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Common Treadmill Injuries vs Running Outside

Are treadmill injuries worse or more common than ones earned from running outside? As winter approaches, we tend to get this question a lot. Below, our experts unveil some of the most common treadmill injuries, how they compare to injuries from running outside and how to keep your body safe either way.

Common Treadmill Injuries

Are you at risk for treadmill injuries? You might be. For runners, avoiding injury is top priority. Not only does getting hurt cut back on how much time you get to spend working on your fitness goals, it’s also painful, frustrating and can be costly.

For many runners, it’s hard to beat the feeling of lacing up and hitting the pavement on a gorgeous day. However, with winter approaching, more runners will be logging miles on the treadmill. Hey, that’s what they’re for: those cold, rainy, snowy days.

But, just how dangerous are these machines compared to a sidewalk or running path?

In general, more than 400,000 Americans are treated in an average year for injuries related to exercise equipment. According to data from the Consumer Product Safety Commission, treadmills cause more accidents than any other piece of exercise equipment. In fact, they reported over 24,400 treadmill injuries treated in hospital emergency rooms in the year 2014 (the last year data was released). They listed slips, sprains and strains from slips and strains as the most common treadmill injuries.

Don’t let these stats scare you from staying on course.

Benefits of Running on the Treadmill


Training on the treadmill has its benefits. It provides a controlled environment where runners can control their pace, incline settings and even add in specific interval and recovery training programs. Studies show that setting the treadmill to a 1-2% grade simulates outdoor running and reflects similar energy output. Plus, with a cushioned belt, it can be more forgiving than running on the hard pavement outside.

Preventing Treadmill Injuries

Knee pain, patellofemoral pain and achilles tendon injuries are some of the most common injuries sustained from running on the treadmill.

Patellofemoral pain is typically a result from an increased load between your femur and kneecap. Achilles tendon injuries are often a result of overuse and can be an ongoing issue for many runners. If left untreated, both injuries can result in instability and chronic pain.

So, when you’re ready to run, take these precautionary measures to safeguard yourself from injury.

  • Cold muscles lack flexibility and blood flow, so warm up with stretches and range of motion exercises before hitting start on the treadmill.
  • Cool down with two to five minutes at a slower speed after your run.
  • Check your posture while you run. Keep your shoulders pulled down and arms relaxed (never text and run). Do not lean forward and hold on to the bar at the front which can cause stumbling.
  • Progress distance and intensity gradually. A good rule of thumb is not to increase your weekly mileage by more than 10 percent each week.
  • Vary speed and incline degrees occasionally to reduce the chances of an overuse injury.
  • Wear proper shoes designed for running that have adequate shock. Typically, running shoes should be replaced after being worn 300-500 miles.
  • Listen to your body. Know your limits and use common sense.

Safety experts at Consumer Reports also share some simple, yet important precautions for those running on a treadmill at home. “It’s not a good idea to position a treadmill right up against a wall, because if you fall and the treadmill belt continues to turn, you’ll get wedged in between the wall and the treadmill. What you need are a couple of feet on either side of the treadmill and then at least 6 feet behind it, so if you do fall, there’s a space for you to escape.”

Consumer Reports also recommends the following safety tips:

  • Straddle the treadmill belt until it starts so that you don’t get knocked off your feet.
  • Looking down at your feet can throw you off balance, so keep your head up while you’re moving.
  • Always use the safety clip. It attaches to your workout clothes and if you should fall, the string pulls out the safety key, which will stop the moving belt.
  • When you’re done running, wait until the belt comes to a complete stop before stepping off.

Treadmill Injuries vs Running Outside

treadmill injuriesNeed to soak up some vitamin D and get some fresh air? We totally understand. Research shows that running outside can deliver a greater energy boost, which results in less tension, anger, and depression than running inside. We get it, running outside is just more entertaining.

Some studies show that runners experience more muscle activation outside because the body has to react to the ground in different ways. Running outside requires you to call on additional muscles, because you’re not running in a linear pattern (one foot in front of the other). Outdoor running has obstacles, for example, imagine hopping over tree roots, changing pace according to traffic patterns or dodging people on the trails.

But, running outdoors doesn’t come without risk, either.

With environmental factors to consider, outside runners need to watch out for trip or slip hazards such as wet leaves, snow and ice. Because of that, those who run outside need to be smart about how they train. Runners benefit from adding in specific strength, mobility and flexibility exercises to supplement their training. When it comes to surface, cement tends to be less forgiving than asphalt and downhill is harder on the knees compared to uphill (but uphill can be harder on the achilles).

Whether on the treadmill or outside, we often see workout-related injuries due to two main reasons. First is poor posture throughout the day, which weakens the musculoskeletal structure. The second is attempting to do too much too fast, which is common with New Years resolutioners.

In both cases, one of the most common injuries suffered by treadmill runners and outside running is Runner’s Knee.

The bottom line?

There is no right or wrong answer. Science aside, it’s up to you. But, prevention is key.

Sure, treadmill injuries are common, but any sport comes with risk. Whether you’re new to running, preparing for your third marathon, or fighting back from an injury, running remains a great option to keep your body healthy and fit. With a good mix of both running on the treadmill and outside, you can still engage in a safe running regimen.

In the end, figure out what options work best for your training schedule and your body. And then, progress patiently. If you do too much, too soon, you could face injuries that will only set you back in the long run (pun intended).

Treatment for Treadmill Injuries at Twin Boro Physical Therapy

If you live in New Jersey and have questions about running on a treadmill or running outside, Twin Boro Physical Therapy is here to help. Don’t run through pain. If you’re suffering from a running-related or treadmill injury, get the attention you need. Our professional therapists provide personalized treatment and hands-on therapy to not only help you reduce pain and recover, but also provide patient education to help you prevent future running injuries.

In addition, as movement experts our physical therapists can evaluate your running mechanics, strength, range of motion, motor control, and balance.

We have 27 convenient Twin Boro Physical Therapy locations throughout New Jersey. Each location uses our proprietary One2Four advanced physical therapy technique that helps us identify an individualized path for patients. We’ll get you back on your feet and running in no time! Read more about our One2Four approach >>

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Why Choose Twin Boro Physical Therapy

Having won a Best in NJ Readers’ Choice in Physical Therapy recognition, Twin Boro has provided NJ residents with high quality physical therapy and rehab for over 38 years! It’s our award-winning approach, proven results and reputation that sets us apart. By incorporating the One2Four program into each patient’s program, the latest and most reliable scientific research and techniques is incorporated into effective evidence-based practice, we deliver only the highest standard of care with the unique One2Four approach.

It’s no surprise that Twin Boro Physical Therapy has also been voted the best physical therapy practice in New Jersey by the readers of mycentraljersey.com.

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