A systematic review of running-related musculoskeletal injuries in runners.

Kakouris and colleagues set out to map the landscape of running injuries by gathering all the prospective and retrospective studies they could find on running-related musculoskeletal injuries, up to mid-2020. What emerged was a clear picture of where runners tend to get hurt and how often. Around four in ten runners experience an injury in any given period, and the knee, ankle, and lower leg are by far the most common trouble spots.

The specific injuries that show up most frequently are Achilles tendon problems, shin splints (technically medial tibial stress syndrome), and knee pain around the kneecap. Interestingly, ultramarathon runners follow a similar injury pattern to regular distance runners, though the ankle becomes particularly problematic for those going very long distances. The authors were careful to flag that comparing findings across different studies comes with real methodological challenges, so these numbers should be read as a useful snapshot rather than a definitive final answer.

If you run regularly, there is a meaningful chance you will experience a musculoskeletal injury at some point, with roughly four in ten runners dealing with one. The knee is the most commonly injured area overall, though your ankles and lower legs are also frequent problem zones.

The most common specific injuries are Achilles tendon pain, shin splints, and knee pain around the kneecap area, each affecting a notable portion of the running population. These findings come from looking at many different studies together, so they give a broad picture of what runners commonly experience, but your own injury risk and pattern will depend on many individual factors.

The fact that ultramarathon runners show similar injury patterns to other runners suggests that the distance itself may not be the main driver of injury type, though this remains an area where more detailed research would help.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review consolidates incidence and prevalence data across a large body of literature, offering a useful epidemiological overview of where running injuries cluster. The distinction between incidence (new injuries developing) and prevalence (injuries present at any given time) is methodologically important here, and the authors report both separately, which strengthens the picture.

Around 40% incidence and 45% prevalence figures suggest these are common presentations, though the standard deviations are substantial, reflecting real variation between studies. The top five specific pathologies by incidence differ somewhat from those by prevalence, a pattern worth noting in clinical practice since it reflects how quickly injuries resolve.

The ultramarathon subanalysis found similar anatomical distributions but a marked shift toward ankle involvement, which may reflect the different mechanical demands of sustained ultradistance running. The authors themselves highlight that methodological heterogeneity across the included studies limits interpretation, so clinicians should view these as representative patterns rather than population absolutes.