How to Prevent Leg Pain While Running

What causes leg pain while running? We know heel strike running does. This is why you should always land with a forefoot strike. But aside from maintaining the proper foot strike when running, you want to land with your shin in a vertical, not a tilted, position. This ensures the ankle lands under the knee, which in turn reduces parallel braking, a risk factor for anterior biomechanical overload syndrome of the leg, also known as nasty leg pain.

My Leg Hurts When I Run

How to Prevent Leg Pain While Running

Most runners extend their leg out in front of them which causes the shin bone (tibial shaft) to be positioned well-ahead of the knee (also known as a vertical tilt of the tibial shaft, or a high tibial shaft inclination angle). The goal is that when your foot strikes the ground when you run, you want to get your shin bone to be positioned more vertically under the knee, not on an angle. The best way to achieve this is by bending your knee (increased knee flexion) at touchdown. Here’s an example below:

Running Leg Injuries
Above shows the tibial shaft (shin bone) in a vertical position, not tilted on an angle, at touchdown. This helps minimize the brake force and the best way to achieve this landing style is to make sure your knee is softly bent at touchdown. This stops the ankle from swinging out ahead of the knee when you run.

One study found that heel strike runners suffering from chronic leg tendon pain who had undergone gait re-training (they were instructed to land forefoot-midfoot) had a reduction in tibial inclination angle (from 11.72 and 11.98 to 2.89 and 2.48!), indicative of a more vertical position of the shin bone at touchdown. As a result, 70% of the runners ran entirely pain-free post-treatment. And when you combine a bent knee with a forefoot strike landing, ample force reduction occurs on the leg, especially at the knee. Runners who continue to heel strike usually show no benefits because of the drastic tilt of the tibial shaft at touchdown, shown below:

My Leg Muscles Hurt When I Run
Here is an example of a large tibial inclination angle at touchdown which contributes to parallel braking and persistent leg cramps. As you can see, at foot strike, the shin bone is tilted, and NOT vertical in relation to the ground. This is what you don’t want to do when you run.

Above, shows a typical heel strike landing where a significant proportion of runners who utilize this style of running are more likely to suffer ongoing leg muscle pain as compared with forefoot runners.

More From Run Forefoot:

Best Shoes for Forefoot Running

Why The Pro’s Don’t Believe in Heel Strike Running

Why Barefoot Runners Don’t Heel Strike

Why Train with a Weighted Vest



Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
Bretta Riches

P.S. Don't forget to check out the Run Forefoot Facebook Page, it's a terrific place to ask questions about forefoot running, barefoot running and injury. I'm always happy to help!