There have been many articles recently suggesting that as a society we are falling well below the recommended levels of physical activity and the link to the increase of diseases such as diabetes, heart disease, various forms of cancer, etc.  In fact, the World Health Organisation recommends 150 minutes of moderate intensity aerobic physical activity or 75 minutes of vigorous intensity physical activity per week for adults aged between 18 and 64. General exercise is also one of the core management options of osteoarthritis in hip and knee joints.

We live in a world where we are consumed by electronic devices and so, a lot of people are taking up physical exercise in the form of running, cycling and gym based programmes in an effort to increase their physical activity levels. Of these activities, running is the most independent, least expensive and hence the most utilised form of exercise that people seem to take up. But don’t just take my word for it! Look at the number of running clubs, sports shops, and variety in trainers that have popped up around us.

There are some programmes which have been specifically written for people who wish to take up running, such as the “couch to 5K challenge”. This programme is very helpful in getting people started who have never run before. Find out more here:

Despite these programmes, running related injuries are most common in novice runners; with 11% of 1075 novice runners in one study reported at least one injury during the first 6 weeks. Some of these running injuries can be related to lack of muscle strength which could then cause an overload on various other issues. Other injuries could be related to a sudden increase in load on the bone/joint or soft tissues. Both types of injuries need to be assessed and analysed further to make sure that the injury is cared for appropriately and also to return the individual to running.

Historically, we as physiotherapists used to assess people presenting with such injuries using couch based assessment tests and suggest the appropriate treatment. But, there are several recommendations by various experts that a thorough running gait assessment, to assess the way people run, should be completed to identify variations which need to be corrected in order prevent injury recurrence.

There is good evidence that retraining running gait with appropriate cues can help return injured people back to running and can also prevent injuries in the long term . The cues will depend on the assessment, which is normally on the treadmill, recorded on an electronic tablet device and analysed through appropriate apps. For example, cadence is an important and modifiable assessment tool for people wanting to run mid to long distances as a low cadence is often associated with various injuries to the ankle, knee and hip joint.

There are also various controversies surrounding appropriate trainer selection and various models have been suggested to help in this context. However, there is no evidence to date that any one type of trainer is superior to the other in terms of injury prevention. As evidence is lacking, various experts in this field have suggested that trainers need to be chosen based on how comfortable they are to that particular individual.

At MCH house we have a treadmill, recording and video analysis facilities, rehabilitation space and perhaps most importantly the relevant expertise and experience in assessing and treating patients with running related injuries so we can carry out the relevant assessment and provide you with the best possible treatment and advice for these injuries.

Our passion in treating such injuries means that we strive to leave you with information and knowledge which will help you in keeping active and prevent injuries in doing so. After all, that’s what we’re here for!


  1. The Bangkok Declaration on Physical Activity for Global Health and Sustainable Development for ISPAH International Society for Physical Activity and Health, British Journal of Sports Medicine 2017, 51:1389 – 1391
  2. World health Organisation physical Activity level recommendation
  3. National Clinical Guideline Centre. Osteoarthritis: The care and management of Osteoarthritis in adults. Clinical guideline CG 177; 2014
  4. Kuitenberg et al, Risk Factors for running related injuries in novice runners participating in a 6-week running program, British Journal of Sports medicine 2014, 48 (7), 560 – 674
  5. Chan et al, Gait retraining for reduction of injury in novice distance runners: 1 year follow up of a randomised controlled trial. American Journal of Sports Medicine 2018; 46: 388-95
  6. Fuller et al, Body mass and weekly training distance influence the pain and injuries experienced by runners using minimalist shoes: a randomised controlled trial. American Journal of Sports Medicine 2017, 45: 1162-70
  7. Malisoux et al, Adaptation of running pattern to the drop of standard cushioned shoes. A randomised controlled trial with a 6 month follow-up. Journal of Science and Sports Mediciine 2017, 20: 734-9
  8. Malisoux et al, Influence of the heel to toe drop of standard cushion running shoes on injury risk in leisure time runners: a randomised controlled trial with a 6 month follow-up. American Journal of Sports Medicine 2016, 44: 2933-40