Running long distances places heavy burdens on the various tissues of your lower body -- muscles, tendons, ligaments, and the fasciae and sheaths holding these elements in place. All of these come together at your joints, the areas where bones meet and leg flexion and extension occurs. As a result, your joints and the special structures they include, such as bursae and cartilage, are frequent sites of aches and pains in runners.
The Knees
The knee is the most frequently injured joint in distance runners. While iliotibial band syndrome and torn cartilage are common complaints, most runners with knee pain have incurred patellofemoral pain syndrome, colloquially called "runner's knee." This happens when the kneecap doesn't track properly as it moves back and forth over the base of the thigh bone during leg flexion and extension, wearing away cartilage over time. Treatment includes rest and ice and possibly exercises to strengthen the quadriceps muscles.
The Hips
Your hip is a ball-and-socket joint, meaning that it allows free movement not just in one plane but throughout an imaginary cone. This freedom comes at a cost, as a large number of supporting structures from both above and below are needed to preserve the hip joint's integrity and function. If your hip hurts when you run, likely culprits include pirifiormis syndrome, an impingement of the sciatic nerve in the butt area; trochanteric bursitis, an inflammation of the fluid-filled sac that serves to reduce friction in the joint; and stress fractures of the top of the femur. In most cases, rest, anti-inflammatory medications and icing will relieve the problem.
The Ankles
The ankle includes seven small bones that articulate with the two bones of the shin. Tendinitis is the most common source of ankle pain in runners. The posterior tibial tendon, peroneal tendons and Achilles tendon are all frequent sites of inflammation. Less often, ankle sprains, tenosynovitis and stress fractures send runners to the sidelines. Treating tendinitis usually includes rest, icing and anti-inflammatory drugs. Orthotic shoe inserts may help correct underlying biomechanical anomalies. Avoid running on hilly or uneven terrain if you've been experiencing ankle pain.
The Toes
Your toes and the joints connecting them to your foot proper do more work than you may realize when you run. The metatarsal bones just proximal to the metatarsophalangeal joints -- that is, the joint forming the "knuckle" of the foot -- are the most common sites of stress fractures in the body. Metatarsalgia is pain in these joints and is usually caused by abnormal weight distribution upon landing because of toe-muscle weakness. This pain is concentrated on the underside of the foot and can normally be relieved with icing the foot and getting new shoes.
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