Physiotherapy for runners
Physiotherapy for Runners — Fix the Cause, Keep the Mileage
Almost every running injury we see is a load problem wearing a diagnosis as a disguise. The tissue is not broken — it has been asked to absorb more than it currently tolerates, usually after a jump in mileage, a new pace target, a change of shoe, or a switch from trail to road. Treating the sore spot without addressing the load only buys you a few weeks.
What we see most in runners
Achilles tendinopathy
Classic after adding speed work or hill sessions too quickly. Stiff and sore for the first ten minutes, then eases — then worse the next morning.
Runner's knee (patellofemoral pain)
Front-of-knee pain on downhills and stairs, usually with a hip and quadriceps capacity gap behind it.
Shin pain / medial tibial stress syndrome
Common in newer runners and anyone returning after a break. Needs load management, not just calf stretching.
ITB-related lateral knee pain
Typically appears at a predictable distance into the run and disappears when you stop — a compression and control issue rather than a tight band.
Plantar fasciitis
Sharp first-steps-in-the-morning heel pain, often after a mileage build or a change in footwear.
More on thisWhat we assess that a generic appointment misses
A running assessment has to look at the whole chain and the training history, because the site of pain is often not the source of the problem.
- Training load history — weekly mileage, recent changes, surfaces and sessions
- Calf, hamstring, glute and foot strength capacity, side to side
- Running mechanics: cadence, contact pattern and control under fatigue
- Footwear history, including when the current pair went in
- Sleep, recovery and any concurrent gym loading
Why we rarely tell runners to stop
Complete rest lets the tissue desensitise, but it also lets capacity fall, so the same mileage that caused the problem is now even further beyond your tolerance. In most cases we modify — reduce volume, remove the aggravating session type, adjust surface — while loading the tissue deliberately in rehabilitation.
Building the return-to-running plan
We use graded progressions rather than a fixed date. Volume is restored before pace, pace before hills or intervals, and each step held long enough to confirm the tissue tolerated it. If you have a race in the calendar, we plan backwards from it and are honest if the date is unrealistic.
Sports massage as maintenance, not treatment
Regular sports massage helps many runners manage the accumulated tightness of a training block. It is genuinely useful maintenance, but if you are booking massage to keep a specific pain at bay, that pain needs assessing instead.
Common questions
Should I stop running completely?
Usually not. We normally modify volume and session type rather than stopping, unless there is a suspected bone stress injury.
Do I need new trainers?
Shoes matter less than most people are told, but a sudden change in shoe type is a common trigger. We will look at when the current pair went in and whether the change lines up with the symptoms.
Is it a stress fracture?
Point-specific bone pain that worsens through a run and hurts when hopping needs proper assessment and sometimes imaging. Tell us if that matches your symptoms.
How soon can I get back to my race?
That depends on tissue, history and how far off the date is. We will give you a realistic answer at the assessment rather than an optimistic one.