Is running becoming a pain?

Running is a complicated thing. Dr Christian Barton, a well-renowned Physiotherapist who specialises in running retraining, described the total irony of learning ball or bat/ stick skills, tactical plays and foot work but never getting taught how to run as kids or adults despite being a vital part of most sports. Dr Barton presented his approach and research at the latest South Australian Sports Medicine Association conference.

Running is truly a massive coordination of muscles and movements over the whole body: Foot strike, pre-loading, loading, mid-stance, terminal stance, push off, initial swing… And that’s just the feet. So what’re the best things you can do to prevent or reduce pain when running? Unanimously, physios and evidence agrees that for most pains in the lower limb you should try increasing your cadence. More steps per minute for the same speed results in a 10-12% decrease in loading forces through your joints and muscles. Beyond this we hit some specifics.

An astounding amount of research has been done in the last five years about forefoot running and minimalist shoes. In brief, the argument is that a shoe with a thick heel (your classic, big, padded running shoe) encourages a heel strike. The heel strike can increase loading through the knee, as opposed to shock absorption in the foot itself. But! For those of us who have run most of their life and not realised there was a different way you could put your foot on the ground, I wouldn’t jump to tell you that you should now run on your toes. A mid- and fore-foot strike will undoubtedly increase the muscular demand on your calf muscles. They will help to decelerate the foot on impact and push off again at terminal stance. Each time your foot lands you’ll essentially be doing a calf-raise at several times your body weight, due to landing forces etc. Tissues generally can only adapt to a 10% increase in load weekly. I would argue that, in most populations, this may be a bit of an overload to your tissues if you went straight from a heel to a forefoot strike pattern!

What else then? Step length. Something that comes hand-in-hand with cadence. Shorter steps can make a big difference. Landing out in front of your body is a predictor of anterior shin pain and knee pain. However, cueing to “run shorter” usually feels weird and can be addressed by looking at cadence first. Further; step width, hip position and foot biomechanics can hinder people from running better. These factors (as well as those above) may be impacted by muscle length and strength capabilities.

Take away comments:

If you’re suffering from any type of leg pain with running, consult with a physio to see if increasing your step rate is your ‘Get Out of Jail Free’ card. A Physio will properly assess all areas and potential issues, creating a  plan to relieve pain and discomfort while running. 

By Suzannah Michell

Physiotherapist