Injury prevention for runners

February 1, 2026

Getting the Balance Right for Runners

Running looks simple, but in reality it is a highly coordinated skill that places repeated demands on the same joints, muscles, and tissues thousands of times per run. Because so many muscles are involved, and because running is repetitive by nature, even small imbalances around a joint can gradually increase stress and raise the risk of injury.


At Weaver Physio, Specialist Running Physiotherapist Richard Mason explains why improving balance, strength, and coordination throughout the body is essential—not only for injury prevention, but also for running efficiency and long-term performance.


Why Balance Matters in the Human Body


Every joint in the body is designed to move in specific directions, and every movement has an opposing counterpart. For movement to be efficient, the muscles that create and control these movements must work in harmony.


Muscles move joints through a carefully timed combination of:

• Contraction (to produce movement)

• Lengthening (to control and decelerate movement)


When this balance is disrupted—often through repetitive postures or activities—certain muscles can become overactive and tight, while their opposing muscles become lengthened and weak. Over time, this imbalance alters how forces travel through a joint, changing movement patterns and increasing tissue stress.


If left unaddressed, these altered mechanics can contribute to pain, overload, and injury.


Running: Repetition, Load, and Technique


Running is a dynamic, single-leg activity that transfers body weight from one limb to the other in a continuous cycle. It is an excellent way to develop cardiovascular fitness and strengthen muscles, tendons, and bones.


However, unlike many sports, most runners are never formally taught how to run. Instead, running technique develops naturally over time—often influenced by lifestyle habits, posture, previous injuries, and strength deficits.


Unless someone has exceptionally efficient natural mechanics, subtle biomechanical faults can build up gradually. These may not cause immediate pain, but over months or years they can lead to:

• Muscular imbalances

• Postural changes

• Reduced efficiency

• Increased risk of overuse injury


Common Running Technique Issues


Upper Body Contributors


Although running injuries often present in the legs, upper body position plays a key role in efficiency and load distribution.


Common upper body faults include:

• Forward head posture, placing strain on the neck and upper spine

• Looking down at the feet, increasing tension through the neck and shoulders and encouraging forward trunk lean

• Rounded or slouched shoulders, often linked to prolonged desk-based work and tight chest muscles

• Arms swinging across the body, rather than forwards and backwards in the direction of travel

• Excessive tension through clenched fists and shoulders

• Poor trunk control, often due to reduced core strength


These issues can subtly increase energy cost and alter lower-limb loading.


Lower Body Contributors


Lower body mechanics play a central role in injury risk.


Common contributors include:

• Pelvic drop or excessive pelvic movement, often due to reduced hip stability

• Anterior muscle dominance, where hip flexors and quadriceps overpower weaker gluteal muscles

• Over-striding, where the foot lands too far in front of the body, increasing braking forces

• Reduced ankle mobility or stability, limiting shock absorption and propulsion


Each of these factors increases cumulative stress on joints and soft tissues over time.


How the Lower Body Works During Running


To understand why imbalance matters, it helps to look at how muscles work together during the running cycle.


At push-off, the calf muscles contract to drive the body forward while the gluteus maximus extends the hip and the quadriceps straighten the knee. As the leg leaves the ground, the hamstrings bend the knee to bring the heel upwards, followed by the hip flexors swinging the thigh forwards.


As the leg prepares for contact, muscles at the front of the shin lift the foot, positioning it for landing. On impact, a coordinated group of muscles work together to absorb load:

• The ankle stabilisers control foot motion

• The quadriceps manage knee loading

• The hip stabilisers—particularly the gluteus medius and minimus—keep the pelvis level


Once the body weight moves over the stance leg, the cycle repeats.


If any link in this chain is weak, tight, or poorly coordinated, load shifts elsewhere—and injury risk rises.


Why Muscle Imbalances Increase Injury Risk


Most running injuries are classified as overuse injuries, meaning they result from repeated micro-stress rather than a single traumatic event. This risk is significantly higher when muscles around a joint are not working in balance.


Strength deficits, reduced flexibility, and poor control all contribute to how load is distributed. When tissues are repeatedly overloaded beyond their capacity, pain and breakdown follow.


Key Areas Where Imbalance Commonly Occurs


Hip Muscles


Modern lifestyles involve prolonged sitting—at desks, in cars, and on sofas—placing the hips in flexed positions for much of the day. Over time, this can shorten hip flexor muscles.


When tight hip flexors are combined with the demands of running, the body can struggle to generate effective hip extension. This limits gluteal activation, causing the glutes to weaken and the running pattern to become dominated by muscles at the front of the body.


This often results in a shorter, shuffling stride and reduced propulsion.


Injuries commonly associated with this pattern include:

• Iliopsoas tendinopathy or bursitis

• Rectus femoris strains

• Iliotibial band–related pain


Knee Muscles


When anterior dominance continues down the chain, tight quadriceps can limit the effectiveness of the hamstrings. This imbalance alters knee loading and increases stress through the front of the joint.


Common knee-related issues linked to imbalance include:

• Patellofemoral pain (runner’s knee)

• Patellar tendinopathy

• Fat pad irritation

• Hamstring strains due to reduced strength and load tolerance


Ankle and Foot Muscles


At the ankle, the calf muscles and shin muscles work as opposing pairs. Reduced calf flexibility limits ankle movement, increasing stress through the Achilles tendon.


The muscles of the foot play a vital role in shock absorption, stability, and propulsion. Weakness here often leads to excessive foot collapse (over-pronation), forcing the calf muscles to work harder to stabilise the limb.


Over time, this increases traction forces through tendons and bony attachments.


Imbalance-related conditions in this region include:

• Shin pain and stress fractures

• Plantar fasciitis

• Tibialis posterior overload

• Calf strains

• Achilles tendinopathy


What About Running Style and Foot Strike?


Much attention has been given to forefoot and midfoot running styles compared to heel striking. While certain strike patterns may reduce ground contact time and improve elastic recoil, they also increase demand on the calf–Achilles complex.


Without adequate strength, flexibility, and foot stability, sudden changes in running style can increase injury risk rather than reduce it.


The key message is not about copying a specific running style—but ensuring the joints and muscles are balanced and capable of handling the demands placed upon them.


Final Thoughts: Balance Is the Foundation of Injury Prevention


Efficient running relies on strength, flexibility, control, and coordination working together across the entire body. When one area underperforms, another compensates—and injury risk increases.


By addressing muscular imbalances, improving movement quality, and strengthening key areas, runners can:

• Reduce injury risk

• Improve efficiency

• Enhance performance

• Enjoy longer, more consistent training


About Richard Mason


Richard Mason is a Specialist Musculoskeletal Chartered Physiotherapist and Specialist Running Physiotherapist based in Northwich, Cheshire. He has completed over 1,000 detailed biomechanical running and gait assessments, using advanced video analysis to identify movement inefficiencies, training-load errors, and injury risk factors.


Richard regularly treats complex and persistent running injuries including Achilles tendinopathy, plantar fasciitis, medial tibial stress syndrome (shin splints), runner’s knee, IT band syndrome, hamstring injuries, and stress-related bone injuries—guiding runners safely from diagnosis through to full return to running.


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When an injury affects your child’s sport, play or everyday activities, it can be difficult to know what to do next. At Weaver Physiotherapy & Sports Injury Clinic, we offer assessment and rehabilitation for children and young people with sports-related and musculoskeletal problems. Based in Northwich, our clinic welcomes families from across Cheshire, including Tarporley, Knutsford, Winsford, Middlewich, Hartford, Weaverham, Sandbach and Frodsham. You can contact us directly to discuss your child’s symptoms and arrange an appointment; a GP referral is not required to book privately. A physiotherapy assessment considers the injury, your child’s movement and the activities they want to return to. Treatment and rehabilitation are then discussed in light of their needs and assessment findings. What happens at a child’s sports injury assessment? The appointment begins with a discussion about when the problem started, what activities affect it and how it is changing your child’s movement. We may ask about their usual sport, training routine, recent changes in activity and relevant medical history. The practitioner will then assess the affected area and relevant movement and function. This helps explore possible causes and identify appropriate next steps. Depending on your child’s presentation, the plan may include advice, a tailored exercise programme and hands-on treatment where appropriate. Treatment is individual . The approach will depend on the assessment findings, your child’s symptoms and how they respond to activity. If rehabilitation is recommended, exercises can be progressed to support comfortable movement and a gradual return to sport. Sports injuries and pain we can assess Children and teenagers may develop pain or injury after a sudden movement, a knock or a change in training. Assessment may be appropriate for concerns involving the: Back, hip or knee Ankle or foot Shoulder, elbow, hand or wrist Sports-related problems can include sprains, strains, tendon pain and injuries associated with repeated loading. Your child’s symptoms and activity will guide the assessment, rather than focusing only on the painful area. If you have noticed a change in your child’s posture or are concerned about a possible spinal curve, speak to your GP. The NHS advises contacting a GP if you think your child may have scoliosis. Read NHS guidance on scoliosis ⁠. Booking an appointment Please contact Weaver Physio to discuss your child’s symptoms and arrange a suitable appointment. Same-day appointments depend on availability, so please book ahead rather than relying on a walk-in consultation. When you get in touch, it can help to explain: When the symptoms began Which movements or activities make them better or worse Whether the problem affects walking, sleep, school, training or sport Any relevant medical history or recent changes in activity It can also help to let your child describe how the problem feels in their own words. Please bring comfortable clothing that allows movement to be assessed. Weaver Physiotherapy & Sports Injury Clinic 110 Middlewich Road, Northwich, Cheshire, CW9 7DP Call 01606 227484⁠ or visit weaverphysio.com ⁠. Free onsite parking is available. When to seek urgent medical help A physiotherapy appointment is for non-emergency musculoskeletal concerns. If your child has a serious injury, or you are unsure whether they need urgent care, use NHS guidance or contact NHS 111. The NHS advises taking a child to A&E or an urgent treatment centre if they have an arm or leg injury and cannot use the limb. Read the NHS guidance on children’s accidents . For information about checking an individual physiotherapist’s registration, visit the HCPC Register ⁠. Frequently asked questions Do we need a GP referral? No. You can contact the clinic directly to ask about booking a private appointment for your child. Do you accept walk-ins? Please book an appointment in advance. Same-day consultations may be available, depending on the clinic schedule. What should my child wear? Comfortable clothing that allows them to move freely is helpful for the assessment. Do you provide scans? Scans are not included in every clinic appointment. If further investigation appears appropriate, this can be discussed with you and your child. How much does an appointment cost? Please contact the clinic for current fees and to discuss the appointment that may be suitable for your child. Discuss an appointment for your child If pain or an injury is affecting your child’s movement, sport or usual routine, contact Weaver Physiotherapy & Sports Injury Clinic to discuss an assessment in Northwich. We’ll talk through your concerns and the possible next steps for your child.
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Have you ever been told that your running style is “wrong” and immediately wondered whether you need to change it? Advice online can make normal differences in movement look like faults. While certain running habits may be worth exploring—particularly when pain keeps returning—there is no single perfect stride, cadence or foot strike for every runner. At Weaver Physiotherapy & Sports Injury Clinic, we take an individual approach to running technique. Your training history, symptoms, strength, mobility, goals and the way you respond to load all matter. For runners in Northwich, Middlewich, Winsford, Knutsford, Sandbach, Frodsham and Tarporley, our Runner’s MOT and running gait analysis⁠ provides clear, personalised feedback rather than generic rules. What are common running form mistakes? A “running form mistake” is often better described as a movement habit to investigate. A pattern may look unusual without being harmful, and a video alone cannot confirm that it is the cause of pain. Common concerns include: Overstriding – the foot appearing to land well ahead of the body. Upper-body tension – raised shoulders, clenched hands, a tight jaw or stiff arm swing. Forcing foot strike – deliberately trying to run on the forefoot or heel when it feels awkward. Slumped posture – losing trunk control as fatigue develops. Abrupt changes in technique – trying to alter cadence, posture and foot strike at the same time. These patterns can change with pace, hills, footwear, fatigue, confidence and training load. Research has found limited evidence that individual biomechanics alone predict running injury, which is why form should be considered alongside the wider picture rather than treated as a diagnosis. Is there one correct way to run? No. Effective running does not look identical from person to person. Your anatomy, strength, experience, speed, terrain and fatigue level all influence your stride. A single photograph or short clip captures only one moment. It cannot explain how you feel during a run, what your training has involved that week, or whether a movement pattern is actually contributing to symptoms. If you are comfortable, progressing well and free from persistent pain, you may not need to change your technique simply because it differs from someone else’s. The aim is not to chase a “perfect” running style. It is to understand your own movement and make sensible adjustments only when they are relevant to your goals or symptoms. How to assess your running form safely Start with one question. Perhaps your foot feels as though it reaches too far forwards, your shoulders tighten on longer runs, or you notice discomfort appearing as you fatigue. During an easy run at your usual pace, consider: Does your breathing feel relaxed? Are your shoulders, hands and jaw unnecessarily tense? Does your stride feel comfortable and natural? Does your movement alter later in the run? Is there recurring pain during, after or the following day? If you use video, record a brief clip from a safe, consistent position beside the route or on a treadmill. Never hold or watch a phone while running. Footage can be useful for observation, but it should prompt questions—not provide a self-diagnosis. How to change running technique without overdoing it Avoid making dramatic changes based on a social-media tip or a one-size-fits-all rule. A sudden change in cadence, posture or foot strike may feel unnatural and can make it difficult to work out what is helping. Instead: Choose one area to explore. Use one simple cue during an easy run. Keep the adjustment gentle and brief. Notice how it feels during the run and over the next 24–48 hours. Do not introduce several technique changes at once. For example, if you feel tense through the upper body, a helpful cue may be “soft shoulders and easy arms” rather than forcing a rigid posture. 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What can running gait analysis help with? A running gait analysis does not promise to predict injury or reveal one universal correction. It can, however, provide a clearer view of movement patterns in the context of your symptoms, training and goals. At Weaver Physio, our Runner’s MOT (/runners-mot)⁠ combines slow-motion video gait analysis with strength, mobility and movement assessment. We look at factors such as: Running rhythm and lower-limb control Trunk, hip, knee and foot movement Strength, balance and mobility Previous injuries and current symptoms Training volume, recovery and running goals Your findings are then used to create practical, personalised recommendations. This may include a gradual gait cue, running-specific strength work, mobility exercises, load-management advice or a structured return-to-running plan. Our Chartered Physiotherapists and Sports Rehabilitators bring more than 70 years of combined clinical experience to help runners move with greater understanding and confidence. Build a stronger, more confident running stride Running form is not a test you have to pass. A movement pattern may be worth exploring, but it does not automatically mean that something is wrong. Pay attention to comfort, recurring symptoms and changes that develop with fatigue. Make adjustments gradually, progress training sensibly and seek individual support if pain continues. For runners across Northwich and Cheshire, Weaver Physio’s running gait analysis service (/runners-mot)⁠ offers professional, tailored guidance to help you run stronger and with more confidence. Frequently Asked Questions Is there one correct running form for everyone? No. There is no single ideal foot strike, cadence or posture that applies to every runner. Comfortable, efficient running can look different depending on the individual, their pace, experience and physical characteristics. Can changing my running form cause pain? It can. Sudden or uncomfortable changes may increase stress in unfamiliar areas. Make one gradual change at a time and reduce or stop if pain worsens. How can I tell if I overstride? Overstriding may appear as the foot landing well ahead of your body, but this does not automatically mean it is causing a problem. A short video can provide useful context, while a gait assessment can help interpret the pattern alongside your symptoms and training. When should I book a running gait analysis? Book an assessment if pain is recurring, your running style has changed, you are returning from injury, or you would like clearer guidance about your stride and training. Weaver Physio supports runners from Northwich, Middlewich, Winsford, Knutsford, Sandbach, Frodsham, Tarporley and across Cheshire.
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