Run Better From The Ground Up

As a physiotherapist with 15 years in clinic, I have lost count of the times a runner has booked in with a sore knee and left saying, I had no idea my foot was the issue. The truth is simple. Your foot is the first point of contact with the ground, and the way it moves sets off a chain reaction that travels through your ankle, knee, hip and spine. Get that first link right and the rest of the chain can share the load smoothly. Get it wrong and somewhere up the line begins to complain.

Why the foot matters so much

Each step is a controlled use of mobility and stability. When your foot lands, it should accept load, adapt to the ground, and then become a firm lever for push off. This requires a natural mix of pronation to absorb shock and supination to create stiffness for propulsion. None of these are dirty words. Pronation is not a problem in itself. It is essential. Problems arise when timing, magnitude, or coordination are off.

Your body is clever and will always find a way to keep you moving. It can do this by changing its movement strategy after injury or overload. Those changes can be helpful in the short term, but they often become less helpful when you push your training. That is why runners can feel fine jogging a few kilometres, only for pain to appear when half marathon or marathon plans begin. Old ankle sprains are frequent culprits. They nudge the system toward protective patterns that linger for months or years. The pattern becomes normal to your brain, even if it is not mechanically efficient.

The knee follows the foot

The knee is a hinge caught between two very mobile regions. It will do what the foot and the hip ask it to do. If the foot pronates through the right range at the right time, the tibia will rotate internally just enough, the femur will follow suit, and forces will be shared across the knee joint surfaces in a way the body likes. If the foot does not pronate well, the tibia may not rotate adequately, which can prompt the femur to rotate more than it should to compensate. That mismatch can increase shearing within the knee. Over time, that can feel like a sharp pain around the joint line, a vague ache behind the kneecap, or a grumpy tendon that flares the day after a long run.

These are not random aches. They are information. They tell us something about how load is being transferred from the ground up.

Rest helps symptoms, not mechanics

A period of rest can calm pain and reduce inflammation. It is often sensible as a first step. But if the underlying problem is a mechanical one, that relief is usually temporary. Increase your mileage again and the same pattern reappears. This is not because your body is weak or broken. It is because it is still using the same strategy. To change the outcome, we need to change the input. That means improving the way you move.

Repatterning the kinetic chain

Movement retraining aims to restore the most efficient pattern from foot to pelvis and beyond. The goal is not to force your body into a textbook pose. It is to guide your bones and joints toward the positions and timings that make running feel smooth and springy.

When we do this well, something interesting happens in the nervous system. We light up familiar maps in the brain that may have gone dim after an injury. With repetition and accurate execution, your brain begins to trust the more optimal pattern again. That trust shows up as better shock absorption, an easier stride, fewer niggles, and more freedom to build training volume.

Strength work then becomes the amplifier. It locks in the new pattern by asking tissues to tolerate higher loads while you hold the improved positions and timings. Strength without mechanics can harden poor habits. Mechanics without strength can lack staying power. Together, they create durable, efficient running.

How I assess movement using the Flow Motion Model

To make this process clear and measurable, I use Gary Ward’s Flow Motion Model in clinic. The Flow Motion Model maps where every bone and joint should be during the five phases of gait when you walk or run. It is a comprehensive, practical way to understand what is happening in your body in real time.

In an assessment, I watch you stand, walk and often jog. I look at how your foot accepts load, how your tibia and femur rotate, how your pelvis and ribcage respond, and how your arms contribute to the whole. The Flow Motion Model gives us a reference for optimal joint positions and timings in each phase. That means I can spot what is missing rather than simply noting what is tight or weak. Missing movement is the key. If a joint is not accessing a normal range at the right moment, somewhere else will pick up the slack.

Once we identify the missing pieces, I prescribe precise movements that encourage your body back into the right place at the right time. These are not random stretches. They are targeted inputs that nudge the system toward efficiency. Clients often feel the change immediately. A foot that suddenly rolls and springs the way it should. A hip that glides instead of gripping. A knee that stops feeling like it is being twisted.

When to get help

If your pain returns as you increase mileage, if you have a history of ankle sprains, or if your knee grumbles during longer runs, an assessment can save you months of frustration. The earlier we restore the missing movements, the faster you can progress your training with confidence.

The bottom line

Your foot is the storyteller of your gait. When it moves well, the tale that travels up to the knee, hip and spine is balanced and predictable. When it does not, the plot twists become aches and pains. Rest can quieten those chapters, but only better mechanics will change the story.

By assessing movement with the Flow Motion Model, identifying what is missing in each phase of gait, and prescribing targeted drills alongside smart strength work, we can guide your body back toward an efficient, pain free stride. The result is not just fewer niggles. It is a more enjoyable run, more consistent training, and the freedom to chase the distances and times you want.