Steps for Injury Prevention

We recently discussed the importance of strength, flexibility and symmetry. The next step for runners who are motivated to reach maximum potential with minimal injury is to understand biomechanics and shoe wear.


To improve efficiency and decrease strain, the importance of biomechanics cannot be ignored.  A lot of times, having a body that is strong, flexible and symmetric allows the proper mechanics of running to develop.  When poor movement patterns have become a habit, a biomechanical analysis by a sports physical therapist will identify the abnormal movement and develop a plan to correct it.  For example, a runner may have good flexibility and strength but have a tendency to move his/her base of support too high.  A simple correction may be exercises to increase stride frequency so the runner feels confident in swinging the leg through.  A biomechanical running evaluation is best done with the use of video software that allows frame by frame analysis of back and side views. 

At St. Luke’s Performance Medicine Center we use video analysis software to analyze running biomechanics.  We use a full-body back and side view to analyze runners, with an occasional close up from the knee down to capture complex foot and ankle movements.  A full-body view is important to identify any abnormalities of alignment, posture or movement that may be decreasing efficiency. 

A couple quick examples of what to look for from the back view:

  • Spine is vertical
  • Shoulders are level
  • Pelvis is level
  • Most movement occurs at the hips and shoulders

A few of the things we look for from the side view:

  • Upright posture
  • Hip, knee and ankle extension during push-off (triple extension)
  • Foot strike position (varies depending on speed)
  • Movement at hips and shoulders

Shoe wear

Proper shoes are important for protection from friction and cushion for impact.  Support from shoes or orthotics should only be used if there is instability in the foot that can’t be stabilized with exercise.  If shoes are too supportive, muscle strength and stability will be lost in muscles that are intended to provide support to the foot. Shoes should fit snugly but not so tight that circulation is affected.  They should also be laced up snugly enough that a finger can’t easily be pushed between the laces and the foot.

Overall, every runner, with or without a history of pain, should be evaluated for strength, flexibility, symmetry, biomechanics and shoe wear.  These areas are the foundation of movement and will allow runners to perform at their highest potential with less chance of injury.