LOLZLetter 312 | Does the Treadmill Cause Running Injuries?

Feb 17, 2025

Welcome,

I'm typing away from a short trip out to Oahu. We are lucky that we can take a direct flight out of LAX (although using "lucky" and "LAX" in the same sentence is rare—LOL). Anyway, it's been a nice, short, and much-needed relaxing vacation. From Friday to Saturday, I slept for 11 hours and did nothing. It was wonderful.

It's not that the weather in the desert has been terrible, but it's been windy, cold, and even rainy for several weeks. Most of my hard efforts for the Los Angeles Marathon have been on the treadmill because of the wind. Regular wind, I can handle. But when the wind sends trashcans flying down the road and closes highways, running indoors is simply more productive (and enjoyable).

Third, thank you to everyone who has shared their stories for the running as you age series. I'm *really* going to finish going through them this week and get the series started for next week. I am waiting for a few more responses.

For those who missed it, I am bringing back the running as you age series and I'm looking for people of all ages to share their running stories. I can still use a few more people of all ages. If you are interested in being featured and sharing your story in the newsletter, send me a separate email at fueledbylolz@gmail.com.

Now, let’s get into the newsletter! Last week, I talked about running shoes and the treadmill. This week, I am discussing running injuries and the treadmill.

Seriously, does the treadmill cause running injuries?

As runners, we are always looking for the best ways to train. Many of us look for things that minimize injury risk, but there is no best way to train. I'm not going to get into it much today (because I feel like I've written a dozen posts about it), but runners use treadmills for SO MANY reasons.

Benefits of Running on a Treadmill

Weatherproof – Treadmills provide a reliable running environment regardless of extreme heat, cold, wind, or rain.
Cushioned Surface – The belt offers more shock absorption than pavement, reducing impact on joints.
Controlled Pacing – You can precisely adjust speed and incline, making it ideal for structured workouts like tempo runs, interval training, and progression runs. (A note from me—I've been able to really dial in pacing this training cycle on the treadmill.)
Reduced Injury Risk from Hazards – No need to worry about potholes, traffic, uneven surfaces, or obstacles that could cause trips or falls. You do, however, need to worry about flying off the back of a treadmill.
Convenient and Time-Efficient – Ideal for runners with tight schedules who need a quick and controlled workout.
Easier Recovery Runs – The predictable surface and consistent pace make it a great option for low-impact recovery days. If you struggle with running slower, consider using the treadmill.
Performance Tracking – Many treadmills display pace and heart rate, helping runners track progress.
Safe Night Running – Provides a secure alternative to running outside in the dark.
Trashy TV – Okay, so I do need to catch up on a couple of episodes of The Bachelor, which I can't really do when running outdoors.

LOL, I say I wasn’t going to get into…then I get into it. Anyway, while treadmill running presents unique challenges, injuries can be avoided with proper technique and awareness. Common treadmill injuries include muscle strains, falls, and repetitive stress injuries.

Are Treadmills Safer Than Outdoor Running?

Although treadmill accidents make headlines, outdoor running comes with its own risks. Runners are susceptible to injuries everywhere. Studies suggest that runners frequently experience injuries regardless of the surface they train on.

Treadmills provide a stable, predictable surface, but runners must be mindful of adjustments in stride and balance. They can easily contribute (note: contribute, not cause) to an injury.

Unique Risks of Treadmill Running

While treadmills offer consistency, they also introduce specific risks:

Ignoring Fatigue and Speed Adjustments

Runners sometimes maintain their set pace too long, even when fatigue sets in. Unlike outdoor running, where natural slowdowns occur, treadmill runners may hesitate to decrease speed, increasing the likelihood of injury. It’s very easy to keep getting faster on the treadmill, even when your body isn’t up for it. (My first stress fracture—a tibia stress fracture—came from pounding out too-fast treadmill runs day after day.)

Tip: Adjust speed when needed and don’t hesitate to lower intensity if form begins to break down.

Changes in Coordination

Unlike outdoor running, where natural scenery moves past you, treadmill running alters sensory input. The belt is helping you move forward. Sudden head movements may affect balance, increasing the risk of falls.

Tip: Keep your gaze steady and avoid abrupt head movements when running on a treadmill.

Changes in Running Form and Poor Mechanics

The treadmill can alter how you run. The continuous belt movement can encourage overstriding, leading to unnecessary stress on the knees and hips. We know by now, running with improper gait may contribute to long-term issues and make you more susceptible to certain running injuries.

Tip: Focus on landing naturally. If something feels off or weird, slow down the treadmill so you can focus on form.

Common Treadmill Injuries

One of the most common questions about treadmill running: does the treadmill cause stress fractures? The answer is it can contribute, but not cause. Generally the cause is overtraining or poor mechanics. I cannot emphasize enough that it's important to run naturally on the treadmill and to slow down the belt if running does not feel natural.

What are some common running injuries on the treadmill?

Stress Fractures – poor mechanics or altering your running form on the treadmill cause lead to using weaker parts of your body, thus leading to stress fractures.
Plantar Fasciitis – Overuse can lead to inflammation of the foot’s connective tissue.
Knee Discomfort – Overstriding and Improper stride mechanics may cause stress on the joints.
Falls and Impact Injuries – Missteps or distractions can lead to severe injuries.

Preventing Treadmill Injuries

How can runners prevent treadmill injuries? Avoiding running injuries on the treadmill requires preparation and awareness:

Start with a Warm-Up – This should be key advice for any workout but you are far less likely to strain something with a proper warm up.
Maintain Proper Form – Relax shoulders, keep arms moving naturally, and maintain an upright posture.
Modify Speed and Incline Thoughtfully – Adjust settings gradually. Do not be afraid to slow it down.
Pay Attention to Discomfort – Persistent pain is a warning sign. Rest and reassess form if discomfort lingers.
Follow Safety Guidelines – Isn’t this the key with everything? Ensure enough space behind the treadmill to prevent injury if missteps occur.

Treadmill vs. Outdoor Running: Which Is Better?

You should know by now—nothing is strictly better or worse in running. It might be better for you, but not for me. Or better for you at the time. Both indoor and outdoor running have pros and cons. Treadmills allow controlled pacing and are ideal for structured workouts, while outdoor running engages more stabilizing muscles due to varied terrain.

Conclusion

Ultimately, running injuries are often linked to training errors rather than the surface itself. There is no single “best” option in running. Whether indoors or outdoors, using proper mechanics, adjusting intensity sensibly, and prioritizing recovery can help prevent injuries. By being mindful of treadmill running habits, runners can use it effectively without increasing their injury risk.