1. How to avoid foot pain with running
Running does not cause foot pain
Running improperly does
The key to running form, and running injury free, is to have a stable base with which to run.
The base is NOT the foot!
The base is the pelvis. To highlight this point, think of what is acceptable when you have an
injured foot. People who can’t run due to injury are most often able to ride a bicycle or use
an elliptical. Why?
Because there is less pressure and load on the foot? Partly. The main reason is that a bicycle
seat stabilizes the pelvis, or at least, the body is able to leverage against the seat to create
stability and keep consistent motion of the legs. The elliptical also reduces stress on the
pelvis by creating lift of the “swing phase” leg without the need for lifting the leg. Thus the
body never has to utilize the hip flexors to do their job, creating leg lift, and improper form is
enabled.
Neil Feldman, DPM
Central Massachusetts Podiatry
299 Lincoln Street – Suite 202
Worcester, Massachusetts 01605
508-757-4003
www.centralmasspodiatry.com

2. Body Position
 Align ear, shoulder, hip and ankle
 Think long
 The key is to keep the pelvis neutral and stabilize with abdominal muscles. The
tendency is to bend forward at the waist, lurch head forward or slump shoulders
forward.
 Run with Relaxed legs and feet.
 Resist the urge to “push off.”
 Be sure the toes stay relaxed and down. If the toes come up, the heel goes down.
 Every foot fall should be In Line with the Body and land underneath the body.
Neil Feldman, DPM
Central Massachusetts Podiatry
299 Lincoln Street – Suite 202
Worcester, Massachusetts 01605
508-757-4003
www.centralmasspodiatry.com

3. Tendencies
With fatigue, the pelvis loses stability and the upper body leans forward. The hip angle is
reduced as a result and thus the hip range of motion is reduced. The foot will land in front of
the body (think relative positions - if the upper body is leaned forward, then the foot should
be landing in line with the body, and thus behind the pelvis), and the toes will have to lift to
allow the foot to clear the ground as the hip won’t be able to lift high enough. The leg
muscles in the shin lift the toes and can fatigue leading to shin splints. The heel will hit the
ground first and can lead to plantar fasciitis and achilles tendonitis, among other ailments.
The toes will grip the ground to stabilize the foot, leading to bunions, hammertoes,
metatarsal pain, stress fractures and/or neuroma’s. Those are just the problems that
develop in the foot!
Neil Feldman, DPM
Central Massachusetts Podiatry
299 Lincoln Street – Suite 202
Worcester, Massachusetts 01605
508-757-4003
www.centralmasspodiatry.com

4. Speed
Speed comes from maintaining or increasing cadence with increased body lean. Our tendency
is to overstride and push more. This creates major inefficiencies and increases energy
expenditure leading to rapid fatigue and breakdown in form.
Shoes
Shoes must allow the foot to function and be shaped as it’s intended to be. If the big toe
wants to go toward the inside; it must not be forced to the outside. Fit must be comfortable
and not constrictive. Proper fit is also heavily dependent on proper mechanics. Don’t let
shoes be enablers of bad form! Focus on width at the areas of need (forefoot and toes) as
well as last shape (curved, semi-curved or straight). Understand posting, stability and the
weight of the shoe.
Orthotics
Support of the arch is a misnomer. All feet pronate (leg rotating inward and arch flattens,
destabilizing the foot) and all feet supinate (leg rotates outward, arch raises and foot
stabilizes). Some do it more than others, and some are at extremes. Essentially, a flat foot
is an over-pronated foot whereas a high arched foot is an over-supinated foot. Not to belabor
the point, but over-supinated and under-pronated are the same thing, and thus this foot type
will be more rigid, and less adaptable. Pronation is the necessary function of unlocking the
foot to allow it to adapt to the ground and ground reactive forces. Usually, due to poor
mechanics or proximal instability (think pelvis), the body is unable to reverse the pronation
(i.e. supinate) and the foot remains unstable throughout the stance phase of gait (foot on
ground). This is NOT necessarily a foot problem!!!! It has as much to do with the body
moving over the foot as it does with the foot itself. The key is the heel. If the heel is turned
outward relative to the lower leg (valgus), then the foot is unlocked or pronated. At an
extreme (over-pronation), the body will always be “fighting” for stability atop the unstable
foot. This will force many of the larger muscle groups above the feet to overwork and
fatigue. I like to use the analogy of walking barefoot on a soft, sandy beach. It takes much
more effort as the ground provides no stability. Overpronators are essentially always on this
proverbial soft, sandy beach. A good orthotic will stabilize the heel and prevent the foot
from unlocking past that which is normal. This will create a consistent point of reference for
the body to then work on gaining stability and hopefully regaining proper movement and
form.
Neil Feldman, DPM
Central Massachusetts Podiatry
299 Lincoln Street – Suite 202
Worcester, Massachusetts 01605
508-757-4003
www.centralmasspodiatry.com