Is My Running Form Causing Issues?

While exercise is typically recommended for preventing and healing injuries – increasing strength and flexibility and reducing inflammation – running with bad form can create orthopedic issues and worsen existing injuries.

Good Form Involves the Whole Body

Running is a whole-body exercise, not just leg movement. Jonathan Buchanan, MD, Avera Orthopedics, stresses the importance of this whole-body perspective in identifying problems with form and adjusting.

“People think that running is just using your feet, swinging your legs back and forth and going from one foot to the next, but when running uphill, downhill, and running on different surfaces, you need to engage your core. You need to engage your glutes,” said Buchanan.

There is a lot of debate about whether there should be a heel strike with every stride or whether it’s better for runners to run on their toes or their midfoot. Buchanan said good form has more to do with how much runners engage the muscles in their feet. The more those muscles are used in navigating the ground, the less pressure is experienced through the rest of the body.

Identifying Mistakes That Lead to Injury

Common mistakes in form include:

• Heel striking, which is landing on the heel first when running, putting extra stress on the knees and lower legs.
• Overstriding, which is when a runner’s foot lands too far in front of their hips and increases the impact on a runner’s back, knees and hips.
• Poor posture, such as hunching over or running too rigidly upright, which can harm the back.

The alignment of a runner’s knees can indicate good form or suggest trouble is afoot.

If a runner’s glutes are weak, their knees will drop in, causing their feet to land awkwardly, which causes a lot of stress to their knees and their glutes, according to Buchanan.

Issues Runners See

Back and knee problems are some of the most common injuries caused by poor running form. One knee injury seen often in running is iliotibial (IT) band tendinitis. The IT band attaches to the side of the knee bone, and when a runner with bad form drops their knee, the IT band gets stretched.

“If your pelvis drops to one side or the other, and you find that your knees cross over – if your knees are going in, and they’re not straight ahead of you – that causes a lot of stress to the low back,” said Buchanan.

Common issues include:

• Runner’s knee
• Shin splints
• IT band tendinitis
• Plantar fasciitis

Improving Your Running Form

Buchanan’s top recommendation for an improved running form is counterintuitive for many runners – strength training.

“Many runners don’t like getting bulky. They don’t want to have to carry more weight around as they run because they feel like it slows them down,” said Buchanan.

What’s good for the glutes is good for the canter – Buchanan recommends all his runners do a glute-strengthening program, focusing specifically on the gluteus medius, which is the rotational glute on the outside of the hip that stabilizes the pelvis and helps the leg to move sideways away from the body.

“Bust out the ‘Buns of Steel’ videos from Jane Fonda,” Buchanan said.

Strength training can help resolve poor posture while running as well.

Reducing the amount of cushioning in running shoes can also lead to better running form as it results in greater use of muscles in the feet and less pressure in the rest of the body. Buchanan advocates for running with bare feet or minimal footwear — something he practices himself.

How Do You Know if You're Causing Yourself Problems?

Runners concerned about their form are encouraged to consult an orthopedic specialist for any ongoing symptoms. From there, they may be referred to a physical therapist. Avera offers direct access to physical therapy, though insurance may require a physician’s order and referral. Buchanan recommends seeking physical therapists who are runners themselves and have a good understanding of the process of running.

Avera Human Performance Center in Sioux Falls has a biomechanics lab that analyzes running form. Runners can schedule a running analysis to receive feedback.