Running Technique and Running Injuries: What Do Physiotherapists Look For?
By Lachlan Gillies | Physiotherapist & Founder of Rebuild Physio Glenelg
When a runner develops pain, one of the first questions they often ask is whether something about their running technique is contributing to the problem.
Sometimes it can be.
But there is no single perfect way that everybody should run.
At Rebuild Physio Glenelg, we assess running technique as one part of the bigger picture when working with running related injuries. Rather than trying to make every runner move the same way, we want to understand whether certain features of an individual’s running may be increasing load on an injured or sensitive area.
For some runners, modifying their running technique may form part of rehabilitation. For others, strength, training load, recovery or gradually rebuilding their capacity to tolerate running may be much more important.
The key is working out what actually matters for the individual runner.
There Is No Single Perfect Running Technique
Runners naturally move differently.
Some runners land on their heel. Others land through the midfoot or forefoot. Some run with a relatively high cadence, while others naturally take longer strides.
These differences are not automatically problems.
Changing the way somebody runs can also change how load is distributed throughout the body. A technique modification that reduces demand in one area may increase demand somewhere else.
Foot strike is a good example.
It is sometimes suggested that runners should move away from heel striking and towards a forefoot strike. However, changing towards a forefoot strike can increase demand through the calf, ankle and Achilles tendon.
This is why we do not try to make every runner look the same.
Instead, the more useful question is:
Is there something about this runner’s technique that may be relevant to their injury, symptoms or running goals?
That is where running assessment can become useful.
What Do Physiotherapists Look at When Assessing Running Technique?
When running technique appears relevant to an injury, there are several features we may consider.
These can include:
Step rate or cadence
Stride length and overstriding
Where the foot lands relative to the body
Foot strike pattern
Trunk position
Pelvic movement and control
Hip and knee movement
Lower limb alignment
Movement through the foot and ankle
How movement changes at different running speeds
Importantly, none of these findings should automatically be labelled as good or bad.
Seeing someone’s knee move inward while they run, for example, does not necessarily mean that movement is causing their pain or that it needs to be corrected.
What we see when somebody runs needs to be considered alongside their symptoms, training history, strength, physical capacity, previous injuries and running goals.
Overstriding and Running Cadence
One feature we may consider during a running assessment is where the foot contacts the ground relative to the runner’s body.
A runner taking relatively long strides may land further in front of their centre of mass. This is commonly described as overstriding.
Cadence refers to the number of steps a runner takes over a period of time.
Research has shown that modifying step rate can alter several aspects of running biomechanics and change how load is distributed through the lower limb.
However, this does not mean every runner should simply increase their cadence.
For some runners, modifying cadence or stride length may be useful. For others, there may be little reason to change it.
The decision depends on the runner, their symptoms and what we find during assessment.
Does Foot Strike Matter?
Foot strike gets a lot of attention in running.
You may have heard that forefoot running is better than heel striking, but the reality is more complicated.
Different foot strike patterns change how forces are managed throughout the lower limb.
Moving towards a forefoot strike can increase demand through the calf and ankle complex. This may be particularly relevant when assessing runners experiencing Achilles or calf symptoms.
For this reason, we do not routinely try to convert runners to one particular foot strike.
Instead, foot strike is considered alongside the runner’s injury, symptoms, running speed, training history, footwear and physical capacity.
If you are experiencing pain around the Achilles tendon, read our Achilles Pain in Runners guide.
If your symptoms are occurring through the calf, our Calf Pain in Running article discusses some of the different problems that can cause pain in this area.
Running Technique and Knee Pain
Running related knee pain is another situation where running technique may be worth considering.
Patellofemoral pain, commonly referred to as runner’s knee, is one of the common knee problems seen in runners.
Depending on the individual runner, we may consider features such as cadence, stride length, trunk position and movement through the hip and knee.
But running technique is still only one part of the picture.
Recent changes in running volume, hills, speed work, strength, recovery and the runner’s overall physical capacity may all influence symptoms.
You can learn more about this condition in our Patellofemoral Pain in Runners article.
For pain around the outside of the knee, read our ITB Pain in Runners article.
Running Technique and Shin Pain
Shin pain is another common problem in runners, particularly following changes in running volume or intensity.
When assessing a runner with shin pain, we may consider running technique alongside their training history, footwear, strength and physical capacity.
It is also important to establish what is actually causing the pain.
Not all shin pain represents the same condition, and different causes of shin pain can require very different management.
You can read more in our guide to Shin Pain in Runners.
Strength and Physical Capacity Still Matter
Running is repetitive.
Every step requires the muscles and tendons of the lower limb to absorb, store and produce force.
This is why we do not look at running technique without also considering whether the runner has the physical capacity required for the running they are trying to do.
Depending on the runner and their injury, rehabilitation may involve developing strength and capacity through areas such as the calf, quadriceps, hamstrings, hips or trunk.
Strength training can also be useful beyond injury rehabilitation. Research suggests that appropriately programmed strength training can improve running economy in middle and long distance runners.
You can read more about this in our Strength Training for Runners guide.
What Is Running Economy?
Running economy refers to the amount of energy required to maintain a given submaximal running speed.
Two runners can therefore be travelling at the same pace while using different amounts of energy to do so.
Running economy is influenced by many factors including physiology, training history, biomechanics and physical capacity.
This is another reason we are cautious about changing someone’s running technique simply because a particular movement looks unusual.
A runner may have developed a running style that works extremely well for them.
Any technique modification should therefore have a clear reason behind it rather than simply trying to make someone’s running look better.
How We Assess Running Technique at Rebuild Physio Glenelg
When running technique appears relevant to your injury, we may organise a practical running assessment as part of your physiotherapy management.
This can involve observing and filming you while running on a treadmill, allowing us to review your movement and consider whether particular features of your running may be relevant to your symptoms.
However, running technique is only one part of the assessment.
We also consider factors such as:
Where your pain is occurring
When symptoms develop during running
Your current running volume
Recent changes in distance or intensity
Your running goals
Previous injuries
Strength and physical capacity
Footwear where appropriate
How your symptoms respond to different movements and loads
Bringing this information together helps us determine whether running technique appears relevant to the problem and, importantly, whether anything actually needs to be changed.
Does My Running Technique Need to Be Changed?
Not necessarily.
Sometimes the best decision is to leave someone’s running technique alone.
If technique does appear relevant, the goal is not necessarily to completely rebuild the way somebody runs.
In some cases, relatively small modifications may change the demands placed on different areas of the body.
Which changes are appropriate depends on the individual runner, their injury and what we find during assessment.
This is why copying a running cue from social media, another runner or a generic running program does not always solve the problem.
Something that is useful for one runner may be unnecessary for another.
Running Injuries Are Usually Bigger Than Running Form
Running technique can be important, but it should not distract from the rest of the picture.
When someone presents with a running injury, we may also need to consider their training load, strength, physical capacity, recovery, previous injuries and footwear.
Our goal is not simply to make someone’s running look better.
It is to understand the factors that may be contributing to their symptoms and develop a plan that helps them return to the running they want to do.
For runners coming back from injury, our guide to returning to running after injury explains how we establish a manageable starting point and progressively rebuild running load.
You can learn more about our approach on our Running Injury Physiotherapy Glenelg page.
Physiotherapy for Running Injuries in Glenelg
At Rebuild Physio Glenelg, we work with recreational runners, competitive runners and people trying to return to running after injury.
Common running related problems we assess include:
Knee pain
Shin pain
Achilles pain
Calf pain
Hip pain
Foot and ankle pain
Muscle and tendon injuries
Recurring running related pain
Running assessment can be incorporated into your physiotherapy management when it is relevant to your symptoms.
If pain is affecting your running, you do not need to work out whether the problem is your technique, strength, training load or something else before booking.
That is what the assessment is for.
If a running injury is stopping you from training or performing at your best, book a physiotherapy appointment at Rebuild Physio Glenelg and we can assess the problem and develop an individual plan to help you return to running.
About the Author
Lachlan Gillies
Founder, Director and Physiotherapist
Rebuild Physio Glenelg
Lachlan has a particular interest in running injuries, sports physiotherapy and strength-based rehabilitation. As a two-time marathon runner and physiotherapist with a strength and conditioning background, he enjoys helping runners understand their injuries, rebuild their physical capacity and return to running and training.
References
Petri AC, et al. Gait Retraining for Patellofemoral Pain in Runners: An Umbrella Review of Clinical and Biomechanical Evidence. Sports Medicine Open. 2026. PubMed
Anderson LM, Bonanno DR, Hart HF, Barton CJ. What are the Benefits and Risks Associated with Changing Foot Strike Pattern During Running? A Systematic Review and Meta-analysis of Injury, Running Economy, and Biomechanics. Sports Medicine. 2020. PubMed
Almeida MO, Davis IS, Lopes AD. Biomechanical Differences of Foot-Strike Patterns During Running: A Systematic Review With Meta-analysis. Journal of Orthopaedic & Sports Physical Therapy. 2015. PubMed
Neal BS, Barton CJ, Gallie R, O’Halloran P, Morrissey D. Runners with patellofemoral pain have altered biomechanics which targeted interventions can modify: A systematic review and meta-analysis. Gait & Posture. 2016. PubMed
Xu et al. Effects of Running Technique Characteristics on the Patellofemoral Joint Load: A Systematic Review and Meta-analysis. 2025.
