It hurts when I run
This past week on The Injury Corner — a Facebook group I created to offer guidance and support for people dealing with chronic pain and injury — there was a great discussion with some helpful nuggets I wanted to share.
We talked about whether barefoot running can help heal low back pain and instability to the sacroiliac (SI) joint, and the difficulty of being told the activity you love may be hurting you.
I find these two subjects to be especially valuable and important both professionally and personally. As a movement specialist, I see many people struggling with the issues of pain while performing the activities they’re passionate about. As an active former athlete, I’ve struggled with the exact same issues myself.
It hurts when I run. Does barefoot running help heal low back pain and potential instability to the sacroiliac (SI) joint?
I have lived a barefoot/minimalist lifestyle for over five years. However, I have been unable to run consistently for the past three. I have gait dysfunction connected to 5 knee surgeries, and a long list of other injuries associated with sports, stubbornness, and my reckless youth. The gait dysfunction shows in my body’s ability to absorb the impact energy of footfall as it transfers up the kinetic chain through my ankles, knees, hips, spine, and shoulders.
Some quick anatomical mechanics: As you can see in the pictures above, the arches of the foot create a spring leaf suspension system similar to that of a truck. This system absorbs the energy of each step, distributes this energy equally throughout your fascial system, and re-releases the energy through the propulsion phase of your gait.
With this dysfunction in my suspension system, the arch is unable to act like a nice shock absorbing spring, and my foot lands stiff and solid. Instead of spreading the energy load throughout my fascia, the impact goes directly into the harder tissues of bone and joint structures, which don’t have the ability to absorb impact as well.
Based on my personal and professional experience, both as a barefoot runner and through helping other runners transition into a barefoot lifestyle, I don’t believe that barefoot running will help heal your SI joint. If anything, there is a really good chance that in the short term it will make things worse. SI joint instability is a mechanical-structural issue, which means the relationship between how you move (mechanical) and how your structure is able to mobilize and stabilize through movement (structural) isn’t functioning in its most efficient state. The problem has little to nothing to do with what is on your feet, whether you are running barefoot or shod. It is a problem with the mechanical-structural relationship of your running gait.
It is not an issue of whether you should run barefoot or shod, but rather should you be running at all? In my professional opinion, you should not.
Now I want to take a moment after that last statement. If you’re a runner currently running through pain, did being told you should not be running kick up an emotional response? Tune in; do you feel anger, fear, judgement, dread? If you feel any kind of emotional process, please take a deep breath and let that move through you before continuing on.
Being told a certain movement isn’t best for your body is a hard pill to swallow.
Believe me, I know how hard a pill it is to swallow. Over the past three years, I’ve repeatedly attempted to get back into running. Each time, three or four weeks in I would get painful calf spasms and I’d be out for weeks again. It has taken me years to change my mindset around exercise. I had to let go of the ego drive to do what I wanted to do (run), and instead focus on the quality movements that my body needs and desires to allow it to heal.
The path to quality, pain-free movement begins by changing your mindset around your fitness, health, exercise, nutrition, and so much more. It begins with a simple understanding:
If I am in pain, then the way I have been moving is hurting me. If I want to feel better, I must change the way that I move. To do this, I must change.
Change is a scary thing. It is a hard pill to swallow indeed. It often brings with it some big fat emotional processes such as noted above. However, If you find the deep desire to change, you have made the first step toward fundamentally changing your life.
With a desire for change, the next step is to begin checking in with your body and asking yourself some important questions about exercise and movement. When you hear yourself saying “It hurts when I run!” Here are a few questions you can ask:
Is this movement safe?
Is this movement healthy?
What is my motivation to continue to perform a movement that hurts me?
What can I let go of from my old paradigm of movement?
What movement is safe, healthy, and loving to my body?
These are questions that must be asked every day and for each exercise based movement you feel a desire to engage in, whether it is yoga, running, resistance training, swimming, cycling, etc. One day a movement may be healthy for your body, and the next day it may be unsafe or unwise to do. Even exercises which you would consider “gentle” can be too much, and yes, this can change from day to day. By getting in the habit of asking these questions each day you will learn how your body communicates with you through pain, and you will develop a new relationship and understanding with your body. This is a beautiful thing that will then shift to other areas of your life.
Pain-free running and beyond
I hope to be able run regularly again. But only when running is a healthy movement choice supported by my body. Only then will I even consider the question of whether to go barefoot or shod. To help me achieve this long-term goal to run again, I am receiving regular assessment and treatment from one of the top movement specialists around.
As long as you are saying “It hurts when I run”, running is not a healthy movement choice. At least not until the inefficiency of movement in your running gait has been fully assessed and corrected. To do this I highly recommend finding a highly skilled movement professional who specializes in gait assessment. This would not be a shoe salesperson!
If you need help finding a movement professional in your area, please let me know. I will do my best to connect you to the best health care team available. If you are in Austin, Texas, contact The Art of Fitness for walking and running gait assessment so we can get you running pain free again.
Do you have a frustrating or inspiring injury related question or story? Please share in the comments below.
It is interesting to read such an honest article, thank you. I work daily with people going through similar issues. The most telling thing is when I have a person do a very precise movement with subtle focus work and ask when I ask that person “what are you feeling”, they respond ” I feel nothing”. It as if they have lost such connection with their body because of pain that they cannot feel the joy that comes from a real connection with that body. So many seem to be focussed on the punishment of that body rather than the connection and harmony of working with themselves. It is at that point that I need to work the person very slowly and precisely sometimes dealing with only one theme or movement isolation for weeks on end eg movement of the femoral head in gait or strengthening the toes. Some people just don’t stick, but I find those who are in the head space you are talking about do. Other people I have to refer to another practitioner What these clients have all reminded me of is that we all have a “Road to Damascas” moment,
and when we do the right teacher or person is there for us because we are ready to listen and really learn.
Thank you for the comments Carla.
Jesse James
As a long time Iyengar yoga practitioner, i would never, EVER, push on a pose if something hurts. If it’s the “bad” pain don’t continue! if it’s the “good” pain – just breathe
Thanks for the comment Hilit. Total agreement.
Here are some of my thoughts on pushing through the pain.
http://cedarvalleywebwerks.com/Tao-Fit/pushing-through-the-pain
Jesse James
Great article as always. I am a plodder and guy who weighs 3 bills and runs. For years I spent a lot of money on “fat boy” running shoes and my hips, feet and knees hurt. I have been a minimalist for a year now and free of pain. My distances have improved and recovery is better wearing minimalist shoes (aqua socks actually)..I did have a brief issue with Morton Neuroma but it subsided
Thanks John.
Jesse James
Great article Jesse! I do have one question. Does this apply to the female pelvis as the male and female pelvis are slightly different. In my experience with going barefoot, I have had less SI joint pain and definitely more when wearing a generic tennis shoe, even just working, walking and standing. I realize I’m talking about pain, but I feel more stable as well.
Hi Kimberly,
Thanks for the question. Are you referring to just going barefoot or barefoot running? Walking barefoot is less demanding than running barefoot. For some people with SI joint pain or instability, spending more time barefoot my help. For others it may exacerbate the pain. When it comes to running, barefoot or shod — if there is pain present, it is not advisable.
There is an obvious difference in hip the knee structure of men and women. Functionally, I really don’t place these differences into much consideration. Both are functionally designed to walk and run barefoot.
Jesse James
Anger, sadness, depression, confusion and resignation are the emotions surrounding my inability to solve the issues plaguing my body. What movements are safe and healthy for my body? I wish I knew, because just when it looks like it’s figured out, it’s not. My posture is better, that’s good. My balance and core strength are better. I used to be fit, but no more. No running, clearly. Walking? Jury is out. Yoga? I like it, and I think it likes me, but I don’t do the super stretchy hurt yourself kind. Swimming – I’d drown, but walking in water is good. The most frustrating part is not being able to find my way back.
Thanks for such a beautiful share Michelle. I think you speak the words that many many people feel. Finding our way back is incredibly frustrating. I know this personally as well. Every journey begins with a willing first step and firm commitment to keep moving forward.
Jesse James
Here here ! I am in total agreement and as a personal trainer and Pilates instructor I cannot agree more !
Thanks Tamzon
Jesse James
So appreciate this post. I question that hits me the hardest is, “What is my motivation to continue to perform a movement that hurts me?” I have lots of answers for this one. All good. Some of the ego, but really, all so so so good. Actually, at the heart of my reasons is the drive and desire to want to heal the world and to help others shine their own light(s) in this world. We need that. The problem I run into is that because my responses to “Why do I run?” are well-good and beyond myself, I have a hard time letting go of running when it hurts. Push on. It’s going to be ok. My optimistic attitude in life can get the best of me sometime and bite me in the Ass. I use running to express my Higher Self, and by doing so, it gives others permission to do the same (express their Higher Selves). WIth a purpose like that, it’s hard to let go at times. I REALLY appreciate how you encourage us to ask ourselves these questions DAILY. One day running may be painful, if in the middle of an injury, and some days it is pain-free and yoga is what my soul and body is crying out for. P.s. I would like to see a post about changing one’s perspective around food and nutrition when going through injury and NOT being able to move as used to.
Katie,
Thanks for sharing. The little bit I know about you, you are a big, bubbling, beaming light in the world. It shows in everything you do. In my experience, when we push ourselves through pain, we are no longer motivated by our higher selves. This is always a sign of something deeper. And in that space there is an opportunity to explore, feel, and let go of more and more of what doesn’t serve us.
I like the idea for a blog on food and nutrition. However, this is not a topic I focus on. How about a guest post?
Jesse James
Excellent article, thank you. The back pain and knee pain that I was plagued with for years did improved if not disappeared with my running barefoot. However, after three years of continuous BF running I was never able to increase my running distance for more than a four mile run. Foot pain. Being diagnosed as having Morton’s Neuroma, orthotics have been prescribed. That wasn’t what this barefoot runner wanted to hear. Living fifty miles south of Phoenix AZ I will be looking for movement therapy in my area. Thanks again.
Hi Patrick,
I find that most barefoot injuries either happen within the first 3 months of transition or well after 10 months. There is something about getting through the first 6-12 months of transitioning that most people assume they are done with the transition and are ready to go. It takes years for the body to fully transition. I’m over 5 years in and my body is continuing to adjust.
I look at an injury such as Morton’s Neuroma as an issue of gait mechanics. If your posterior or anterior core is inhibited, your body will recruit from your feet and toes for stability. This places stress on the musculature and structure of the arch of your foot. This can degrade the arch causing a medial collapse in which the nerve can become exposed at foot fall. I haven’t seen anyone find relief with orthotics. If anything, the orthotics create even more long term problems for your structure. I suggest finding a highly skilled movement professional who can help assess and correct both walking and running gait mechanics.
Jesse James
Thanks again Jesse for your passion and dedication in helping others. I have been going back and forth with this “to run, or not to run” thing. Not only for my clients…but also for myself. Since attending NKT I, I have been consumed with correcting my own dysfunctional movement patterns before running again. It is so hard to tell a client to stop doing what they are doing. And…I really don’t want to tell them to stop. I want to teach them to listen to their bodies more, and be more cognizant of their pain in relation to what they are doing. I’m a “cheerleader”, and I want to give my clients hope. Am I giving them false hope? Am I prolonging their pain by giving them temporary relief so that they continue to do more harm to their bodies? This is a tough one for sure. In the meantime…I will continue to educate myself on ways to help others move better and advise caution on the long term affects? Thanks again!
I agree Amy. It is difficult to tell somebody that what they’re doing may be hurting them. I remind myself that I’m not “telling” them anything. I’m providing my professional opinion. It is up to them to weigh the benefits and risks of the decisions they make. I can’t make anyone change. They must be willing to change themselves. If they have the desire to change, then I’m there to help guide them through the process. If they are not at a point where they are ready to change, then I offer them the space to hurt, grow, flail, cry, or vent.
Jesse James
Ask yourself if know a runner that has not had a running related injury.The idea of always running farther and faster means you are always trying to cause exhaustion .Your form fails,your gait gets sloppy.Why did you start running.Maybe get fit,loose weight etc.If you injure yourself running you will be unfit and continue too run thru pain you create a setup for more injury.How does that meet your initial goal .
Agreed. There is a delicate balance between form, function, and our desires to push ourselves beyond our current abilities. Push to far and we break down the body.
Jesse James
excellent article I am in agreement as long time runner with knee issues …. thanks
Thanks Mike.
Jesse James
You’ve hit the nail on the head with what I have been struggling with. I ruptured my achilles tendon two years ago, and due to some nerve damage from anesthesia I lost a considerable amount of plantar flexion, or at least the strength in that motion. The most I have been able to run is a 5k since, and my main issue is that my gait is horrible when I run. Also, I have one large calf and one that’s atrophied, so the atrophied leg doesn’t pull it’s weight and the normal leg gets exhausted. I’ve been considering giving up running, but I sure do love and miss those trails.
Thanks for sharing Rory. Are you seeking help from a movement professional? If you teach the structure to respond appropriately through gait, you should be able to get back to pain free running.
Jesse James