What’s Really Causing Your Running Injuries

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Long-distance running is the perfect activity to reveal your muscle imbalances. As your mileage increases, problematic patterns become more evident, as does the likelihood of injury. If you want your body to be able to withstand the force from all the pavement you’ve been pounding, it’s imperative that all muscle groups are working together efficiently. The trick is to discover your body’s hidden muscle imbalances and head them off before they take you down. 

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The first point of contact when running is typically the heel of the foot. Ideally, you want to land on your midfoot (heel with forefoot). If there is a large amount of force through the heel that is unable to be evenly distributed, certain muscle groups will absorb that force. Over time, this can lead to injury. 

Proper muscle balance is important for maintaining a vertical distribution of weight transfer during running, meaning alignment from the foot, shin, and knee is as straight (straight leg or proper alignment) as possible. That translates to no knee caving in, over-pronation, or hip drop.

If you find yourself landing hard on your heel, try these exercises.

Hip Flexor Release

  • Lying on your stomach, place a lacrosse ball just below your hip bone. 
  • Put as much weight as you can onto the lacrosse ball.
  • Bend the knee on the side of the release back to a 90-degree angle. 
  • Swing your leg side to side in a tolerable range of motion. 
  • Repeat this in 30 second– to two-minute intervals.
  • Muscles released: Iliopsoas.

Vastus Lateralis Release

  • Lying on the side you want to release, place foam roller under your bottom leg halfway between your hip and knee.
  • Slide your leg up and down along the foam roller, moving it from the top of the knee to the base of the hip. Try to work over the more tender areas as much as you can tolerate.
  • Repeat in 30-second intervals for two minutes.
  • To focus on a specific area of the IT band, locate the most tender area with the foam roller and stop. Bend your knee at a 90-degree angle, and then straighten. 
  • Repeat motion of bending and straightening knee for 10–15 seconds. 
  • Muscles released: Vastus lateralis.

Kegel Ball Squeezes

  • Lie on your back with your knees bent and your feet flat on the ground. 
  • Place a small medicine ball in between your knees, with your back flat the entire time.
  • Contract your pelvic floor muscles, or Kegels, and squeeze the ball, holding for five seconds. 
  • Repeat. 
  • Here are some variations:
    • With Bridge
      • Complete steps 1–3.
      • Raise your hips off of the table by pushing up through your heels. Your butt should no longer be on the table.
      • Hold for five seconds. Repeat.
    • With Knees to Chest
      • Complete steps 1–3.
      • Bring your knees to chest in a slow and controlled motion so your feet are off of the table.
  • Target Muscles: Rectus Abdominis, Pelvic Floor, Hip Adductors, Transverse Abdominus.

Inner Quad Squats

  • Place feet shoulder-width apart with your toes pointed out at a 45-degree angle and weight placed on your heels. 
  • As you begin to squat, bring your hips back like you are sitting in a chair that is too far behind you.
  • While squatting, try to move your knees out. 
  • Shift balance to the balls of your feet. 
  • Go as low as possible, then push back up through your heels. 
  • Repeat. 
  • Muscles being worked: hip adductors, gluteus maximus, vastus medialis.

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As you propel yourself forward, it is important that your posterior chain is working properly. This includes your calf muscles, hamstrings, glutes, and lats. Over the course of a run, especially a longer-distance run, muscles will begin to fatigue and shut down. 

If the muscles mentioned above are not working efficiently and in a balanced manner, it can cause the runner to shift their weight forward. This shift in weight places additional and undue stress on the front side of the body resulting in ankle, knee, back, and hip pain. The lack of work from your posterior chain also means the foot and ankle have to pick up the extra slack and you’ll see injuries like Achilles tendonitis and plantar fasciitis.

To avoid these injuries you can get your posterior chain to work with these exercises.

Calf Releases

  • Sit with your calf on top of a lacrosse ball. 
  • Place opposite leg over the one you are releasing. 
  • Roll yourself up and down over the ball. 
  • Find a tender spot and stop and move your foot up and down for 30 seconds.
  • Muscles being released: Gastrocnemius and soleus.

Glute Step-Backs

  • Stand with feet shoulder-width apart. Slightly bend the support leg with your knee over your heel. 
  • Step the other foot back and behind the support leg.
  • Here are some variations:
    • Straight
      • Face forward and shoulders square. 
    • Twisting
      • Rotate upper body and chest toward your support leg.
    • Side-Bending
      • Facing forward, bend to the side opposite the support leg.
  • Switch support leg. Repeat.
  • Muscles being worked: Gluteus medius. 

Kneeling Lat Pull-Downs

  • Using resistance bands or a cable resistance machine, kneel with both knees on a pad. Keep chest upright, shoulders down and back, abs engaged, feet hip-width apart and behind you.
  • Pull down until your elbows form a 90-degree angle, forearms parallel to the ground. Make sure your arms and elbows are close to your body throughout the exercise. 
  • Hold and repeat.
  • Muscles being worked: latissimus dorsi, rhomboids.

David Reavy, founder of Chicago-based React Physical Therapy, is the creator of the Reavy Method, a whole-body approach to physical therapy and exercise. Reavy works with numerous pro athletes from the NFL, NBA, MLS, and the WNBA.

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