In treating a large population of long-distance runners with running pain over the past several years, we have identified several injuries commonly experienced:

  • Runner’s knee (patellofemoral pain syndrome)
  • Achilles tendinitis
  • Plantar fasciitis/fasciosis
  • Shin splints
  • Iliotibial band syndrome
  • Patellar tendinitis
  • Hamstrings tendinitis/tendinosis

All of these conditions tend to present in long-distance runners that share a similar “movement profile” between their training and competition. In other words, these conditions commonly present in individuals whose training movements look fairly similar to their competition movements. An athlete who consistently trains for long-distance running events solely by following running programs will be at a greater risk for running pain than an athlete who diversifies their workouts with various types of movement or cross trains.

Team sports such as soccer, basketball, lacrosse, etc. involve a high volume of continuous running. However, these athletes are also required to move in many planes of motion. They cut side-to-side, produce rotational movements through the hip and torso, providing them with a diversity of different movements to stimulate balanced muscular strength and motor control. Strict long-distance runners have one training stimulus, forward movement. Therefore, unless the strict running athletes perform some form of cross-training, they will stimulate strength in only one plane of motion and create imbalance.


Planes of Motion

Body PlanesLet’s take a step back for a moment, what is a “plane of motion” and what are the planes of motion we utilize for movement? Simply stated, a plane of motion is a particular direction of movement a certain joint or group of joints are able to move in. We as humans have three basic planes of motion, or three distinct directions in which our body can produce movement:

  1. Sagittal plane: forward and backward movement
  2. Coronal/frontal plane: side to side movement
  3. Transverse plane rotational movement

The human body moves and should train in several different directions, not just in forward movement.


Muscular Imbalances


Mid foot stanceAthletes whose training primarily consists of running are strengthening movement in only one plane of motion, the sagittal plane (the forward and backwards plane). By neglecting training movements in the other directions, muscular imbalances develop that often lead to pain. An example of this muscular imbalance is in the performance of a forward lunge. When strength has not been developed in the transverse (rotational) plane, the hip muscle demonstrates poor muscle control of leg rotation as the lunge is performed.


Running stance

In addition to poor hip muscle control performed in a lunge, another example is a runner positioned at mid foot stance. A runner with poor strength and control in the coronal (side to side) plane will allow the hip of the weighted leg to “hike upwards” (in image B below, it’s the right leg). This positioning places strain on the soft tissues and joints of the low back and leg, and is a key driving factor for iliotibial band syndrome and knee pain.¹


Next Steps to Running without Pain

If you only run to train, that does not mean you are effectively training to run. Adding a diversity of movements to weekly workouts will improve overall stability, performance, and prevent the onset of running pain and disabling injuries. Here are a few action steps to implement pain-free running:

  1. Visit your local chiropractor at Norwood Chiropractic & Sports Injury Center for a movement evaluation. This step is important because it will help you target your personal weaknesses when you diversify your workouts. Visiting one of our clinics will also help get you back to pain-free movement more quickly. Schedule an appointment with us today.
  2. Follow movement specialists who blog about running. One of my personal favorite websites is the Running Physio.
  3. Join a local running group. It is a great way to develop comradery over a shared interest, learn about better mechanics, and how others have overcome their pain.



  1. Clinical Journal of Sports Medicine, vol. 10, no. 3, 2000, pp. 169-175