While most overuse injuries in runners are associated with an abrupt increase in mileage, according to Ellerbusch, other factors contribute to making these injuries worse. Extrinsic factors like training errors, poorly fitting shoes, and irregular running surfaces can cause or exaggerate overuse injuries. Likewise, intrinsic problems like poor flexibility or anatomical malalignment in the runner's legs or feet can lead to chronic overuse problems. Overuse Injuries of the Knees Knee injuries account for up to half of all runners' overuse injuries. Although the location of this pain can vary, it usually occurs in the front of the knee.
Runners usually get patellofemoral pain in both knees.
Squatting, jumping, and prolonged sitting aggravate this overuse injury. ITB pain occurs when this band of tough connective tissue rubs excessively on the bulge at the lower end of the femur. Some runners experience popping and snapping as the ITB band catches and rubs on this bony protuberance. Runners' knees are subject to these and a variety of other overuse injuries, including tendinitis, bursitis, and impingements. According to Ellerbusch, the most common overuse problems runners experience in these areas are medial tibial stress syndrome and stress fractures of the tibia and the foot bones.