Hi guys. I’m Dr. James Porco, Performance Specialist with Back In Motion where we offer Physical Therapy in Fort Myers, FL and I want to share some important information with you if you’re having pain while running.
There are three common areas of the body that will cause pain when running or give you a running injury.
In our practice as Doctors of Physical Therapy, we have seen that the major areas that cause a running injury are the thoracic spine or the T spine, which is the mid back, as well as the hip, and the foot & ankle.
At Back In Motion, we see either mobility restrictions or strength limitations that can cause running injuries and it’s important to do a thorough examination because, even though these are the most common that we see, the injuries aren’t , in fact, always in those areas.
Injuries can actually manifest in other places, like the knee, lower back or calf.
#1 The Hip
When we talk about the muscles of the hip, we want to look at the gluteus medius in particular, which is a muscle on the side of the hip that stabilizes the pelvis when you’re running.
When you take a step and you’re in mid stance, if this muscle is weak, your pelvis will actually dip to the side. If that muscle can’t stabilize the pelvis, then you’re expending energy to try and stabilize with all kinds of other muscles in that area.
You’re also allowing your knee to dive in, which can cause pain in that area, as well as causing your back to side bend, which can create compensatory pain there as well.
So we look at specific muscles, as well as the strength and mobility of the hip as a prime area for running injuries. Treatment for these issues may include incorporating hip strengthening and stabilization exercises into your running program.
#2 The Thoracic Spine
When we talk about the T spine or thoracic spine, we’re really talking about the trunk region. The reason we look there is because it is one of the primary areas of your body that you should be rotating from.
Often we’ll see runners who are very stiff and rigid and just move their arms, without actually getting any trunk rotation. If you’re not rotating in your trunk, which drives the body forward and propels it, you’re going to compensate by using your foot and ankle to push off more in different positions, which can cause conditions like achilles tendonitis and plantar fasciitis.
#3 The Foot or Ankle
No matter where they actually occur in the body, the third most common area to look at for the source of running injuries is the foot and ankle.
The ankle requires considerable and various types of mobility to properly support a regular runner. It also needs to be able to accept and produce force in a very particular way in order to propel you forward.
So we look at the ankle for things like subtalar joint inversion (rotation of the ankle inward) or eversion (rotation of the ankle outward) and how much of those you’re getting.
Additionally, we look at ankle dorsiflexion or plantar flexion: dorsiflexion is being able to glide the knee over the toe and plantar flexion is how far you can get your toes (to point) downward.
All of these are relevant for pushing off while you’re running, as well as for accepting the weight while you are preparing to take that next step in your run.
Fix the Cause, Not the Symptoms
When we look at these three areas, we can pretty much identify the root cause of any of your dysfunction or pain.
What is notable is that It can actually manifest in the knee as patellofemoral pain (front of the knee & around the knee cap), the lower back and even the tibia (the large bone at the front of your leg) with common conditions like shin splints.
We can help you identify and rectify running injuries by focusing on the primary areas, like the hip, thoracic spine and the foot & ankle, that are often the very source of what needs to be treated to get you back to running pain-free.
About The Author:
Dr. James Porco received his Bachelor’s in Exercise Science (2015) and Doctorate of Physical Therapy (2019) from Florida Gulf Coast University. Prior to pursuing his doctoral degree at FGCU, Dr. Porco was a Certified Strength & Conditioning Specialist for the Boston Red Sox, where he developed his specialization in athletic performance. Dr. Porco’s practice is focused on treating both recreational and competitive athletes and is himself an avid runner and weightlifter in his free time.