Friday 5: 5 Tips I Give to Runners | Modern Manual Therapy Blog

Friday 5: 5 Tips I Give to Runners

Runners are great patients! They are often very motivated (sometimes too much) and much like golfers, if you do a great job, you get more referrals! Here are 5 Tips/Cues that I give to runners during treatment.

1) Ankle mobility/symmetry
  • Using the half knee ankle dorsiflexion test as a easy self screen 
  • this test can easily be used during self tibial IR mobilizations or self TC mobilizations with their hands or EDGE Mobility Band
  • under FMS rules, you want to treat the larger asymmetries rather than just motion loss, so if a patient has minimal loss of ankle df after a few Tx, but it's symmetrical with the other ankle, move on to an area with larger asymmetry in movement/motor control
2) Hip mobility/control
  • hip abduction strength has been correlated with knee pain
  • clams and side straight leg raises with the heel on the wall have both been researched enough to prescribe them as great exercises to help with lower limb stability
  • a recent study showed runners could minimize lateral thigh/knee strain with a wider striking pattern 
  • this is a cue I give, just thinking about it 1%, just enough to make a slight difference, but not try too hard and cause other larger changes in the chain
  • here is one of my favorite exercises, also easily combined with the EDGE Mobility Band around the proximal and lateral thigh for some extra mobility and getting to that ever important end range!

3) Avoid overstriding
  • overstride increases the ground reaction force, often placing unnecessary strain on LE structures
  • cuing a slight forward lean and to try to land with the foot underneath you as opposed to in front of you often helps reduce lower LE Sx
  • biomechanics research shows a decrease of hip extension may lead to overstriding, a great reason to work on those hip flexors with ITB and psoas work
    • Greg Lehman reviews this research very well here!
4) Train smart
  • It has been reported that up to 80% of running injuries are caused by improper training, my next COTW write-up for Monday is a runner I've been working with
    • he was so happy to be able to run again after being sidelined for months that he ran 8 days straight - not a good idea (although he was fine)
  • all training methods call for appropriate rest periods, this goes for sleep as well
  • recovering from an injury also means knowing your limits
5) Cadence
  • Increasing cadence decreases overstride, which also decreases ground reaction force
  • I don't always cue for the 180 BPM, because those studies were based on very high level runners
  • I find many runners with a cadence much lower than 150, and cueing between 150-180 normally helps reduce excessive force on the knees
Have more questions about running? Chris Johnson is a plethora of information with a lot of great videos and posts on his site!


  1. Matthew VanSlykeMarch 1, 2013 at 8:15 AM


    I am a runner and DPT student. I think you have done an excellent job
    highlighting many of the most common MOI factors for running related
    injuries. I also appreciate your positive take on runner passion. I have
    heard many say runners are the worst patients because when thy get
    injured they are often told if it hurts to run then don't run. Which I
    think is excellent advice to listen to your body's pain signal but often
    is the case that without a proper movement assessment the runner's
    problem may continue to be unresolved leading to chronic injury.
    Excellent therapists like yourself are able to reassure runners that by
    taking a little time their running career will be better in the long
    term. Thanks for the excellent material you continue to provide on this

    Matt VanSlyke, SPT

  2. Thanks Matt! I love running myself and many of these cues I had to work on myself to start running again after six year break!