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Decreasing Running Pain: 3 Key Factors


With many New Years’ resolutions geared toward improving one’s overall health, many individuals will turn toward a classic fitness activity, running. Achieving higher levels of health and fitness can be fun, while also providing a sense of achievement for all ages and skill levels. However, pain and dysfunction may occur due to several factors including: poor mechanics, deconditioning, and foot structure.

Running Mechanics

The honest answer to the question of “what are proper running mechanics?” is, “it depends.” This can be a frustrating answer, but think about all possible variations of the human anatomy. For example, tall and short people will have drastically different mechanical leverages at any given joint; this holds true for pronated and supinated foot structures as well. Depending on the body, there will be different running mechanics; however, stabilization patterns for proper positioning, remain relatively consistent between different body types. Stabilization is created by the soft tissue structures of the body (i.e. muscle, ligaments, tendons, fascia, cartilage and the nervous system) and may require mild modifications for different individuals.

Two simple mechanical changes that any runner can make to their form include: landing with the foot underneath the body and adding a slight forward lean (~6°) of the torso in relation to the lower extremities – the legs. These two simple modifications can make a huge difference for many runners! In an article published in the Journal of Bone and Joint Surgery, a team of orthopedic specialists concluded that in order to be efficient, we must learn to “move our center of mass through space, along a path requiring the least expenditure of energy.”[1] The importance of this article is its indication that there may be many different mechanical solutions to improve one’s running capabilities.

These two strategies noted above are not solely focused on improving time, but more so on reducing pain; thereby increasing the longevity and enjoyment of running. The advantage of these two alterations is in returning maximum potential energy created throughout the gait cycle. Implementing these mechanics decreases the metabolic cost of muscle activity, which in turn improves the speed and longevity of each running event. Do not be alarmed if your cadence (steps/minute) changes as a result of modifying your gait pattern. The truth is, there is no set cadence optimal for everyone. There are many elite level runners with varying cadences. According to Thomas Michaud, the average recreational runner has a cadence of 175 steps/minute, which is below the commonly advised steps/minute of 180.[2]


With the hope of a new-and-improved-self, many individuals will hit the pavement by throwing on a new pair of Saucony, Asics, or New Balance, and going full throttle. Although this idea sounds wonderful, many individuals should instead ease into a new running regimen. We have all heard of success stories where so-and-so jumped right in and achieved their goals in no time, but these stories are few-and-far-between. I would urge any new or novice runner to slowly increase mileage, while saving some energy and confidence for the next run. The simple rule: “you can always add more,” holds true. If injury occurs, many will stop and say running is “not for them”, and their goals are lost before they ever had an adequate chance to achieve them.

Research indicates that with different body physiques and structural alignments, people will respond to the physical demands of running differently. It does not mean that if you hit the ground running, you absolutely will injure yourself. It indicates that people who have been largely sedentary will sustain a higher prevalence of injuries. To avoid this, increase your mileage per run and per week at a steady pace; keeping you wanting more in addition to minimizing the insult to any deconditioned tissue structures. Also, I recommend keeping a log of the miles you run per week. This is important in identifying the miles per week threshold of the onset of pain or discomfort. The first general plateau, comparing miles per week to injury rates, is roughly 19 miles per week. However, there are certain individuals with specific foot structures that will have pain occurring at far less mileage per week.

Foot Structure

The most common foot structure seen with a lower mileage plateau is the “pronated or flat foot,” specifically very low-arched individuals.[3] Flat-footed individuals typically present with different types of pain and injury rates compared to normal- or high-arched individuals.[4,5] A common myth associated with flat-footed individuals, is that they more commonly experience plantar fasciitis, caused by their foot’s increased range of motion. However, plantar fasciitis is seen more frequently in high-arched individuals. High-arched individuals have the highest dysfunction and pain rates second to flat-footed individuals. It is not the increased range of motion that leads to pain, as Michaud points out, but the speed at which the foot pronates.[2]

There are many simple exercises to help increase the strength of foot musculature; their objective is to stabilize the transverse and medial arches, while slowing the speed of pronation through the midfoot. One example of these simple exercises is to place a towel around the sole of your foot and then apply pressure into the towel, pushing your toes and inner foot into the towel. Often, these types of exercises will strengthen the superficial musculature of the foot, but ignore the deeper, more neurologically forgotten (and arguably more important) muscles of the foot – the intrinsic foot muscles.

Achieving Higher Function

To achieve a higher level of knowledge and proficiency in stabilizing your intrinsic foot musculature, I advise you to seek out a Dynamic Neuromuscular Stabilization (DNS) practitioner. These healthcare providers understand and appreciate the deeper, ingrained paradigm between mobilization and stabilization movement patterns seen with the human body, and will take ample time out of each visit to achieve a higher level of function. Here at ICT Muscle & Joint Clinic, our staff is trained in and utilizes DNS principles and exercises daily! If you are an individual experiencing foot pain, or any other joint pain due to running, call us today! We look forward to meeting with you and helping obtain your goal of pain reduction and elimination, while more importantly achieving a higher level of function!



1 Saunders JB, Inman VT, Eberhart HT. The major determinants in normal and pathological gait. J Bone Joint Surg. 1953; 5813:153.
2 Michaud T. Injury-Free Running: How to Build Strength, Improve Form, and Treat/Prevent Injuries. 2013
3 Nielsen R, Buist I, Parner E, et al. Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1-year prospective cohort study. Br J Sports Med. Published online June 13, 2013 as 10.1136/bjsports-2013-092202
4 Williams D, McClay I. Measurements used to characterize the foot and the medial longitudinal arch: reliability and validity. Phys Ther. 2000;80:864-871
5 Williams D, McClay I, Hamill J. Arch structure and injury patterns in runners. Clin Biomech. 2001;16:341-347

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