Why do I feel pain when I run? How do I stop my running from hurting? Should I stop running if it hurts?
These are all questions we get in clinic each and every week, and its important to address these questions effectively. We all know running is great to optimise our health and prevent pain, but it must be done well.
Running is a great exercise not only for cardiovascular fitness but also because it requires minimal equipment, can be a social or a great way to unwind and is easy to track improvement. There are many community running events such as the 5km Parkrun that are great goals to aim towards when starting your running journey. See https://www.parkrun.com.au/
You may be an avid walker and want to delve into running; although they may seem like similar movements, running requires greater range of movement, greater muscle strength and greater balance. To be ready to run in this article we will talk about specific mobility and strength required for running and explain a few ways how to check these things!
Please take into consideration there are many other factors that may determine whether you are ready to run and if in doubt seek further medical advice!
Your checklist:
[MOBILITY]
Can your joints move far enough? Test these at home before you embark on your running journey!!
Hip extension of over 15 degrees
HIP EXTENSION
During running we require greater hip extension, movement through the ankle and movement through the big toe.
The hip extension we require is at least 15 degrees; you can test this by standing up straight in the mirror- stand on one leg and bring the other behind you. Try not to twist your torso or lean forward.
If it is less than 15 degrees the main culprit is likely to be your hip flexors. This group of muscles get tight when sitting down for long periods.
Try this stretch to stretch out your hip flexors- the aim is to increase your hip extension!
Hip Flexor Stretch - https://www.youtube.com/watch?v=cjOWkVF2reo
Emily has added her arms over her head and is leaning away from the hip she is stretching
ANKLE DORSIFLEXION
The movement of your foot back towards your body is called dorsiflexion and the movement is important in being able to get your foot far enough behind you when you run and force distribution.
To test your dorsiflexion we use the knee to wall test. Stand facing a wall with one of your knees touching- try to shuffle back the foot and see how far you can get whilst maintaining the knee on the wall. There should be at least 5cm between your foot and wall, ideally greater than 10cm is ideal for the ankle movement required for running. When your knee to wall is below 10cm it is often caused by tight calf muscles. To work on improving your knee to wall try these stretches for your calves.
L: knee to wall test R: calf stretch
HALLUX (BIG TOE) EXTENSION
Your big toe is important for propelling your body forward during running and must have satisfactory movement. If it has limited movement your foot may turn excessively inward or outward during running and potentially cause injuries such as shin splints or knee issues. To test this keep your foot on the ground and lift up your big toe- there should be at least 30 degrees of movement here. To increase the movement you will need to work on the connective tissue at the bottom of your feet. You may do this by pressing on tight spots on your feet or rolling your foot on a spikey ball.
L: Big toe extension of over 30 degrees R: Rolling plantar fascia with a spikey ball
[STRENGTH]
Are your muscles strong enough? Do they have enough endurance to sustain good running form for the ENTIRE run…not just the first 5 minutes? Test these at home before you embark on your running journey!!
Running involves a single leg gait so it is crucial that you have strong pelvic stabilising muscles to keep the pelvis steady when running. If the pelvis is unsteady during running it may manifest in other lower limb injuries such as shin splints.
A great exercise is resisted glute clams- you should aim to be able to complete 25 reps both sides.
The hip extension mentioned previously is important in the running gait. Our gluteus maximus muscle is our most powerful hip extensor and may be strengthened to increase the power or our stride.
A great exercise for this is glute bridges- you should be able to complete 25 reps.
https://www.verywellfit.com/how-to-do-the-bridge-exercise-3120738
Our calf muscles are important as when we are running 3-8 times your body weight is being absorbed by your musculoskeletal system and the calf complex is the first point of contact. If our calf muscles aren’t strong enough to manage this force they become tight and there is a higher risk of achilles injuries.
Ideally you should be able to do 25 single calf raises on each leg.
READY TO RUN CHECKLIST
Hip extension at least 15 degrees both sides
Knee to wall at least 10cm both sides
Big toe extension at least 30 degrees both sides
25 resisted glute clams both sides
25 glute bridges
25 single leg calf raises both sides.
IS IT SAFE FOR ME TO RUN? A friendly reminder to avoid going from “zero to hero”
Even with all of the above in place, the body needs “perfect practice” at keeping form. We also want to carefully introduce load to protect your ligaments and bones from going straight into a new and intense exercise. Ultimately, we want to prevent you from needing us!
If you are new to running, we’d strongly encourage you to slowly build up your loading and distance by using a couch to 5km app, the links are below. It keeps track of you running in intervals, so that you keep form and slowly build up your kilometres!
Apple: https://apps.apple.com/au/app/couch-to-5k-run-training/id448474423
Android: https://play.google.com/store/apps/details/?id=com.active.aps.c25k
WHAT DO I DO IF RUNNING IS STILL PAINFUL?
All of the above advice is general in nature. If you have had an injury, are struggling with any of the checklist or need further guidance with exercises and stretching you should contact your health professional. As osteopaths, we look at the whole body and may be able to help address other musculoskeletal issues that are preventing you from running at your optimum.
Author: Dr Emily Nelson, Osteopath
Summit Osteopathy 2021