Running is Melbourne’s sport. From the annual Melbourne Marathon drawing tens of thousands of participants along the Yarra, to the daily pre-work runners cutting through the CBD, to the trail runners pushing into the Dandenongs on weekends, this city runs. And with that volume of running comes an inevitable volume of running injuries.
Shannon Clinic has been assessing and managing running injuries from our Collins Street CBD clinic since 2007. Led by Dr. Nicholas Shannon, a sports and exercise medicine chiropractor with postgraduate qualifications and 20 years of clinical experience. Our approach to running injuries combines accurate diagnosis, targeted treatment, and load-based rehabilitation designed to get you back running properly. Not just pain-free for a week, then the same injury again two months later.
Dr. Shannon is a published author on running medicine. His peer-reviewed paper Running Medicine: A Clinician’s Overview, published in the Chiropractic Journal of Australia (Vol. 44, No. 1, 2016), provides an evidence-based overview of common running injuries encountered in clinical practice, the mechanical and technique deficiencies associated with those injuries, and the role of foot striking patterns in injury risk. It is the foundation from which Shannon Clinic’s approach to running injury assessment and management has been built.
The most common reason running injuries recur is that the underlying cause was never identified. Treatment that targets the symptom such as the sore knee, the tight Achilles, the aching shin without addressing why that structure is being overloaded will produce short-term relief and long-term repetition. At Shannon Clinic, we find the cause. Book a running injury assessment at our Melbourne CBD clinic, located at Suite 9.16, 220 Collins Street.
Why Running Injuries Happen and Why They Keep Coming Back
Running injuries are more frequently a combination of mechanical imbalances/weaknesses and overuse the result of cumulative tissue loading that exceeds the body’s capacity to repair and adapt. Unlike acute traumatic injuries, they don’t happen in a single moment. They build over days, weeks, or months, driven by one or more of the following:
Training load errors — the most common cause
One of the most common drivers of running injuries we see is a mismatch between how much load a runner applies and how much load their body can currently tolerate. This is typically expressed as a rapid increase in weekly volume, sudden introduction of speed or hill work, a return to full training after a break or holiday, or inadequate recovery between sessions. At Shannon Clinic, we use acute:chronic workload ratio principles to quantify this mismatch and build return-to-running plans that respect the body’s adaptation timeline, not the runner’s impatience.
Biomechanical contributors
How a runner moves influences where load concentrates in the body. Hip weakness that allows the pelvis to drop during the stance phase increases iliotibial band tension and patellofemoral loading. Reduced ankle dorsiflexion range shifts load proximally to the knee and hip and adds tension to the Achilles tendon. Overstriding with a low cadence amplifies ground reaction forces at the knee. Foot pronation patterns influence load distribution from the ankle upward through the kinetic chain. None of these factors are inherently wrong, however they become clinically relevant when they contribute to a load that exceeds a tissue’s capacity.
Footwear
Shoe selection is a meaningful but frequently overstated variable. The right shoe for a given runner depends on their foot type, running volume, preferred surface, and injury history, not on marketing claims. Shannon Clinic’s approach to footwear is evidence-based: we assess foot type in the context of the runner’s full clinical picture, and where relevant reference our running shoe guide for Melbourne Marathon runners and our summary of the research on how shoe weight affects running performance and economy.
Inadequate strength and capacity
Running requires significant force production from the hip, knee, ankle, and foot at every stride, at speeds and volumes that expose any capacity deficit. Runners who do not include structured strength training alongside their running volume are progressively accumulating a strength deficit relative to their training load. This deficit eventually manifests as injury.
Insufficient recovery
Adaptation, that is, the process by which the body gets stronger, more efficient, and more resilient happens during recovery, not during training. Inadequate sleep, high training frequency without adequate rest days, poor nutrition, and accumulated life stress all impair recovery and reduce the load threshold at which injury occurs.
Common Running Injuries We Assess and Treat in Melbourne
Plantar fasciitis and heel pain
A common foot complaint in runners, and one of the most mismanaged. Plantar fasciitis produces a sharp, stabbing pain at the heel, typically worst with the first steps after waking or after prolonged sitting. It is caused by overload of the plantar fascia at its calcaneal attachment. Despite its name, this is not primarily an inflammatory condition in chronic presentations, hence it does not respond well to anti-inflammatory based treatment interventions. Modern evidence supports progressive tendon loading as the cornerstone of rehabilitation, not rest and stretching alone.
Contributing factors include rapid increases in training volume, reduced ankle dorsiflexion range, calf tightness and weakness, footwear changes, and running surface changes. Assessment at Shannon Clinic identifies which of these are present and builds management around them.
Achilles tendinopathy
Pain at the Achilles tendon. It is either mid-substance (the most common form in runners) or at its heel bone insertion. It’s characterised by morning stiffness, pain at the start of a run that may ease with warm-up, and progressive worsening with sustained or high-load running. Loading errors are a common driver of Achilles tendinopathy.
Treatment that removes load without progressively rebuilding it produces temporary improvement followed by recurrence. Evidence-based management uses progressive tendon loading, typically starting with isometric holds and progressing through isotonic and sport-specific loading, alongside training modification and contributing factor correction. See our detailed guide to Achilles tendon pain for a full breakdown of assessment and management.
ITB syndrome (iliotibial band syndrome)
Pain at the outer knee that develops during running. One of the hallmark presentation of ITB syndrome is the onset of pain at a predictable distance, which improves with rest. It is one of the most common running injuries in recreational runners. ITB syndrome reflects compression of the fat pad beneath the band at the lateral knee, driven primarily by hip and glute weakness, training volume spikes, or downhill and cambered surface running. Treatment targets the cause: hip and glute strengthening, load management, and where relevant technique modification.
Patellofemoral pain syndrome (runner’s knee)
Pain around or behind the kneecap that worsens with running, stairs, and prolonged sitting is the classic presentation of patellofemoral pain syndrome. Frequently it is called ‘runner’s knee.’ It reflects increased loading of the patellofemoral joint, most commonly driven by quadriceps weakness, reduced hip and glute control, and training load errors. Despite its reputation as a chronic condition, patellofemoral pain responds well to a structured rehabilitation program combining hip and quad strengthening with load modification.
Medial tibial stress syndrome (shin splints)
Diffuse pain that can run along with the inner or outer aspect of the shin bone that develops during or after running. The key feature of medial tibial stress syndrome that differentiates it from a stress fracture is that the pain is not localised to a single point, it spans a broader area. It is an injury to the periosteum – the outer layer of the bone. Early diagnosis, intrinsic foot muscle strengthening and load management are critical. Any runner with shin pain that becomes sharp, localised, and is present at rest should be assessed urgently and referred for imaging to exclude a stress fracture.
Tibial and metatarsal stress fractures
Bone stress injuries occur when cumulative bone loading exceeds the bone’s capacity to remodel and repair. In runners, they most commonly affect the tibia, metatarsals, navicular, femur, sacrum and calcaneus. Risk factors include rapid training load increases, low bone density, inadequate caloric intake (particularly in female runners), and vitamin D deficiency. Stress fractures require accurate diagnosis, MRI is the gold standard and a structured return-to-run protocol managed in close collaboration with the athlete and their coach.
Hamstring tendinopathy
Pain at the sitting bone (ischial tuberosity) that worsens with hill running, speed work, and prolonged sitting is the characteristic presentation of proximal hamstring tendinopathy. Although it is not among the most common tendinopathies in runners it does occur, particularly in those incorporating track intervals or returning from injury too quickly. This tendinopathy requires careful load management as it is highly sensitive to compressive load, stretching the hamstring is counterproductive in the early stages.
Gluteal tendinopathy
Pain at the outer hip or buttock that is aggravated by stairs, hills, and single-leg stance activities reflects gluteal tendinopathy, a condition driven by compressive loading of the gluteal tendons at their greater trochanter insertion. It is increasingly recognised as a significant contributor to what was previously labelled ‘greater trochanteric bursitis.’ Evidence-based management focuses on load management and progressive tendon rehabilitation. Again, stretching the hip in positions that compress the tendon is contraindicated in the early stages.
Calf strains and soleus injuries
Calf strains in runners range from mild gastrocnemius strains with immediate onset pain and tenderness, to the more insidious soleus injury which develops gradually, presents with a deeper, more diffuse posterior lower leg pain that progressively worsens towards the end of a run, and is frequently misidentified as an Achilles complaint. Accurate diagnosis matters: gastrocnemius and soleus injuries have different rehabilitation timelines and different return-to-run criteria.
Ankle sprains
Lateral ankle sprains are among the most common acute injuries in runners. These typically occur on uneven terrain, traversing a gutter, trail running, or during a moment of fatigue late in a long run. Inadequately rehabilitated ankle sprains are one of the most significant and underappreciated causes of recurrent chronic ankle pain. Shannon Clinic provides thorough ankle assessment and structured graded return-to-running rehabilitation. See our ankle sprain guide for the full management approach.
Low back pain in runners
Running-related low back pain is more common than most runners expect, and is frequently dismissed as unrelated to running mechanics. In reality, hip mobility, pelvis stability, thoracic rotation, and running technique all influence lumbar loading during the gait cycle. Assessment at Shannon Clinic for running-related back pain examines the full kinetic chain, not just the spine in isolation. See our back pain chiropractor Melbourne CBD page for a full overview of our approach.
Running in Melbourne — A City That Takes It Seriously
Melbourne has one of the most active and well-organised recreational running communities in Australia. The Melbourne Marathon Festival, one of the nation’s largest draws over 30,000 participants annually across the full marathon, half marathon, and shorter distances. The Melbourne Running Festival, Run For the Kids, Run Melbourne and dozens of local parkruns and club events throughout the year sustain year-round training loads across the population.
The practical consequence of this running culture is that Melbourne sees significant volumes of training-load-driven injury, particularly in the 12–16 week lead-up to the Melbourne Marathon when weekly mileage increases most rapidly. Shannon Clinic is positioned to serve this community from our Collins Street clinic, central to the CBD and accessible from across inner and middle Melbourne.
Whether you are a first-time 5km runner dealing with your first shin pain, an experienced marathoner managing a recurring Achilles complaint, or a triathlete balancing running load alongside cycling and swimming, Shannon Clinic’s approach is the same: find the cause, build the capacity, keep you moving.
Running Shoes — What the Evidence Actually Says
Running shoe selection is one of the most discussed and most misunderstood variables in running injury prevention. The evidence on footwear and injury risk is more nuanced than most shoe marketing suggests, and more nuanced than the minimalist vs. maximalist debate that dominated a decade of running media.
Key evidence-based principles that inform our approach to footwear assessment at Shannon Clinic: foot type matters but is not the only variable; shoe weight has a measurable effect on running economy (research shows energy cost increases by approximately 1% for every additional 100 grams of shoe weight, though cushioning serves a protective function at the lower end of the weight spectrum); highly cushioned maximalist shoes can paradoxically increase impact loading in some runners by altering leg stiffness during landing; and transitions between shoe types, particularly to lower drop or minimalist shoes requires gradual adaptation to avoid calf, Achilles and metatarsal overload.
The relationship between foot strike pattern, footwear, and injury risk is covered in depth in Dr. Shannon’s peer-reviewed paper Running Medicine: A Clinician’s Overview (Chiropractic Journal of Australia, 2016). You can also read a full breakdown of the shoe weight evidence on our shoe weight and running performance post, and our guide to running shoe selection for the Melbourne Marathon.
Training Load Management — The Most Effective Injury Prevention Tool
The acute:chronic workload ratio is an evidence-supported framework for understanding and managing running injury risk. It compares the load applied in the most recent week (acute load) to the average load applied over the preceding four weeks (chronic load). Research consistently shows that ratios exceeding 1.5, that is, a runner applies 50% more load in a given week than their four-week average — are associated with significantly elevated injury risk. Conversely, maintaining a ratio between 0.8 and 1.3 keeps athletes in the ‘sweet spot’ of adaptation without excessive injury risk.
Shannon Clinic’s training load monitoring service applies these principles to runners’ actual training data. Whether runners are building toward a race or returning from injury, it helps to identify load spikes before they cause injury.
For runners preparing for the Melbourne Marathon or any other goal event, load management is not about doing less. It is about building load intelligently, progressing volume and intensity at a rate the body can adapt to, with recovery built into the program rather than treated as optional.
What a Running Injury Assessment at Shannon Clinic Involves
Every running injury patient at Shannon Clinic receives a thorough assessment that goes beyond the site of pain. Running injuries are almost never isolated to the structure that hurts. The sore structure is usually the victim of a load it was not prepared for, applied by a system that is not moving or recovering efficiently.
Assessment includes:
- Detailed running history — weekly volume, recent changes, race goals, training surface, shoe history, and any previous injuries
- Injury history and prior management — what has been tried, what worked, what didn’t, and for how long
- Load analysis — acute and chronic training volume and intensity to identify any load errors contributing to the presentation
- Clinical examination — specific orthopaedic and neurological testing of the injured structure and contributing joints
- Movement assessment — hip mobility and strength, ankle dorsiflexion range, single-leg squat control, and functional movement patterns relevant to running
- Footwear assessment — shoe type, age, and fit in the context of the runner’s foot type and injury presentation
- Imaging review and referral — if you have existing MRI or X-ray, we review it in context; if imaging is warranted we arrange referral through our Melbourne imaging networks
From assessment, we establish:
- An accurate diagnosis — what structure is injured and why
- The contributing factors — loading errors, biomechanical deficits, footwear issues, or recovery failures driving the presentation
- A treatment plan — targeted at the injury and its causes
- A return-to-running plan — structured, load-managed, and specific to your goals and timeline
Running Injury Treatment at Shannon Clinic
Treatment at Shannon Clinic is evidence-based, load-focused, and rehabilitation-driven. We do not simply reduce your running and wait. We identify what needs to change, treat what can be treated, and build the capacity that prevents the problem from recurring.
What we use:
- Chiropractic manipulation and joint mobilisation — for spinal, hip, knee, ankle, and foot joint dysfunction contributing to the injury or to aberrant movement patterns
- Progressive tendon rehabilitation — evidence-based loading protocols for Achilles, patellar, hamstring, gluteal, and plantar fascia presentations, progressing from isometric through isotonic to sport-specific loading
- Hip and glute strengthening — targeted exercise for the muscle groups most commonly deficient in runners presenting with knee, ITB, and lower limb complaints
- Soft tissue therapy — targeted treatment of the myofascial contributors to the injury, including calf, hip flexor, and iliotibial band
- Training load management — structured return-to-run planning using acute:chronic workload principles to rebuild volume and intensity safely
- Footwear guidance — evidence-based advice on shoe selection, transition timelines, and any relevant orthotic considerations
How to Find Your Melbourne Running Injury Chiropractor
Shannon Clinic is located at Suite 9.16, Level 9, 220 Collins Street, Melbourne VIC 3000 — in the Manchester Unity Building at the corner of Collins and Swanston Streets. We are centrally accessible from across the CBD and inner Melbourne.
Getting here:
- Tram: Multiple tram routes stop on Collins Street directly outside the building
- Train: Flinders Street and Melbourne Central stations are both within easy walking distance
- Parking: Wilson Parking at 222 Collins Street and secure parking at 230 Collins Street are nearby
Published Research on Running Medicine
Shannon Clinic’s approach to running injury is grounded in published evidence, not convention. Dr. Shannon’s peer-reviewed paper Running Medicine: A Clinician’s Overview published in the Chiropractic Journal of Australia (Vol. 44, No. 1, 2016). It is an open-access resource available to any clinician or patient wanting to understand the evidence base behind running injury assessment and management. It covers the most common injuries encountered in clinical practice, the mechanical and technique contributors to those injuries, and a detailed analysis of foot strike patterns and their relationship to injury risk.
This is the same evidence base that informs every running injury assessment at Shannon Clinic. It is not generic sports medicine content, it is a clinical framework developed by Dr. Shannon from practice, research, and 20 years of treating runners in Melbourne’s CBD.
Book a Running Injury Assessment in Melbourne CBD
If a running injury is keeping you off the road, limiting your training, or threatening your next race — Shannon Clinic is ready to help. Our Collins Street clinic has been managing running injuries since 2007, with a clinical approach built on sports and exercise medicine principles and genuine understanding of what runners need to get back running safely. As Melbourne’s most credentialled sports chiropractor, Dr. Shannon brings the same standard of care to recreational runners as to elite athletes.
Shannon Clinic — Suite 9.16, Level 9, 220 Collins Street, Melbourne VIC 3000