When we think about running related injuries, it is easy to think about the obvious contributors; recent increase in training or change in load, deficits in strength or decreased capacity. What is not as often considered or often overlooked is psychosocial factors.

What is a psychosocial factor?

Psychosocial factors are factors relating to the interrelation of social factors and individual thought and behaviour. This can include mental health, fear avoidance, fear of change, the all or nothing approach and differing beliefs on what an injury may be and how to treat it.

Differing beliefs held by runners may lead to training errors. “Sleep is for the weak” may lead to under-valuing recovery and rest. “Go hard or go home” may over value high intensity training.

What is telling is a study involving over 1000 runners which found that nearly half had an injury and 86% of those injured continued to run despite it causing pain. This indicates that most runners run for a multitude of reasons, some being so important that they are willing to run with pain.

We see this all the time at CSSM especially during COVID. People use running as a way to “clear their head” or “get out of the house.” Asking someone to stop running is not always a viable option (nor correct treatment depending on the injury). We need to consider what the consequences of not running are. If someone is using running as a stress relieving tool or for management for their mental health, it is extremely important to consider the effects of removing running altogether and what alternative options there are to help decrease the impact on the person.

Education needs to be communicated around taking positive steps to manage stress and mood, planning sleep, rest and recovery, eating a balanced diet and limiting alcohol consumption, having a good support and monitoring wellbeing.

Positive thoughts around injury should also not be underestimated either. Ardern et al (2012) found positive psychological responses including motivation, confidence and low fear were associated with a greater likelihood of returning to the pre-injury level of participation and returning to sport more quickly. This is precisely why education when treating a runner is so important. Helping a runner understand their injury helps them understand their treatment. This will create better treatment compliance and have better patient-centered outcomes!

So what does this mean for you and your running-related injury?

1. Do not be afraid of seeing a practitioner about your pain. In most cases, we do not want to stop you running all together-just optimise your load.

2. Emotional recovery is very important. Reflect on your management of acute stress. Could it be improved with some breathing and relaxation techniques? What about long-term strategies? What is your work/ life balance? Is there a role for psychology or counselling?

3. Plan for recovery! Plan recovery days, recovery weeks, tapering prior to a race and periodisation meaning plan your months to include training, tapering, competition, recovery and strength and conditioning.

4. Optimise your sleep: athletes need 9-10 hours of sleep a night. Develop a sleep routine, avoid caffeine and alcohol before bed, create a comfortable sleeping environment.

5. Improve your diet: eat to refuel and recover! Is there a role for a nutritionist/ dietitian in your life?

If you’d like to know more about psychosocial factors and how it can affect your running, contact team CSSM.

About the author

CSSM podiatrist Alicia Schifferle firmly believes that healthy feet equal a healthy life. As a podiatrist, she has an understanding of the vast range of musculoskeletal injuries that occur in the foot and leg as well as the most appropriate and effective treatment approaches for each individual patient. By assessing the cause of pain and designing a treatment plan to prevent future problems, Alicia is motivated to improve every patients’ quality of life.

When not at CSSM, Alicia works in Monash Health, in an acute podiatry setting with a clinical focus on wound assessment and treatment as well as managing lower limb diabetic complications.

Whilst knowledgeable in all types of podiatric care, Alicia has a particular interest in sport-related injuries and the relationship between foot mechanics and performance or injury.


Ardern, C. L., Taylor, N. F., Feller, J. A., & Webster, K. E. (2012). Fear of re-injury in people who have returned to sport following anterior cruciate ligament reconstruction surgery. Journal of Science and Medicine in Sport, 15(6), 488-495.

Linton, L., & Valentin, S. (2018). Running with injury: A study of UK novice and recreational runners and factors associated with running related injury. Journal of science and medicine in sport, 21(12) 1221-1225. The Running Physio: Running Injuries | RunningPhysio (running-physio.com)