Most injuries to runners involve a critical interplay between an individual's biomechanical predisposition and some recent change in their training programme. This may involve a rapid increase in weekly distance, intensity, or frequency of hill or track workouts. This review emphasises that a through understanding of the anatomy, pathophysiology, and predisposing biomechanical factors is essential for adequate injury treatment and prevention. As a sports medicine spedialist, it is also important to be familiar with the wider differential diagnosis for each of the common running injuries seen in a sports medicine clinic. In addition, all female runners should be questioned regarding any history of menstrual or eating dysfunction that can contribute to lowered bone mineral density and higher risk of injury. Because these injuries are related to cumulative overload of the lower extremity, they often come on insidiously and a strong index of suspicion is necessary for prompt detection. The vast majority of injuries, when identified early on, can be treated effectively with minor modifications in the training programme, correction of underlying muscle and flexibility imbalances, and attention to appropriate footwear.