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Diagnosing Running Injuries Using a Runner’s Training & Medical History

Updated: Mar 7, 2022

With the increase of running-related injuries, it’s important for clinicians to formulate running-specific assessment plans for their patients. In this article series, we will be discussing a standardized approach that you can use integrate as a part of your assessment process. A running assessment is a step by step process including 4 stages:

  • Comprehensive medical review & training history.

  • A Physician Examination.

  • A running gait analysis, if the runner is symptotic.

  • Physical therapy consultation to propose programs for correcting biomechanical aberrations of running motion.

Medical & Training History

Medical & training history documentation is an excellent tool used by clinics for diagnosing running-related injuries in patients.

Here’s an effective ‘Runner intake questionnaire’ you can provide your patients at their first visit for assessing their running pattern & potential triggers for injury.

Clinical usage of the ‘Runner Intake Questionnaire’


Knowing about the running surface & route used by the patient can help you estimate the resulting joint and muscle loads, & identify aspects that may be associated with injury risk.



Beveled Roads

When the foot lands on the lateral side of the road, the lower extremity is subjected to strain.


Soft tissue injuries such as midportion Achilles tendinopathy


Eccentric loading to knee extensors


Recreational runners with weekly volume <24 km/week or <3 years of training have a higher risk of developing leg pain.

Additionally, training for >7d/week (or >1 sessions/day) is considered as excessive. Such high volumes don’t allow enough time for the soft and bony tissue recovery, increasing the chances of injury. Studies have shown that <2d/week of rest increases the risk of overuse injury by 5.2 fold!


Assessing the mileage and wear pattern of the patient’s shoes can be extremely valuable. An average running shoe begins to break down at 350-400 miles, leading to abnormal loading mechanics of the foot and lower extremity.

Any asymmetry in the wear pattern of the sole might indicate an asymmetric running motion. A runner with a worn-out lateral heel of the shoe is forced to land in excessive supination with each step, increasing soft tissue stress in the midfoot.


Surprisingly, most patients are unable to determine their foot-strike pattern accurately. Hence, we recommend that you use a video-based tool to accurately assess this parameter in the clinic.

As per recent studies, Fore-Foot Striking seems favorable for patients with unstable knee joints in the AP axis. As opposed to this, a Rear-Foot Strike pattern may be recommended for runners with unstable ankle joints. Cushioned shoes encourage heel striking whereas shoes with minimal or no drop encourage mid to forefoot striking.

Although the documentation of medical & training history is very important, it is seldom used in isolation. Instead, it should act as a guiding criteria for subsequent examinations of the patient.

Once this step is complete, you can use this documentation for conducting a comprehensive physical and functional assessment of the patient.

At auptimo, we help clinicians introduce running analysis at their centers through GaitON, our motion analysis system. Its inbuilt running protocol assesses important biomechanical faults in running form and summaries all results in organised reports with normal values.

For more information on GaitON’s running protocol, click here.

We, at auptimo help clinicians introduce running gait analysis at their centers through GaitON, our motion analysis system. For more information on GaitON’s running protocol, click here.​


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