Most running injuries are not bad luck. They are load that went up faster than the tissue could adapt. I find where that happened, treat it, and build the capacity to get your mileage back without the same injury coming back with it.
Free ConsultationRunning physical therapy is rehab and injury prevention built around the demands of running: the miles, the pace, the surface, and the calf and hip capacity it takes to absorb thousands of landings. At Fortitude & Freedom Performance Therapy in Waukee, Iowa, Jake Pawol, PT, DPT, OCS treats runner's knee, shin splints, Achilles pain, IT band pain, and plantar fasciitis one on one in a fully equipped gym, and tests you at running loads rather than on a table. Iowa allows direct access, so no physician referral is required.
Most runners who come in have already tried rest. Two weeks off, the pain goes quiet, the first long run back, and it is there again by mile four. Rest lowered the load. It did nothing to raise what the tissue can take.
Running injuries come from a gap between the load and the capacity. The load went up: a new training block, a faster pace, more hills, a race on the calendar. The calf, the hip, or the tendon was not ready for it. That gap is the injury, and the sore spot is only where it shows up.
So I treat both sides. We bring the load down to a level the tissue tolerates, which is usually not zero. Then we build the capacity with strength work in the gym, and bring your miles back in a shape that holds.
Each of these has its own pattern, and each one usually traces back to the same question: what changed in your training before it started?
Pain around or behind the kneecap that shows up on hills, stairs, or the second half of a long run. It is the most common running injury I see.
The fix is rarely the knee itself. It is quad and hip strength, plus a short-term change to the load the knee sees, so you can keep running while the strength comes up.
Pain along the inside of the shin that starts early in a run, often after a jump in mileage. Left alone, it can become a bone stress injury.
I screen for that first. Then the work is calf and foot capacity, plus a mileage plan that rises slower than the one that caused it.
Morning stiffness in the Achilles, or a calf that tightens up in every run. The calf does more work per stride than almost any other muscle, so it is often the first thing to fail.
Tendons respond to slow, heavy loading. That is what the plan is built on.
Pain on the outside of the knee or the hip that arrives at the same point in every run. Foam rolling the IT band feels like work but rarely changes it.
The useful work is hip strength and control, so the leg holds its line late in a run when you are tired.
Heel pain on the first steps of the morning that eases as you warm up, then comes back after a run.
I treat the chain: calf, ankle range, and foot strength, with a loading plan that lets most runners keep some miles while it settles.
A marathon or half marathon build is where small aches turn into injuries, because the mileage climbs every week.
If you have the Des Moines Marathon or a spring half on the calendar, we plan the rehab around your build so race day stays on the table.
One on one with me for the full session, in a gym with the equipment to test and load what we are talking about.
We start with what changed: mileage, pace, shoes, surface, and race dates. Then I test strength, calf capacity, and single leg control, and watch you run.
Manual therapy and dry needling are used when they calm a sore area down enough to load it. They are never the whole session.
Every session includes strength work for the calf, the hip, and the trunk. Capacity is what keeps the injury from coming back.
You leave with a plan for this week's running, not only your exercises. We change the plan as the numbers improve.
Road, trail, and HYROX runners from around Waukee train the same way you do, and the plan fits your season.
Usually not. Most running injuries tolerate some running, and finding that level is part of the first session. Full rest makes the pain go quiet, but it also takes away the fitness and the tissue capacity you need when you come back. I would rather change your runs than cancel them.
Runner's knee, shin splints, Achilles pain, IT band pain, and plantar fasciitis make up most of what I see. Nearly all of them start after a change in training, such as more miles, more speed, or more hills, that went up faster than the tissue could adapt.
Yes. I watch you run as part of the evaluation, and I look at what changes when you are tired, because that is when most injuries show up. Gait is one piece of the picture. Strength and training load usually matter more, so the analysis always comes with a plan for both.
Yes. If you have a race date, we plan the rehab or the prehab around your training block. The goal is to get you to the start line healthy, with the mileage and the strength to finish the race.
No. Iowa has had unrestricted direct access to physical therapy since 1988. You can book without seeing a physician first. Call or use the contact page and our team will get you scheduled.
Yes, in many cases. Fortitude & Freedom is a hybrid practice. We accept Blue Cross Blue Shield and TRICARE, and we offer a cash option for everyone else. Either way you get the full session with me. Use the contact page and our team will confirm your coverage before you book anything.
This content is for general education and is not medical advice. It does not replace an evaluation by a licensed clinician, and reading it does not create a patient relationship. Talk to a qualified health professional about your own symptoms before you act on anything here. If you have severe, sudden, or worsening symptoms, seek medical care right away.
Book a one-on-one evaluation in Waukee and find out what is driving the pain, and how much running you can keep while it heals.
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