Why Ann Arbor Runners Keep Getting the Same Injuries (And What I've Learned Treating NCAA Track Athletes)

By Dr. Tim Dehr, CCSP

Ann Arbor is a running town. Any given morning, you'll see people logging miles around Gallup Park, along the Huron River trails, through the Arboretum, or on the Border-to-Border Trail. We've got the Dexter-Ann Arbor Run, the Ann Arbor Marathon, and countless runners training for everything from 5Ks to ultras.

But if you're a runner dealing with chronic pain — whether it's your knee, your IT band, your hip, or that nagging lower back issue that flares up every time you try to increase mileage — you've probably noticed something frustrating: the same injuries keep coming back.

You rest. You ice. You do the stretches you found on YouTube. Maybe you even take a few weeks off completely. The pain goes away. Then you start running again, and within a few weeks or months, it's back. Same knee. Same hip. Same problem.

Here's what I've learned after nearly two decades treating runners — from recreational joggers to NCAA Division I track athletes — and working with elite competitors at events like the 2019 Big Ten Indoor Track & Field Championships: most running injuries aren't random bad luck. They're the result of specific mechanical problems that never got fixed.

And until those mechanical problems are addressed, the injuries will keep coming back.

The Pattern I See in My Ann Arbor Practice

When a runner comes into my office, they usually describe one of these scenarios:

Scenario 1: The Comeback Injury

They took time off for an injury. It healed. They ramped back up slowly and carefully. But the same injury returned, often in the exact same spot.

Scenario 2: The Migrating Pain

They fixed one issue (let's say runner's knee), but now something else hurts (IT band, hip flexor, plantar fasciitis). The pain keeps moving around, but it never fully goes away.

Scenario 3: The Training Ceiling

They can run 20-25 miles per week without problems, but every time they try to increase volume or intensity, something breaks down. They've hit a ceiling they can't seem to push through.

All three of these patterns point to the same root cause: the way your body is moving is creating stress somewhere, and that stress will eventually manifest as pain.

Rest doesn't fix movement dysfunction. It just gives your body time to recover from the latest breakdown. But when you start running again with the same mechanical issues, the countdown to the next injury starts immediately.

What I've Learned from Working with NCAA Track Athletes

I've had the opportunity to work with Division I and Olympic track and field athletes and at championship-level competitions, including the Big Ten Indoor Track & Field Championships. These are some of the most biomechanically efficient runners in the country, supported by world-class coaching and sports medicine teams.

But even at that level, I see the same principle play out: when something in the kinetic chain isn't working properly, the body compensates, and compensation eventually leads to injury.

Here's what makes NCAA track athletes different from recreational runners:

They have coaches watching their form. They have strength and conditioning programs. They do prehab and rehab religiously. They get regular soft tissue work, physical therapy, and chiropractic care. They take recovery seriously.

What makes recreational runners in Ann Arbor similar to NCAA athletes:

The biomechanical rules are exactly the same. If your pelvis is rotated, your hip isn't extending properly, or your foot isn't distributing force correctly, it doesn't matter if you're running a 4:30 mile or a 10-minute mile — you're going to develop compensation patterns, and those compensations will eventually cause pain.

The insight that matters most:

Elite athletes don't get hurt less because they're more talented. They get hurt less because they address mechanical issues before they become injuries. Recreational runners, on the other hand, usually only address mechanical issues after they're already in pain.

That's the gap my practice is designed to close.

The Most Common Running Injuries I Treat in Ann Arbor

1. Runner's Knee (Patellofemoral Pain Syndrome)

What it feels like:

Dull, aching pain around or behind the kneecap. Gets worse going downhill, walking down stairs, or after sitting for long periods ("movie theater sign").

What's actually causing it:

Your kneecap isn't tracking properly in its groove. This is almost never a knee problem — it's a hip problem. When your hip isn't stable or isn't extending properly during your stride, your femur (thigh bone) rotates inward, pulling the kneecap off its normal track.

What I'm looking for:

- Weak glutes (especially glute medius)

- Tight hip flexors from sitting all day

- Poor foot mechanics (overpronation)

- Pelvic misalignment or rotation

Common in:

- Runners increasing mileage too quickly

- People who sit at desks downtown all day, then run in the evening

- Runners with one leg slightly shorter than the other

- People who do most of their running on cambered roads (always tilted to one side)

2. IT Band Syndrome

What it feels like:

Sharp, burning pain on the outside of the knee, usually starting a few miles into a run. Often gets worse on downhills or when the outside foot strikes the ground.

What's actually causing it:

Your iliotibial (IT) band is a thick strip of connective tissue running from your hip to your knee on the outside of your thigh. When it gets tight and inflamed, it rubs against the bone on the outside of your knee with every stride. But here's the thing: the IT band doesn't get tight on its own. It gets tight because your hip isn't stable, so your body recruits the IT band to help stabilize your pelvis during running.

What I'm looking for:

- Weak hip abductors and glutes

- Pelvic drop on one side during running

- Tight hip flexors pulling the pelvis forward

- SI joint dysfunction or pelvic misalignment

Common in:

- Runners training for long distances (half marathons, marathons)

- Trail runners dealing with uneven terrain around Waterloo, Pinckney, or the Potawatomi Trail

- Runners who do lots of repetitive loops in one direction (track running, always running the same route)

3. Sciatica and Lower Back Pain

What it feels like:

Pain, numbness, or tingling in the lower back, glutes, or down the back of the leg. Can range from a dull ache to sharp, shooting pain that stops you mid-stride.

What's actually causing it:

The sciatic nerve is being compressed or irritated, usually at the lower back (lumbar disc issue), the SI joint, or by the piriformis muscle deep in the glute. For runners, this is almost always related to poor hip extension — when your hip doesn't extend fully during your stride, your lower back hyperextends to compensate, compressing the nerve roots.

What I'm looking for:

- Hip flexor tightness limiting hip extension

- Weak glutes failing to stabilize the pelvis

- Lumbar spine restrictions or disc issues

- SI joint dysfunction

- Tight piriformis muscle

Common in:

- Runners with desk jobs (tight hip flexors from sitting)

- People increasing weekly mileage too aggressively

- Runners with poor core strength

- Athletes doing high-volume hill training without proper pelvic stability

4. Plantar Fasciitis

What it feels like:

Sharp pain in the heel or arch of the foot, especially with the first few steps in the morning or after sitting. Often improves once you "warm up," then returns after long runs.

What's actually causing it:

The plantar fascia (connective tissue running along the bottom of your foot) is getting overstretched and inflamed. But plantar fasciitis is rarely just a foot problem. It's usually the result of poor foot mechanics, tight calves, or — most commonly — dysfunction further up the kinetic chain (hips, pelvis, lower back) that's changing how force is distributed through your foot.

What I'm looking for:

- Overpronation (foot rolling inward too much)

- Tight calves and Achilles tendon

- Pelvic misalignment affecting leg length

- Weak foot intrinsic muscles (muscles within the foot itself)

Common in:

- Runners who recently changed shoes or increased training volume

- People with flat feet or high arches

- Runners training on hard surfaces (sidewalks, asphalt)

- Athletes with tight calves from hill running or speed work

5. Hip Flexor Strains and Hip Pain

What it feels like:

Pain or tightness in the front of the hip, sometimes radiating into the groin. Often worse when lifting your knee or during the "swing phase" of running.

What's actually causing it:

Your hip flexors are working overtime to compensate for weak glutes or poor pelvic stability. Instead of your glutes driving your leg backward, your hip flexors are working excessively to pull your leg forward for the next stride.

What I'm looking for:

- Weak glutes (especially glute max)

- Anterior pelvic tilt (pelvis tilted forward)

- Poor hip extension during stride

- Tight psoas muscle from prolonged sitting

Common in:

- Runners doing lots of speed work or hill repeats

- People who sit in Ann Arbor traffic commuting from Ypsilanti, Saline, or Dexter

- Athletes increasing training intensity without addressing strength imbalances

Why Being a CCSP Matters for Runners

I'm the only Certified Chiropractic Sports Physician (CCSP) in Ann Arbor. That certification required advanced post-graduate training.

What that means for you as a runner:

I'm not just treating your knee because your knee hurts. I'm assessing how your pelvis moves. I'm checking your hip mobility, your foot mechanics, your spinal alignment. I'm looking for the mechanical dysfunction that's causing your knee to hurt.

The Mistakes I See Ann Arbor Runners Make

Mistake #1: Training Through Pain

Pain is your body's way of telling you something is wrong. Ignoring it doesn't make you tougher — it makes the problem worse. I see too many runners push through knee pain, hip pain, or back pain because they're training for a race or don't want to lose fitness.

The better approach:

Address pain early. Small mechanical issues are easy to fix. Chronic injuries that have been compensated around for months are much harder to unwind.

Mistake #2: Only Resting When Injured

Rest reduces inflammation and gives your body time to heal, but it doesn't fix mechanical dysfunction. If you rest until the pain goes away, then resume running with the same movement patterns that caused the injury, you're just starting the countdown to the next breakdown.

The better approach:

Use rest periods strategically to address the root cause. Get assessed. Fix the mechanical issue. Then return to running with better movement patterns.

Mistake #3: Increasing Mileage Too Quickly

The classic "too much, too soon" mistake. Your cardiovascular system adapts faster than your musculoskeletal system. Just because your lungs can handle 40 miles per week doesn't mean your joints, tendons, and ligaments can.

The better approach:

Follow the 10% rule (increase weekly mileage by no more than 10% per week). Build gradually. Listen to your body. If something starts to hurt, address it before it becomes a full-blown injury.

Mistake #4: Ignoring Strength Training

Running is not enough to keep you healthy for running. You need strong glutes, a stable core, and balanced hip strength to handle the repetitive impact of thousands of foot strikes per run.

The better approach:

Incorporate 2-3 strength sessions per week focusing on single-leg stability, glute activation, core strength, and hip mobility. It doesn't have to be complicated — bodyweight exercises, resistance bands, and basic weightlifting go a long way.

Mistake #5: Running on Cambered Roads

Many roads in Ann Arbor are cambered (slightly tilted) for drainage. If you're always running on the same side of the road facing traffic, one leg is perpetually hitting the ground on a downslope while the other hits on an upslope. Over time, this creates asymmetries, leg length discrepancies, and compensations that lead to injury.

The better approach:

Mix up your routes. Run on flat trails when possible (Gallup Park, Border-to-Border Trail, Barton Nature Area). If you're running on roads, vary which side you're on or do out-and-back routes so you're alternating the tilt.

Recovery Timeline: What's Realistic?

This is the question every runner asks, and the honest answer is: it depends.

Minor issues (caught early):

2-4 weeks of treatment, often with modified training allowed throughout.

Moderate injuries (present for a few months):

6-8 weeks to resolve the injury, plus another 4-6 weeks to fully rebuild strength and return to normal training volume.

Chronic issues (recurring for years):

12+ weeks to address the underlying mechanical dysfunctions, retrain movement patterns, and rebuild the strength and stability needed to keep you healthy long-term.

Factors that affect recovery:

- How long you've had the injury

- How severe the tissue damage is

- Your age and overall health

- How closely you follow the rehab plan

- Whether you're willing to modify training during recovery

I don't promise miracles or overnight fixes. I offer a systematic, evidence-based approach to identifying and correcting the root cause of your injury.

Where Ann Arbor Runners Train (And What I See)

Gallup Park and Geddes Pond Loop

Beautiful flat, paved loop. Great for easy runs and long runs. Watch out for: cambered sections along the road portions, crowded on weekends.

Common injuries I see from Gallup runners: IT band issues from always running the loop in the same direction, knee pain from high volume on hard surfaces.

Huron River Trail / Border-to-Border Trail

Mostly flat, crushed limestone trail. Softer surface than pavement. Great for runners recovering from impact-related injuries.

Common injuries I see: Hip flexor tightness from uneven trail surfaces, occasional ankle sprains from roots/rocks.

The Arboretum and Nichols Arboretum

Hilly, beautiful trails with varied terrain. Great for building strength, but challenging on the joints if you're not prepared.

Common injuries I see: Sciatica and lower back pain from steep hills stressing the lumbar spine, knee pain from downhill running.

Barton Nature Area / Bandemer Park

Trails with moderate elevation. Mix of dirt and grass. Softer surface, better for joints.

Common injuries I see: Ankle instability from uneven terrain, IT band issues from hill training.

Roads and Neighborhoods (Burns Park, Old West Side, Kerrytown)

Paved roads, cambered for drainage. Convenient for quick neighborhood runs.

Common injuries I see: Runner's knee and IT band issues from cambered roads creating leg-length discrepancies.

When to Call My Office

You should schedule an evaluation if:

- You've been dealing with pain for more than 2 weeks

- The same injury keeps coming back

- Pain is preventing you from training

- You've tried rest and it's not helping

- You want to prevent injuries before they happen

- You're training for a race and need to stay healthy

- You've hit a training ceiling you can't push through

Who I Work With in Ann Arbor

I treat runners at all levels:

NCAA Division I track and field athletes

High school cross country and track runners

Recreational runners training for 5Ks, 10Ks, half marathons, marathons

Trail runners tackling Potawatomi, Waterloo, and Pinckney trails

Ultra runners training for 50Ks, 50-milers, and 100-milers

Casual joggers just trying to stay active without pain

People getting ready to run their first 5k

The common thread: Everyone benefits from proper biomechanical assessment and treatment that addresses the root cause, not just the symptoms.

Schedule Appointment in Ann Arbor

Whether you're training for the Ann Arbor Marathon, trying to stay healthy for weekly long runs around Gallup Park, or just tired of the same injuries coming back every season, I can help.

Call (734) 929-4523 or [schedule online]

Performance Health Chiropractic

2330 E Stadium Blvd #3

Ann Arbor, MI 48104

Hours:

Monday – Thursday: 9:00 AM – 1:00 PM, 3:00 PM – 6:00 PM

Friday – Sunday: Closed

Related Articles:

- [Sciatica Treatment in Ann Arbor]

- [Sports Rehabilitation]

- [Lower Back Pain Treatment]

About the Author:

Dr. Tim Dehr is a Certified Chiropractic Sports Physician (CCSP) and the only CCSP practicing in Ann Arbor, Michigan. He has nearly two decades of experience treating musculoskeletal conditions in athletes and active individuals. Dr. Dehr has worked with NCAA Division I track and field athletes and provided chiropractic care at championship-level competitions, including the Big Ten Indoor Track & Field Championships.

Disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice. Running injuries can have multiple causes, and proper diagnosis is essential for effective treatment. If you're experiencing severe pain, swelling, or inability to bear weight, seek immediate medical attention.