Does Running Hurt? Want to Run the City to Surf?


The City to Surf and Sydney Running Festival are fast approaching. We see a large increase in running related soreness and injuries at this time of year as runners increase their training to prepare for the glory of finishing their chosen event at such a glorious time of year for running.

Problems with foot pain, arch pain, shin splints, sore knees and sore calves can stop some runners before they even reach the start line.

The most common reasons why runners get hurt are:

  1. Too much too soon. Basically over-training. Your body needs time to repair and strengthen itself after each training session. If you increase your distances or speed too quickly, your body cannot heal as fast as you keep damaging it and you will break down with an injury. This is more relevant as you get older, as we take longer to heal than teenagers!                      A common rule to follow is the 10% rule. If you only increase your training by 10% per week, this should give your body time to adapt to the increased training and time to heal and get stronger so you can withstand longer distances, higher speeds and increased strain to the bones and soft tissue of your body.
  2. Poor Technique. For distance running, it is really important to maintain a high cadence. This means the rate of steps you take per minute. Studies have shown that about 180 steps per minute, or as close to this as you can manage will reduce the tendency to land with a heavy heel strike, and makes running less shocking on the body as you will reduce the vertical “bouncing” when you run and hence not hit the ground as hard (so the ground doesn’t hit you back as hard!). This reduction in ground reaction force means you will be less fatigued when you run so you can run further, faster and maintain good running form for longer. This should reduce your chance of injury too.
  3. Double Jointed/ Hypermobility A topic that receives little attention is the main reason we see most of our injured patients. Ever wondered why some people can run and play sports with few problems and virtually no pain, while others think running = pain and give up extremely quickly. The main cause of low arches, over-pronation and pronation related sore shins, knees and feet is hypermobility due to ligament laxity. Often called “double-jointed” it is extremely common, and is more common in females as well as certain racial groups such as Asians, Indians, Polynesians and Africans, but plenty of Caucasians have it too. It is a family trait, not a racial one so you inherit it from your parents. It is a big advantage for some sports like martial arts and gymnastics where “bendy-ness” is an advantage. However, it can be a big disadvantage for running as your muscles have to work a lot harder if your ligaments don’t support your arches and ankles very well. These are the patients we see the most, and a biomechanical examination, digital running analysis and shoe advice plus orthotics where necessary can help these patients run with far fewer problems.
  4. Structural Problems This group have bony structural problems, such as twisted shins bones, bowed legs or a short leg on one side. I have a genetic 13mm leg length difference that was missed by more than seven health professionals as an elite teenage runner in high school. It is extremely common and frequently missed. At Sydney Sports Podiatry we can determine in the clinic if you may have a leg length difference, then confirm it accurately with a referral for a leg length scan. We can then work on ways of getting you back to balance, usually with an orthotic or shoe modification.


If running hurts and your training is being interrupted, it’s time to come in for a biomechanical assessment. We can check your running posture, check you for hypermobility, muscle range, running technique and shoe selection. We can also check your old orthotics if you already have some.

Small changes can have big improvements. Sydney Sports Podiatry- Runners Treating Runners

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