How Can You Make Running Less Painful?

Millions of U.S. runners are starting to greet the warmer weather with an outdoor run. Some portion will finish those runs with knee, foot or back pain.

What can a runner with consistent pain do to fix it short of a costly gait analysis? There’s no easy solution, but experts say there are ways of lessening the discomfort. Some are simple, while others require more work.

Fortunate runners feel no pain thanks to superior technique and genes, says Jonathan Roth, an orthopedic surgeon based in Wayne, N.J. For those who regularly ache after running, it’s smart to make an adjustment. That can mean a change in routine or a different sneaker.

“The best person to tell whether you’re running correctly is you,” Dr. Roth says. “If it doesn’t feel right to you, if it causes pain, if it makes your knees hurt, then it’s not the right shoe for you. It’s not putting you into a right position. It’s more trial and error at that point.”

New sneakers aren’t expensive, but buying the right set can take some work. Some stores put customers on a treadmill to observe their technique and the sneakers that best work for them. People with knee and hip pain are sometimes better off with a flatter shoe.

Irene Davis, a professor of physical medicine and rehabilitation at Harvard Medical School, has studied what role modern shoes play in runners’ pain. Among her conclusions: Modern, heavily padded sneakers can be a major problem for runners.

In the 1970s, the early days of the running boom, shoes were thin and didn’t change your style of running as much. Feet would hit the ground at a flatter angle, rather than striking dominantly with the heel, as often happens today.

“Because of wearing this chronic, supportive, cushion shoe, we end up coddling our feet, making them weaker and putting them at the risk of being injured,” Dr. Davis says. “The closer that we run to the way we were adapted to run, from an evolutionary standpoint, the lower the risk of injury.”


To change your form, Dr. Davis suggests thin shoes. (Among those she recommends: Vivobarefoot, Xero Shoes and Inov8 Bare-XF 210.)

But she adds a warning: It could take up to a year for your body to adjust. You must condition your legs properly, and the process is slow. It begins with brisk walking, then adding slow running miles one at a time, with days off in between. The key is not to rush, she says.

“It would be like me going to the gym and lifting a hundred pounds when I haven’t done any training for it,” she says. “And you’re going to get hurt.”

Dr. Davis says that when you run in minimal shoes that make it easier to land on the front of your foot, your feet and calves get stronger. Stronger feet are healthier feet. Her team’s research on the increase in leg and foot muscle volume after a transition to minimalist running shoes was published in the July 2016 edition of Clinical Biomechanics.

“There is a building body of evidence that this type of running is going to help us be less injured,” she says. “I go back to the fact that you can’t outdo Mother Nature.”

There’s also a matter of where you run. Roads or sidewalks made of asphalt or concrete are hard and put a lot more pressure on you feet and legs than a track, which is made from a softer surface. Better still: running on grass or dirt.

“A nice, flat, well-maintained dirt trail is probably one of the best,” Dr. Roth says. “That’s what people have been running on hundreds and thousands of years.”