Ask The Doc: Pose Running For Healthy Joints

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by THERESA LARSON, DPT, Marine Corps Veteran, CrossFit Coach

Ask The Doc: Pose Running For Healthy Joints

[F]or running, walking and regular training there is no reason to have a (heel) lift. You want to perform at the most optimal levels of your being which means naked feet…
According to “Healthy People 2020 Exercise in Medicine ™”, approximately 20 million Americans run. Up to 79% of runners will sustain an injury in a given year. 49% of those injuries will be a re-occurrence. The technical term for such trends is ‘That’s Crazy’!

Common injuries with running are Ilio-Tibial (IT) Band Syndrome, anterior femoralimpingement (AFI), labral tears of the hip, patella-femoral pain syndrome, low back pain, stress fractures, Achilles tendonopathies, plantar fasciitis, and torn ACL’s.

Who among us has had at least one of these issues? Most of these are due to improper running technique.  Our collective improper running technique was born of years of faulty motor patterns that stem from imbalances in joint range of motion, muscle strength, and coordination. And poorly designed shoes – but we’ll get to that later.

So How Do We Fix Those Injuries And Nagging Pains?


  • Nope – I hate to break it to you, but stretching is not going to help your IT Band (it takes thousands of pounds to change that tissue).


  • Not really. I would stop focusing on just rubbing the bottom of your foot to get rid of your plantar fasciitis – its cause comes from above the foot.

Run through it?

  • Nope. Bunions, heel spurs and other foot protuberances are a sign of bad form, and certainly ain’t sexy.

The Hard Reality Of Biomechanics

The Hard Reality Of Biomechanics

[H]eel striking puts a greater impact peak through the knee and low back than landing on your forefoot.
We have become soft in our culture with our cushy high heel shoes we like to wear with running and exercising. Olympic lifters use a bit of a raised heel for two reasons- a) it helps to get into a lower squat position, b) it helps align the ankle, hip, and spine with greater ease under higher loads. But for running, walking and regular training there is no reason to have a (heel) lift. You want to perform at the most optimal levels of your being which means naked feet (ideally, or shoes with limited support).

According to research performed by Harvard University’s Dr. Irene Davis, PhD, DPT, heel striking puts a greater impact peak through the knee and low back than landing on your forefoot. Truth is, as children we pose ran naturally, so what happened? Our nation’s warriors who wear prosthetic’s are being taught to pose run to reduce impact peak force it has on both their artificial and natural joints.

So why are we not maintaining this technique from childhood to adulthood? Our culture, our shoes, lack of education, not sticking to principles of joint biomechanics are some of the reasons.

What Happens When You Heel Strike

  1. Our feet dorsi-flex and land on the ground, your heel immediately everts and unlocks your midfoot into a unstable position.
  2. Our heel cord – where the gastrocnemius, plantaris, and soleus attach – works extremely hard as it’s forced to take on eccentric stress (lengthening) while also having to contract quickly.
  3. This often leads to an imbalanced step, pissing off the big toe enough that it develops bunions and/or plantar fasciitis.
  4. The resulting increase in friction on the heel cord can lead to posterior-lateral heel spurs.
[R]unning is a controlled fall, but lean at the ankle, not at the hip.
Now with a forefoot strike your leg externally rotates and ankle dorsiflexes causing the heel to invert and lock the midfoot creating a stable position of the foot; it is now a rigid foot lever. This is similar to a squat with feet domed, leaving the big toe in contact with the ground and the heel down. (Think of what happens with your foot when given the cue ‘knees out’ or ‘screw open the hips’ – your feet naturally dome). You create a stable lock in your foot and platform to lift heavy weight, or bear repeated running strikes.

Now let’s think about other things besides heel striking that can cause problems in the knee, ankle and or hip. Common motor pattern issues that lead to the injuries listed above  are a result of decrease in strength of your glutes and quadratus lumborum (pictured) that directly cause ones hip to adduct and internally rotate (figure B in picture). This causes a damaging knee angle (knee going in) and/or a pronation (collapse) of the foot.

It's all connected

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