When a runner comes to me with knee pain, the first thing they usually blame is their form, their shoes, or their arch. Occasionally that matters. Far more often, the real culprits are two things that have nothing to do with how you run and everything to do with how you prepared to run.

Cause one: too much, too soon. Most running injuries are overuse injuries, and overuse is a load problem. The mileage jumped faster than your tissues could adapt. Bones, tendons, and muscles remodel on a slower clock than your motivation does—when your training outruns that clock, something gives.

Cause two: a body that was never built for it. Running is a series of single-leg landings repeated thousands of times. If your hips, knees, and calves don’t have the strength to absorb and redirect that force, every stride borrows against tissue you don’t have. It’s not that you’re running wrong; it’s that no one built the engine underneath the running.

The encouraging part is how fixable both are. A recent randomized trial of 264 recreational runners found that a simple home-based strength and neuromuscular program—15 to 30 minutes, two to four times a week—cut running-related injuries by 47% and time-loss injuries by 54% over nine months. That’s not elite athletes with a full gym. That’s a program you can run in your living room.

Where to start. Two short strength sessions a week: one knee-dominant exercise, one hip-dominant exercise, and progressive calf loading. Then respect the load rule—build mileage gradually so this week never dwarfs the last few. Do those two things and you’ve addressed the causes behind the large majority of running injuries, without changing a thing about your stride.

Source: Naderi, Yasemi & Mousavi (2025), Research in Sports Medicine. DOI: 10.1080/15438627.2025.2558950