Running Injury Rehab Guide: IT Band, Plantar Fasciitis, Runner's Knee & More — Melbourne

The lateral knee pain that won't quit

IT band syndrome produces a sharp, burning pain on the outside of the knee — typically appearing at a specific point in every run, then fading, then returning sooner and sooner until running becomes impossible. It's not actually a problem with the IT band itself being 'tight'; it's a compression issue driven by inadequate hip and glute strength.

The mistake most runners make is stretching the IT band and foam rolling obsessively. These address the symptom, not the cause. Targeted hip and glute loading is what changes the outcome. Running is permitted through rehab, with load modification.

Supported by JOSPT research on hip strength deficits in IT band syndrome presentations.

Morning pain, all-day frustration

Classic plantar fasciitis presents as intense heel pain with the first steps of the morning, which eases after a few minutes of walking. Runs can feel manageable during activity but worsen the next morning. It's a load capacity problem — the plantar fascia is being asked to do more than it can currently tolerate.

Pushing through or resting completely are both poor strategies. Load modification combined with progressive calf and intrinsic foot strengthening is consistently the most effective approach. Chronic cases that have been run through can take 3–4 months. Early intervention matters significantly here.

The kneecap that rebels

Patellofemoral pain syndrome — pain around or behind the kneecap — is the most common complaint in new runners. It typically worsens going downhill, down stairs, or after sustained sitting. The kneecap isn't tracking correctly through the groove of the femur, usually because hip and glute strength is insufficient to keep the femur from rotating inward under load.

The research is clear: hip-targeted strengthening outperforms knee-targeted exercise for patellofemoral pain. Running volume is temporarily reduced, not stopped, while a targeted programme addresses the underlying deficit.

See BJSM systematic review on hip strengthening for patellofemoral pain.

The beginner's burden — and the comeback runner's too

Medial tibial stress syndrome presents as a dull, diffuse ache along the inner edge of the shin — worse at the start of a run, sometimes easing mid-run, and flaring again afterwards. It's one of the most common presentations in the months leading up to the Melbourne Marathon as runners dramatically spike their training volume.

Critical: if pain is focal to one spot, present at night, or not improving within 2 weeks, a stress fracture must be ruled out via MRI or bone scan. MTSS is manageable with load modification and calf strengthening. A stress fracture is a significantly different injury with a very different timeline.

The experienced runner's nemesis

Achilles tendinopathy is more common in experienced runners than beginners, and it's notoriously stubborn when managed incorrectly. Pain and stiffness at the back of the heel — worst in the morning and early in a run — is the hallmark presentation. The Achilles is a load-sensitive structure: both overload and underload worsen it.

Anti-inflammatories and rest are not the answer. Eccentric and heavy slow resistance calf loading is the gold standard — specifically because tendons remodel through progressive mechanical stress, not rest. Running is modified but not eliminated. This is a condition where the quality of your rehab programme matters enormously.

Evidence summarised in BJSM tendinopathy guidelines and Sports Medicine.