Running Without Pain: Why Every Runner Should Include Strength Training and Physiotherapy

Running has become one of the most popular ways to stay healthy in Australia. Whether you're training for your first Parkrun, preparing for a half marathon, or simply enjoying a few kilometres along the Esplanade in Cairns, running is an incredible form of exercise for your heart, lungs and overall wellbeing.

But there's one thing almost every runner experiences at some point: pain.

Sometimes it's a sore knee after increasing your distance. Other times it's a tight Achilles, aching hips, or a calf that suddenly refuses to cooperate halfway through a run.

The good news is that pain doesn't automatically mean you have to stop running.

In many cases, it's a sign that your body needs to become better prepared for the demands you're placing on it. That's where strength training and physiotherapy come in.

Running is repetitive... and that's exactly why preparation matters

Every time your foot hits the ground, your body absorbs forces that can be two to three times your body weight. Multiply that by thousands of steps during a single run, and it's easy to understand why running asks a lot from your muscles, tendons and joints.

The body is incredibly good at adapting to these forces—but only if it's given enough time and capacity to do so.

Think about someone who decides to go from running twice a week to training five days for an upcoming race. Their fitness may improve quickly, but tissues like tendons and bones usually adapt more slowly than the cardiovascular system.

That's often when little aches begin to appear.

Why do some runners stay injury-free while others don't?

There's rarely one single reason.

Running injuries usually develop because several factors come together over time. Your weekly mileage, recovery, sleep, previous injuries, strength, experience and even everyday stress can influence how your body responds to training.

Research shows that running-related injuries are common, particularly around the knee, foot, ankle and lower leg, but there's no single movement or muscle that's responsible for all of them.

That's why treating runners isn't about finding one "bad" exercise or one "perfect" shoe.

It's about understanding the runner in front of you.

Strength training makes runners more resilient

Many recreational runners think strength training is only for people who want bigger muscles.

It's actually one of the best tools for helping your body tolerate the demands of running.

When you gradually strengthen muscles and tendons, you're improving your ability to produce force, absorb impact and maintain good movement quality as fatigue builds during a run.

A large systematic review published in Sports Medicine found that strength training improves several aspects of running performance, including running economy and overall performance in middle- and long-distance runners.

In simple terms:

A stronger runner often uses less energy to run the same pace.

That's a huge win whether you're chasing a personal best or simply trying to enjoy running without feeling exhausted.

What areas should runners focus on?

You don't need twenty different exercises.

A good running programme usually focuses on movements that challenge the muscles most involved during running.

Calves: the forgotten powerhouse

Your calf muscles work incredibly hard every step you take.

They're responsible for helping propel you forward and absorbing load when your foot lands. Weak calves are commonly associated with problems such as Achilles tendon pain and calf strains.

Exercises like single-leg calf raises and bent-knee calf raises build strength where runners need it most.

Glutes and hips: stability and power

Your hips help control your leg every time you're standing on one foot—which is essentially what running is.

Strong glutes contribute to better control through the pelvis and lower limb, especially during hills, acceleration and longer runs.

Quadriceps: helping the knee handle load

The quadriceps play an important role in controlling the knee during running, stairs and downhill sections.

Building strength here helps improve your ability to tolerate running volume rather than simply avoiding discomfort.

Single-leg strength

Running isn't a symmetrical exercise.

Every stride happens on one leg at a time.

Exercises like split squats, step-ups and single-leg Romanian deadlifts help prepare your body for that reality.

Does strength training prevent injuries?

This is where social media often oversimplifies things.

You'll see plenty of videos promising "5 exercises to prevent every running injury."

The science is more nuanced.

A recent systematic review investigating exercise programmes for injury prevention concluded that there's currently not enough evidence to say one specific programme prevents running injuries for everyone.

That doesn't mean strength training isn't valuable.

It means injuries are influenced by much more than one exercise routine.

Strength training improves physical capacity. A body with greater capacity is generally better prepared to handle training.

That's a much more realistic—and evidence-based—way to think about injury prevention.

Training load matters more than most runners realise

One of the biggest reasons runners develop pain isn't because they're running.

It's because they're suddenly running more.

More kilometres.

More speed sessions.

More hills.

More days each week.

Your body loves progression. It doesn't love sudden jumps.

Instead of worrying about following a rigid "10% rule", it's often more useful to pay attention to how your body is responding from week to week.

Ask yourself:

• Am I recovering well?
• Is soreness lasting longer than usual?
• Is pain getting worse during or after runs?
• Am I increasing more than one thing at once?

Small adjustments early are often easier than dealing with weeks away from running later.

Recovery is part of the training plan

The strongest runners aren't always the ones who train the hardest.

They're often the ones who recover well enough to keep training consistently.

Sleep, nutrition, hydration and stress all influence how your body adapts after a run.

If recovery isn't matching your training load, your body has fewer resources available for adaptation.

Consistency almost always beats occasional "perfect" training weeks followed by forced rest.

What does a physiotherapist actually do for runners?

Many people think physiotherapy starts after an injury.

For runners, it can be valuable long before pain becomes a problem.

A running assessment looks beyond the painful area.

It considers your training history, previous injuries, strength, movement quality, flexibility where relevant, and your goals.

For example, two runners with knee pain might need completely different treatment plans depending on why their symptoms developed.

The aim isn't to find something "wrong" with your running style.

It's to understand what your body needs to tolerate the running you enjoy.

Should you stop running if something hurts?

Not always.

Pain exists on a spectrum.

A little discomfort during or after a run isn't automatically a sign that you've caused damage.

What matters is how symptoms behave.

Pain that settles quickly, doesn't progressively worsen and responds well to modified training is very different from pain that's becoming more intense, changing your running mechanics or lingering for days afterwards.

This is where physiotherapy helps remove the guesswork.

Instead of choosing between "push through it" or "stop completely", you can often modify training while continuing to stay active.

Building a routine that works

You don't need to spend hours in the gym.

For many recreational runners, two strength sessions each week are enough to complement a running programme.

Those sessions should include progressive lower-limb strengthening, balance where appropriate, and exercises that reflect the demands of running.

The best routine is the one you'll actually continue doing.

Simple. Consistent. Progressive.

The goal isn't perfection. It's longevity.

Every runner will experience setbacks at some point.

That doesn't mean you've failed, and it doesn't mean running is bad for your body.

The goal is to build a body that's capable of adapting to the sport you love.

Running should help you feel healthier, stronger and more confident—not afraid of movement.

Strength training, sensible progression and personalised physiotherapy are all pieces of the same puzzle.

They're not about making you invincible.

They're about helping you keep doing what you enjoy for years to come.

Our Running Physiotherapists