathy is an overload injury. It occurs when the tendon that joins the hamstring on the the pelvis is overloaded, causing microtrauma and pain.
