Image credit to Ryder Wear ♦ 

Many runners experience back pain, especially lower back pain. However, research shows that back pain is less common among runners. So, although running is not bad for your back, there are several things you can do to avoid suffering from back pain while and after running.

A sedentary lifestyle significantly increases the incidence of recurring low back pain. But runners have other factors that can lead to nonspecific lower back pain.
The main causes of back pain while and after running are:

• Hyperlordosis – A condition that occurs when the lower back experiences stress or extra weight and is arched to point of muscle pain or spasms.
• Muscle strains and sprains.
• Excessive wear and tear of the spinal discs, known as degenerative disc disease (DDD).

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Disclaimer: This post is not medical advice and is not intended to provide diagnosis or treatment for any medical conditions. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns.

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Here are 8 tips for preventing lower back pain while and after running:

1. Suitable Running Shoes

Wearing the wrong or worn-out running shoes can lead to lower back pain.
Running shoes need to fit your feet, running activity, style, body weight, and the surface on which you run.
Click on the link below to read more on how to find the best running shoes for you:
What to look for when buying running shoes?

Highly Cushioned Running Shoes May Contribute to Back Pain

Highly cushioned running shoes absorb shock and help to protect the joints, but they may also change the way your foot hits the ground.
Several studies have demonstrated that runners land harder when landing on cushioned surfaces. Some cushioned running shoes can force the impact toward the middle of the foot and the toes rather than the heel. This may create a misalignment that can radiate to your lower back over time and lead to back pain.

Insoles Can Help

Shoe inserts are sometimes used to treat lower back pain in people who have a pronated foot function or type of foot dysfunction or imbalance. A study showed that interventions that modify foot function, such as wearing orthotic insoles, may help reduce or even prevent lower back pain.

2. Strength Training For Runners

Strength training for runners and exercises that improve your posture helps prevent back pain from running.
When our core, glutes, hips, or hamstrings are weak, the back muscles work harder to compensate. So you should do strength exercises that focus on those muscles.

Regarding the training frequency, the Office of Disease Prevention and Health Promotion recommendation is to do back-strengthening and stretching exercises at least two days a week.

3. Doing A Proper Warm-up

A warm-up before a run helps us to run faster and reduces the risk of injuries. However, when suffering from lower back pain a proper warm-up is crucial.

A proper warm-up includes the following 3 steps detailed in the Warm-up Before Running post:
1) Dynamic warm-up to lubricate the joints
2) Technique exercises
3) Walking/Easy running

To protect your back, you must also do warm-up exercises for the spine. Such as the Cat / Cow exercise.
In the following link, there are 8 example exercises for your back to include in your warm-up routine:
Warm-Up Exercises to Protect the Back

4. Avoid Overtraining

Not giving yourself enough recovery time leads to injuries and pains, such as lower back pain.
When you overtrain, there is a risk of stretching or tearing the muscles and ligaments in your lower back, which can lead to symptoms such as pain, stiffness, and muscle spasms.

10 Signs That Indicate Overtraining:

1. Persistent injuries or muscle pain.
2. A decline in performance.
3. The legs feel heavy and tired.
4. Persistent fatigue.
5. Increased irritability and moodiness.
6. Feeling slower and weaker.
7. Loss of motivation.
8. Reduced appetite and weight loss.
9. No Period.
10. Higher heart rate

5. A Good Night’s Sleep

Getting enough sleep is needed to avoid low back pain. A good sleep gives your spine time to recover from the previous day’s activities. It also helps the spine decompress after running.
However, getting too much sleep is not good for you either. Because people who oversleep are more likely to experience back pain.
Usually, the reasons for back pain after a night’s sleep are:

• An old or wrong mattress
• Poor sleeping position
• Laying on your back for long periods

6. A Good Running Form

A poor running technique may lead to lower back pain and other pains and eventually turn into irritating injuries.
However, a proper running technique will help you reduce the impact on your body as you run.
Additionally, a good technique will help you maintain proper running posture and control of the lumbopelvic region, which reduces pressure on the lumbar spine and reduce back pain.

So, although there is a debate about whether there is one correct running technique or whether it varies from person to person, most experts agree on the following guidelines:

• Run from your hips, and drive forward with your knees.
• Your body should be leaning slightly forward from the ankles and the spine at a moderate angle.
• Upper body while running:
  Keep your upper torso straight, so the head should be up with your eyes looking ahead.
  The shoulders need to be relaxed and slightly pulled back.
• Swing your arms naturally while your elbows are about 90 degrees and close to your body.
• Although most runners and even elite runners are heel strikers, it is recommended to land with the forefoot or mid-foot, but not with the heel. Thus reducing stress on your joints during the run.

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When running on a treadmill, maintain a correct posture by keeping your shoulders back, your body upright, and your head up.
Do not lean forward because the treadmill pulls your feet backward. Unless you are using a steep incline, that may require leaning forward.
If you lean forward too much, you may end up with lower back and neck pains.

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7. Yoga For Runners

Yoga is a mind-body exercise that combines physical postures, controlled breathing, and meditation to achieve relaxation, which is often recommended to treat not only back pain but the stress that accompanies it.

Practicing yoga for even a few minutes a day can help to prevent or relieve back pain.
So, runners with limited time can include a few yoga poses in the cool-down after a run.

Following are several yoga poses that may be helpful in treating back pain recommended by Healthline (with example videos):

1. Child’s Pose (highly recommended)
2. Cat-Cow (highly recommended)
3. Two-Knee Spinal Twist (highly recommended)
4. Downward-Facing Dog
5. Extended Triangle
6. Sphinx Pose
7. Cobra Pose
8. Locust Pose
9. Bridge Pose

Notice: If you feel pain while doing a pose, stop the practice (especially when practicing poses 4 – 10).

8. Running Downhill – Smaller Steps and Avoid If Possible

Downhill running without proper engagement of the core muscles can put a lot of pressure on the lower back, resulting in pain and soreness afterward.
So generally, if you suffer from back pain, you should avoid running downhill as much as possible.

How to Run Downhill Properly

While running downhill, you should shorten your stride and take smaller steps, especially when there is a steep descent.

Our instinct is to lean back when running downhill. But this puts a strain on your joints and lower back. Therefore it is better to lean forward.

A lot of people can develop stress in their lower back from being unaware of keeping their core strength as they run downhill. Also, holding your stomach in as you run down steep hills can take a lot of pressure off your lower back.

Finally, if the terrain is too steep, do not hesitate to slow down and walk.

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➤ References

1. T Videman, S Sarna, M C Battié, S Koskinen, K Gill, H Paananen, L Gibbons (1995): “The Long-Term Effects of Physical Loading and Exercise Lifestyles on Back-Related Symptoms, Disability, and Spinal Pathology Among Men“. Published by Spine Journal. https://journals.lww.com/spinejournal/Abstract/1995/03150/The_Long_Term_Effects_of_Physical_Loading_and.11.aspx
2. “Everything You Need to Know About Hyperlordosis“. Published by Healthline’s Medical Affairs. Medically reviewed by William Morrison, M.D. — By Marjorie Hecht — Updated on September 2, 2018. https://www.healthline.com/health/hyperlordosis
3. Chaunie Brusie, Jason M. Highsmith, MD Neurosurgeon (Aug 24, 2021): “Degenerative Disc Disease Symptoms, Causes, Treatments and More“. Published on SpineUniverse .
   https://www.spineuniverse.com/conditions/degenerative-disc-disease
4. Rice, Hannah M.; Jamison, Steve T.; Davis, Irene S. (2016): “Influence of Footwear and Foot Strike on Load Rates during Running“. Published on Medicine & Science in Sports & Exercise.
   https://journals.lww.com/acsm-msse/Fulltext/2016/12000/Footwear_Matters__Influence_of_Footwear_and_Foot.14.aspx
5. Hylton B. Menz, Alyssa B. Dufour, Jody L. Riskowski, Howard J. Hillstrom, and Marian T. Hannan (2013) “Foot posture, foot function and low back pain: the Framingham Foot Study“. Rheumatology 52(12) pp2275–2282. Available on: https://academic.oup.com/rheumatology/article/52/12/2275/1802417
6. “Prevent Back Pain” (2021). Published on: Healthfinder.gov. Provided by: U.S. Department of Health and Human Services.
   https://health.gov/myhealthfinder/healthy-living/safety/prevent-back-pain
7. Henry Halse (2019): “Pre-Workout Stretches to Protect the Back“. Published on LIVESTRONG.com.
   https://www.livestrong.com/article/106856-warmup-exercises-protect-back/
8. Rory McAllister (2022): “Is Heel Striking Dangerous? The Latest Research On Heel Strike Vs Forefoot Running“. Published on Marathon Handbook.
   https://marathonhandbook.com/forefoot-vs-heel-strike-running/
9. “The 10 Best Yoga Poses for Back Pain“. Published by Healthline’s Medical Affairs. Medically reviewed by Gregory Minnis, DPT, Physical Therapy — By Emily Cronkleton — Updated on August 25, 2020. https://www.healthline.com/health/fitness-exercise/yoga-for-back-pain

Patellofemoral pain syndrome (PFPS), also known as a runner’s knee, is common among runners and cyclists. It is also reported to be about 25%–30% of all injuries seen in a sports medicine clinic.
But it can be prevented!
So here are 8 tips on how to prevent Runner’s Knee.

What is Runner’s Knee?

Runner’s knee is the common term used to describe any one of several conditions that cause pain around the kneecap, also known as the patella.
These conditions include anterior knee pain syndrome, patellofemoral malalignment, chondromalacia patella, and iliotibial band syndrome.

As the name suggests, running is a common cause of a runner’s knee. However, any activity that repeatedly stresses the knee joint can cause the disorder, for example, walking, skiing, biking, jumping, cycling, and playing soccer.

According to the Harvard Medical School, runners’ knee is more common in women than in men, particularly in middle-aged women. Also, overweight people are especially prone to a runner’s knee.

Runner’s Knee Symptoms

There are several possible underlying causes of a runner’s knee, and because of this variety, its symptoms can vary. Some symptoms are relatively common. Other symptoms are a result of an underlying knee condition.

Primary symptoms of runner’s knee may include:

• Pain in the front of the knee.
  Misalignment of the femoral groove and the patella may cause pain around the front of the knee or the sides of the kneecap.
• Knee crepitus.
• Pain worsens when moving.
• Knee swelling.
• Stiffness in the knee after rest.

Here are 8 Tips on How to Prevent Runner’s Knee:

1. Strengthen and Stretch Your Lower Body

Do exercises for strengthening and especially stretch your quads, calves, and hamstrings.
Strengthening your lower body will help to keep the knee stable while running.
Also, stretching helps to increase leg flexibility and reduce tightness.

Here are 10 exercises for a runner’s knee recommended by Healthline:

1. Standing quad stretch
2. Standing hip flexor stretch
3. Straight leg lift
4. Standing calf stretch
5. Step up
6. Clam exercise
7. Wall slide
8. Donkey kick
9. IT band stretch
10. Hamstring stretch

2. Proper Warm-up and Cool-down

Do a proper Warm-up before running and Cool-down after.

Warm-up

Running when the muscles are cold and the joints are stiff, can lead to a runner’s knee and other unnecessary injuries.
A proper warm-up includes the following 3 steps:
1) Dynamic warm-up to lubricate the joints
2) Technique exercises
3) Walking/Easy running

Cool-down

The post-run cool-down dramatically reduces the chances of running injuries including the runner’s knee. It relaxes the muscles and helps to eliminate lactic acid and other metabolic waste products from the muscles.

A proper cool-down includes two parts:
1) Jogging and/or walking
2) Static stretching

For information, doing static stretches improve your flexibility and range of movement. It also speeds the recovery by bringing more blood and oxygen to your muscles.

3. Try Not to Run on Hard Surfaces

Running on hard surfaces increases the impact force when your foot hits the ground and delivers more force to your joints. This may lead to a runner’s knee, so try not to run on hard surfaces like concrete.

4. Use Shoe Inserts If Needed

Use shoe inserts if you have problems that may lead to the runner’s knee.
If your runner’s knee is caused, even partially, by foot biomechanics, inserts (or insoles) for the runner’s knee can help.

The insoles’ support prevents the inward rotation of the knee that results from overpronation of the foot.

5. Gradually Increase Mileage and Intensity

The more miles you run, the more time the body needs for recovery and getting used to the training volume and intensity.
Listed below are 4 guidelines for gradual and consistent training:

• Increase the running distance slowly.
• A drastic increase in the weekly mileage can cause a runner’s knee and other injuries. For example, if you usually run 20 miles per week, you should not jump in one week to 30 miles.
• It is recommended not to increase the weekly mileage above 10% than the week before.
• However, the training progress should not be linear, cutting back mileage and intensity by 40% to 60% every fourth week may help to prevent the runner’s knee and any knee pain injury from becoming a severe injury.

6. Make Sure Your Shoes Have Enough Support

Running shoes are typically neutral and support (stability) shoes.
The support shoes have extra strength in the inner arch to help runners who roll their feet when running.
The arches and heels support force the body to get in posture and center the body correctly. Also, support shoes distribute body weight evenly on the foot.
According to research, running shoes that are suitable for you can help decrease the pressure put on the knees and help with knee pain.

7. Do Not Bend the Knee Past 90 Degrees

Repeated bending and kneeling can irritate the bursa on top of your kneecap. Therefore, avoid bending the knee while bearing weight and flexing the knee past 90°.

8. keep a Healthy Weight

In general, reducing excess body weight can help to prevent a runner’s knee.
Each step taken while running puts 3 to 8 times your body weight on each leg. 
Additionally, extra pounds can cause mobility issues and throw your joints out of alignment.
Therefore, being overweight can cause unwanted stress on the knees.

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Runner’s Knee Frequently Asked Questions

What are the symptoms of a runner’s knee?

The most common runner’s knee (Patellofemoral Pain Syndrome) symptoms are:
1) Rubbing, grinding, or clicking the sound of the kneecap that you hear when you bend and straighten your knee.
2) Pain in and around the kneecap that happens when you are active. Or pain after sitting for a long time with the knees bent. This sometimes causes weakness or feelings of instability.
3) Kneecap that is tender to the touch.

What is the fastest way to recover from a runner’s knee?

To speed recovery from runner’s knee and relieve pain, you can:
1) Rest your knee when possible.
2) Ice your knee to ease pain and swelling.
3) Compression: Wrap your knee with an elastic bandage or sleeve to restrict swelling,
4) Elevate your leg on a pillow when you sit or lie down.
5) Do stretching and strengthening exercises, especially for your quadriceps muscles, calves, and hamstrings.

How long does it take to recover from a runner’s knee?

On average, it takes four to six weeks to recover from the runner’s knee (patellofemoral pain syndrome). However, it is individual and depends on the injury severity, so some runners may recover more quickly, while others take longer to heal.

Can I do squats if I have bad knees?

Squat exercises can help build leg and hip strength, leading to more stable joints.
As long as you’re able to practice with minimal knee joint discomfort, it is safe to include squats in your exercise routine.
People with “runner’s knee” may find the most benefit in Wall Squats since squatting against the wall can help reduce the risk of putting unnecessary or incorrect pressure on the knees.

Post Images Credits:

• Image credit to Ryder Wear

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Want to run faster and improve your athletic performance? Discover the secret to unlocking your potential with VO2 max – a crucial metric that measures your body’s ability to consume and use oxygen during exercise. In this post, we’ll explain what VO2 max is and why it matters for runners, cyclists, and swimmers. We’ll also share tips for improving your VO2 max to help you achieve your fitness goals. Ready to take your running game to the next level? Let’s dive in!

Although it sounds like a rocket name, in short, VO2 max is the maximum volume of oxygen that your muscles can consume per minute.

Therefore, it is referred to as aerobic power since it measures the rate at which oxygen is consumed. That means it directly relates to your current cardiovascular fitness.

1. So, What is VO2 Max?

VO2 Max is an abbreviation for the Maximum Volume of O2 (oxygen), which is transferred to the blood. The VO2 level changes and increases as you start exercising, and the VO2 Max is the level at which the amount of oxygen you process hits its maximum and plateaus.

In short, it’s a combination of how much oxygen-rich blood your heart can pump and the muscles’ efficiency in extracting and utilizing the oxygen.

Since VO2 max refers to the maximum amount of oxygen you can utilize during exercise, it’s commonly used to test the aerobic endurance or cardiovascular fitness of athletes before and at the end of a training cycle.

VO2 Max Measurement

VO2 max is measured in milliliters of oxygen consumed in one minute, per kilogram of body weight (ml/kg/min). 

For example, a runner with a VO2 max of 65 ml/kg/min will be able to perform at a high level for a longer duration than a runner with a score of 40 mL/kg/min.

However, this relates to aerobic work. Someone with a high VO2max will not necessarily be able to perform at a higher capacity during resistance exercise or short-duration high-intensity work, such as sprints.

2. Why Measuring VO2 Max is Important?

VO2 max is very important because it may be used as a representation of how much oxygen your body utilizes during exercise at a maximum effort.
This means the value of VO2max reflects the total body health that extends from the integrated functioning of multiple physiological systems. So, it reveals the heart, lungs, blood vessels, muscles, and nervous system all work together.

The importance of VO2 Max was further emphasized when in 2016 the American Heart Association published an official scientific statement recommending that clinicians routinely measure VO2max and consider it as a vital sign, together with traditional measures like body temperature, blood pressure, and heart and respiration rates.

Additionally, it’s one of the most important running metrics because it can also have an impact on running efficiency and improve form that can help to prevent injuries.

3. What Affects Your VO2 Max Level?

There are many factors that can influence VO2max, e.g. training, age, gender, genetics, and body composition.

Here are the Main 6 Factors Affecting VO2 Max:

• Genetics. It is said to play a 20-30% role in VO2max.
• Age: After the age of 25, the VO2max declines by 1% a year, and about 2% per year after age 30.
• Training status: Athletic training can alter a person’s VO2max by as much as 20% depending on their lifestyle and fitness habits.
• Gender: Males typically have a higher oxygen consumption value than females.
• Body composition. Research studies suggest that VO2max decreases as body fat percentage increases.
• Exercise mode: Measures of athlete’s VO2max on a treadmill, then a cycle, and finally in a swimming pool test. The results will all differ significantly. Treadmill running has been shown to produce the highest values.

4. How Can I Estimate My Own VO2 Max?

The best and most accurate way to assess VO2 max is to undergo a test during which you would be maximally exercising while wearing a mask to collect breath samples that allow a machine to calculate the quantity of oxygen that you are consuming.

However, for many people, this type of testing is not typically available, and there are several other ways to estimate VO2 max:

Calculating VO2 Max

Depending on your age, gender, and even body weight, several equations have been developed to help you estimate your aerobic fitness level from a mile walk, jog, or even a 6-min walk test.

The VO2 formula for absolute VO2 is VO2 (mL/min) = (HR x SV) x a-vO2.
“HR” stands for heart rate in beats/min and “SV” for stroke volume, or the amount of blood the heart pumps in each beat.

Ok, If that’s too much math ☺
You can simply use online calculators, such as ShapeSense VO2 Max Calculator.

Watches that measure VO2 Max during exercise

The most accurate way to find out your VO2 max is under lab conditions using expensive gas exchange equipment. But there is a simpler way, many of the best running watches now use intelligent algorithms and a heart rate monitor to estimate your VO2 max by tracing your vital stats and recent workout performance.

Well, some fitness trackers and watches measure VO2 max. You can find it, particularly in brands such as Garmin, Polar, and Fitbit. Note that a few brands have their terms for VO2max.

For example, Polar Index is an estimation of your maximal oxygen uptake (VO2max) while working out, as explained in the video below:

Some of the Garmin watches display your current VO2 Max rating. Also, Garmin users can see their VO2 Max measurement history with the Garmin Connect app.

You can find in Appendix A of this post the Maximal VO2max Norms.

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5. VO2 Max and Running Performance

Since oxygen is critical to running fast, your VO2 max is the best running fitness measure.
However, don’t confuse running fitness with running results. Having a high fitness level doesn’t always mean you will race well, there are many physiological and mental components to a great race, but having a high fitness level is extremely important.

➤ Scientifically, as exercise intensity increases, so does oxygen consumption.

While running, a point is reached where exercise intensity can continue to increase without the associated rise in oxygen consumption. This point at which oxygen consumption plateaus defines your VO2max.

How does VO2max help to run faster?

Training at VO2max increases the amount of oxygen your body can use. In simple, the more oxygen you can use, the faster you can run.

VO2max running can increase the efficiency of your running and improve your form. Since such workouts are much more intense than regular training, they force you to run more efficiently and with better form.

Furthermore, training at VO2max also increases leg muscle strength and power, which improves the running economy (i.e. how much energy it takes to run at a certain speed).

Therefore, it is helpful and important to include some VO2 max workout running and speed work in your training plan once every 1-2 weeks to help tweak your form and running efficiency.

Even if you’re a very casual athlete, improvements in the VO2max can lead to reduced levels of stress and more ease of getting through your daily tasks.  Such as climbing a flight of stairs or bringing the groceries in, to be honest with ourselves, these two activities leave many of us winded.

6. How to Improve Your VO2Max

In general, there are two ways to improve your VO2 max:
a) Do workouts that increase your oxygen absorption.
b) Decrease your mass (i.e. lose weight).
A good training plan will do both.

In terms of your training, one way to improve VO2Max is by incorporating more high-intensity interval training. This will push your body’s anaerobic threshold and train your body to better-utilizing oxygen.

6.1. Aerobic VO2 Max Workouts

Working on your aerobic fitness is still the best way to affect your VO2 Max score. A beginner should be able to see a physiological change and improvement by up to 10-20% in 4 to 12 weeks.

But it’s also important that your training intensity matches your VO2 Max. If you’re not training hard enough, you could see levels decreasing.

You can increase aerobic capacity simply by doing an activity like running or biking often, or you can use intervals. Researchers have found that 2-3 minutes of moderate to intense aerobic effort that is followed by 1-2 minutes of active rest is what challenges your VO2Max system.

Here are a few workouts which you can do to improve your VO2max:

The following 3 workouts can increase your VO2 max.
There’s one you can do on hills, and another meant for the road/track.
Note that you can do either on a treadmill so long as you adjust the incline as indicated.

➤ If you do not know your current VO2Max, click on read this.

6.1.1. Workout 1: On the Road / Track

30 / 30 and 60 / 60 Seconds Session

• 30 seconds at VO2 max pace
• 30 seconds at 50% of VO2 max pace
• Repeat until feeling like you can’t do anymore
• Do this 30 / 30 for 8 weeks and after that increase to 60 / 60 secs sessions

6.1.2. Workout 2 – Hill or Treadmill Intervals

Hill intervals workout is great for VO2max development.
You’ll need to find a decent hill and then run hard uphill for 2 to 3 minutes (choose your duration before you start), jog back down to your starting point, and repeat.

Pace yourself so you don’t burn out at the top of the first hill. But make sure you finish the workout feeling like you couldn’t do more.

Comments:

• When doing the above workouts, you should do a warm-up before running and a proper cool-down at the end of the exercise.
• You can include the above workouts as part of a short/medium distance run.

6.1.3. Workout 3 – Long interval workout to improve VO2 max

Training at or near your VO2 max pace improves your body’s ability to process a higher volume of oxygen. Below there are two training examples to do that:

Example 1 – Do 20 minutes interval workout:

• ► 3 minutes at VO2 max pace
• ► 2 minutes of easy running
• ► Repeat 4 times

Example 2 – Do 20 minutes of 85% VO2max: 
Training at about 85 percent of your VO2max pace improves your muscles’ ability to process oxygenated blood. Just divide your VO2max pace by 85 percent (0.85), then use that pace for a 20-minute run.

6.2. Increase your VO2 Max by losing weight (fat)

It’s losing body fat to be exact, as losing muscle would be detrimental to your physical prowess.

VO2 is scored relative to body weight. Therefore cutting down our body fat percentage would indirectly increase our VO2max value.

Following are the 14 best ways to burn fat fast as advised by Healthline’s Medical Affairs:

1. Start strength training.
   Strength training is a type of exercise that requires you to contract your muscles against resistance.
2. Follow a high-protein diet
3. Squeeze in more sleep
4. Add vinegar to your diet
5. Eat more healthy fats
6. Drink healthier beverages
7. Fill up on fiber
8. Cut down on refined carbs
9. Increase your cardio (aerobic exercise)
10. Drink coffee
11. Try high-intensity interval training (HIIT)
12. Add probiotics to your diet
13. Increase your iron intake
14. Give intermittent fasting a shot

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7. VO2 Max Frequently Asked Questions

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Appendix A – Maximal VO2 Max Norms Table

Following is the VO2 max chart, taken from top-end sports, that shows normative data for VO2max by gender and age.

Maximal Oxygen Uptake Norms For Women (ml/kg/min)

	Age (years)
Rating	18-25	26-35	36-45	46-55	56-65	65+
Excellent	> 56	> 52	> 45	> 40	> 37	> 32
Good	47-56	45-52	38-45	34-40	32-37	28-32
Above average	42-46	39-44	34-37	31-33	28-31	25-27
Average	38-41	35-38	31-33	28-30	25-27	22-24
Below average	33-37	31-34	27-30	25-27	22-24	19-21
Poor	28-32	26-30	22-26	20-24	18-21	17-18
Very poor	< 28	< 26	< 22	< 20	< 18	< 17

Maximal Oxygen Uptake Norms For Men (ml/kg/min)

	Age (years)
Rating	18-25	26-35	36-45	46-55	56-65	65+
Excellent	> 60	> 56	> 51	> 45	> 41	> 37
Good	52-60	49-56	43-51	39-45	36-41	33-37
Above average	47-51	43-48	39-42	36-38	32-35	29-32
Average	42-46	40-42	35-38	32-35	30-31	26-28
Below average	37-41	35-39	31-34	29-31	26-29	22-25
Poor	30-36	30-34	26-30	25-28	22-25	20-21
Very poor	< 30	< 30	< 26	< 25	< 22	< 20

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➤ Athletes With The Highest Recorded VO2 Max Scores

Once you have found your position in the VO2 Max Norms tables above, you will be amazed at the VO2 level of the elite athletes.
For example, cyclist Oskar Svendsen’sscore is 97.5! The score of the ultra runner Kilian Jornet is 92.0.

Following is the list of athletes with the highest recorded VO2 Max scores ever.

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➤ References

1. David Dack (2022): “The Complete Guide To VO2 Max – Why It’s Important & How To Measure it (2022 Update)“. Runners Blueprint.
   https://www.runnersblueprint.com/vo2-max
2. Ross, Robert, Steven N. Blair, Ross Arena, Timothy S. Church, Jean-Pierre Després, Barry A. Franklin, William L. Haskell, et al. “Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association.” Circulation. American Heart Association, November 21, 2016.
   https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000461
3. UC Davis Health – Sports Medicine: “VO2 Rate of Oxygen Consumption“.
   https://health.ucdavis.edu/sports-medicine/resources/vo2description
4. Shete, A.N., Bute, S.S. and Deshmukh, P.R. (2014) “A Study of VO2 Max and Body Fat Percentage in Female Athletes“. Journal of Clinical and Diagnostic Research, 8, BC01-BC03.
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316241/
5. Rachael Link, MS, RD (2019) and Medically reviewed by Grant Tinsley, Ph.D., Nutrition: “12 Ways to Promote Long-Term Fat Loss“. Published by Healthline’s Medical Affairs.
   https://www.healthline.com/nutrition/best-ways-to-burn-fat
6. “High-intensity interval training” – Wikipedia.
   https://en.wikipedia.org/wiki/High-intensity_interval_training
7. Neufer PD. (1989): “The effect of detraining and reduced training on the physiological adaptations to aerobic exercise training“. Sports Medicine 08, 302-320.
   https://pubmed.ncbi.nlm.nih.gov/2692122/

The treadmill is the perfect partner for a cardio workout and building endurance without putting too much stress on the body. It’s also a convenient option for getting physically and mentally fit when running outside is not possible.
To make the most of your treadmill workout, it’s important to know some tips for running on a treadmill. By following these tips, you can improve your technique, stay motivated, and get better results.

While running on a treadmill, you have full control over your speed and incline, and you can easily adjust the workout intensity to match your fitness level.

For those who are lucky to have access to a treadmill, here are 12 great treadmill running tips that can help you have an efficient, healthier, enjoyable treadmill workout and also improve your outside running.

1. Get Familiar with Your Treadmill and Its Features

To maximize your workout, learn the various functions of the treadmill that you are using.
If you use a home treadmill, carefully read the user manual. And, if you are using a treadmill at the gym, ask a trainer to walk you through its functions before you hop on since it’s not always obvious at first glance.

Many treadmills have the following features:

• View and adjust your speed showing how fast you are going.
  Depending on the model and age of your treadmill, the mechanism to change the speed may be a keypad entry, a push-button, or a dial.
  The pace display on the console is usually in Miles Per Hour (mph) or Kilometers Per Hour.
  
• A heart-rate monitor to help you measure the intensity of your workout.
  Monitoring your heart rate while training helps to improve your cardiovascular fitness. While running, your heart rate can indicate if you push yourself too hard or whether you can increase the intensity to achieve your target heart rate.

• A calorie burn calculator that shows you what you are getting from your run. However, usually, these readouts aren’t very accurate since they do not consider your age, weight, gender, and so on. 
  Still, if you do the same workout regularly and the “calories burned” number goes up, this means you’re getting more fit.
  
• Pre-set training programs, to assist you in varying your workout. These can be useful because they allow you to just set and forget, without making adjustments and pressing buttons while you’re exercising.
  
• View and adjust your speed showing how fast you are going. This is usually in miles per hour. If you prefer a minutes-per-mile measurement, check this chart.
  
• Automatic and manual incline

• There are treadmills with a built-in cooling fan to keep you cool while exercising, such as XTERRA Fitness TRX4500.
  With a built-in fan or stand fan, not only does the breeze feel good when you get hot, but the airflow makes it mentally easier. Also, you’ll get that added wind resistance without needing to change the incline.

2. Start With a Proper Warm-Up

Just as with outdoor running,  a proper warm-up is essential for avoiding injuries. Additionally, a proper warm-up can improve your running performance.

When the muscles are cold and the joints are stiff, intense training can endanger the muscles and expose us to unnecessary injuries. Therefore a proper warm-up is required.

A warm-up raises your heart rate, sends oxygen to your muscles, and raises their temperature, so the muscles work more efficiently during the workout.

A proper warm-up should include the following 3 steps:

1) Dynamic warm-up to lubricate the joints
2) Technique exercises
3) Walking/Easy running

More information on how to do a proper warm-up down in the post: “Warm-up before running is essential, but it should be done correctly”

3. Safety: First Rule – Not Step On or Off While the Treadmill Is Moving

In our treadmill running tips, safety is first and foremost.
It’s important to avoid injuries by not jumping or falling off a fast-moving treadmill. If you need to run to the bathroom, grab a hand towel, or get some water, slow the machine down to a very reduced pace and lower the incline. Then step off carefully.
When you get back on, do the same, and don’t try to pick up right where you left off at a fast pace or high incline.

Also, before starting a workout, make sure you have everything you need, like a towel, water, headphones, etc. So you won’t be tempted to hop off.

More safety tips for running on a treadmill:

• Look forward
• Don’t rely on handrails
• Start by straddling the deck
• Increase either speed or incline
• Don’t go barefoot
• Don’t step off a moving treadmill
• Keep children away
• Leave plenty of space

4. Use a Slight Incline (if possible)

If your treadmill has manual or automatic incline adjustment, set the incline between 1 to 2 percent. So, you’ll use the incline for a more intense treadmill workout.
Since there is no wind resistance indoors, a gentle uphill better simulates outdoor running. Of course, if you’re just getting started with running, it’s okay to set your treadmill’s incline to zero until you build up your fitness and increase your comfort level on the treadmill.

But once you’re comfortable, don’t decrease. Keeping the incline at zero is actually like running on a slight downhill. Don’t let it be too easy. If you’re watching a TV show while you barely break a sweat on the treadmill, you’re probably not working hard enough.
While it’s not good to do every run or your entire run at a hard pace (easy days are important), you should once in a while try harder and push yourself.

Using an incline is a great way to increase calorie burning. You will burn more calories per mile when walking uphill. The American College of Sports Medicine notes that for every 1% of the grade, you increase your calories burned by about 12%.

Uphill Interval Training

Researchers found that incorporating uphill interval running within the training programs of distance runners improves various physiological, biomechanical, and neuromuscular parameters relevant to running performance. Therefore, for at least part of your workout, try increasing your speed or incline, so you’re feeling challenged.

Use the incline on the treadmill for an interval training workout. The high-intensity interval will bring you to a vigorous level of exertion, then the recovery phase will let you catch your breath.

Don’t Make the Incline Too Steep

At the same time, don’t set the incline too steep, i.e. more than 7 percent. This places too much strain on your back, hips, and ankles, which also may lead to running injuries.

Some runners assume they’re getting a good workout if they challenge themselves to complete their entire run on a steep incline (anything over 2 percent). But that much straight hill running is never a good idea and could lead to injuries. Think about it: Outside, you would never find a 3-mile hill at a 5 or 6 percent incline.

So, while training, every few minutes alternate between steep inclines and flat running.
The uphill segments help build strength, and the flatter ones build stamina and endurance. 

You can do this manually and a better option (if possible) is to use a predefined program on your treadmill. E.g. in the following video by Runner’s World:

As a rule of thumb, you should avoid running at a steep incline for more than 5 minutes.

5. No Need to Hold the Handrails While Running

The purpose of the handrails is for safety when getting on and off the treadmill. The handrails also help you if you accidentally trip while training and are useful for people with medical conditions.

However, for an efficient workout, there is no need to hold the rails during the workout, as this causes the following 3 problems:

a)  It forces you to hunch over, an inefficient running form that can lead to neck, shoulder, and back pain.
Keep your posture straight and erect. Your head should be up, your back straight, and your shoulders level.

b) Although holding on to the rails can make you feel like you can keep up the pace and work harder, Actually, you’re reducing your load and making it easier on yourself. Try to pretend that the rails are not even there, as if you’re running outside. If you’re concerned about falling, you’re probably running at too fast of a pace or too steep of an incline. Slow down and/or reduce your incline. Safety and form are more important.

c) Holding the handrails makes your workout easier, it affects the quality of your treadmill workout. It transfers the load from your legs to your upper body, reducing the amount of effort required and reducing the number of calories you burn during your workout.

6. Maintain a Correct Posture Without Leaning Forward

When it comes to running on a treadmill, learning how to run properly on a treadmill is essential for avoiding injury and maximizing results. To run properly on a treadmill, it’s important to:

• Keep your shoulders back
• Keep your body upright
• Keep your head up

Maintaining this posture helps to align your spine and reduce stress on your joints. Additionally, to improve your balance and efficiency while running on a treadmill, try:

• Keeping your arms at a 90-degree angle
• Swinging your arms naturally

By following these tips for how to run properly on a treadmill, you can get the most out of your treadmill workouts while minimizing your risk of injury.

Treadmill Running Form

There is no need to lean forward because the treadmill pulls your feet backward. Unless you are using a steep incline, that may require leaning slightly forward, remember to stand upright and not lean in.
If you lean forward too much, you may end up with neck and back pain, or you could lose your balance.

At the warm-up and while running, it is recommended to check and correct your posture, by settling your shoulders above your hips and pulling in your abs.

Avoid Looking Down While Running

It’s hard to not frequently look at the console to see how much time or distance you have left, but if you are looking down, your running form will be compromised. Don’t stare at your feet, either. You’re likely to run hunched over, which may lead to back and neck pain.

When you get onto a treadmill, you might be tempted to look down at your feet to make sure you are getting onto the platform correctly. But many of us forget to raise our heads as we continue walking or running on the treadmill.

Looking straight ahead is the safest way to run, whether you’re on the treadmill or running outside.

7. Maintain Your Normal Stride Length

In general, you should be running on the treadmill the same way you would run outdoors. So, avoid stride shortening and try to run with your natural gait and your normal stride length. If your form feels off, slow your pace until you feel like you’re using the proper form. Then gradually increase the pace.

Another mistake to avoid is overstriding. Every running expert agrees that overstriding is bad. Reaching forward so that your front foot lands “too far” in front of your center of mass causes you to slam your foot down and brake with each stride, lowering your efficiency and raising your risk of injury.
Since the treadmill’s belt is moving you forward, overstriding creates a braking force with the belt.

To avoid these mistakes, try to keep your feet under your body, not ahead or behind it. Additionally, Keep your stride quick to help minimize the impact transferred to your legs.

8. Improve Your Running Cadence with a Treadmill

What is Running Cadence?

Cadence (also known as stride rate) is the number of steps a runner takes per minute (SPM). It’s the most common metric used to measure running form and remains important for several reasons.

Having the right cadence will improve your running performance and reduce your injury risk, as cadence has a big impact on your running economy.

The more steps you take per minute, the more efficiently you’ll run.

Finding Your Current and Optimal Running Cadence

Elite runners run at a cadence of about 180 steps per minute, however, studies show cadence is not one size fits all. Your optimal cadence depends on several factors, including your height, weight, and running ability.

Cadence also varies based on the type of run you’re doing. A training or long-run cadence will be slower than a speedwork or racing cadence. Therefore you should determine your base cadence for your different types of paces: easy, normal, tempo, marathon, etc.

You can find out your cadence by counting how often one foot hits the belt in a minute (since you have a timer right there on the console). Then multiply that number by two to get your steps per minute (SPM).
A better way is using a sports watch that measures cadence, such as Garmin Forerunner 245, which measures cadence.

How to Improve Cadence with a Treadmill?

To improve your stride count during your treadmill run, focus on taking shorter, quicker strides and keeping your feet close to the belt. This exercise will help you deal with boredom on the treadmill and even improve your outdoor running.

Now that you have a number, you can improve your steps per minute for your different types of runs.

Simply take one of your base steps per minute and increase that by 5 to 10 percent to find your personal goal cadence number. For example, if your base running cadence is 159 SPM, your goal cadence should be between 167 and 175 SPM.

Even if it’s not as fast as the elites, this small increase will still improve your running performance and reduce your chance of injury.

Improving your cadence should be done gradually, unless it may lead to injuries. It is recommended to increase your cadence by no more than two to five steps per minute in one session. Once that starts feeling like second nature, increase it slightly again and again until you reach your personal goal cadence number.
Your body may need 6  to 8  weeks to adapt to your higher cadence, but it will adapt and become part of muscle memory.

9. Listen to Music or Podcasts

Another useful treadmill running tip is listening to music while running on a treadmill can reduce the perception of exertion and boost endurance by up to 10 to 15 percent. This can do wonders for your performance and fitness gains.

Listening to music on the treadmill can be a great way not to get bored and run longer. Choose motivating songs and create a playlist for your workout. This will help prevent you from continually checking the clock or checking how much time is left till the end of the workout.

Not a fan of music? Then turn to podcasts.

If you choose to watch TV or movies on a screen, be sure to be alert to your form, especially your neck, and head. Don’t crane your neck up to see a screen, and don’t bend over or lean forward to get a good view either. If the screen on the treadmill you use doesn’t work for your size or posture, skip the videos and stick with music or podcasts.

10. Visualize a Route or a Race – Treadmill Running Tip

A trick to increase motivation while running on a treadmill is to visualize an outdoor route that you frequently drive or run.
Picture yourself running along and imagine the trail, buildings, or other landmarks you’d pass along the way. Change the incline set at the time you’d be heading up a hill on your outdoor route.

You can also change the speed when you run outside at different speeds because of factors such as the terrain, hills, traffic lights, and changing weather conditions. So, to simulate outdoor running conditions or a race, try varying the pace and/or the incline throughout the run.

11. Stay Hydrated Before, After, And During Your Workout

One of the top treadmill running tips, you can lose even more water running on a treadmill than you would if you were running outside since there’s little air resistance to help keep you cool. So, keep within easy reach a bottle of water or other beverage. Many of the treadmills have water bottle holders.

Depending on the temperature and humidity of the room in which you run, drink at least 4 to 6 ounces every 15 to 20 minutes during your workout session (if you feel thirsty drink and don’t wait).

12. Proper Cool Down At The End of Your Workout

When running outside, a proper cool down is also essential after a workout on the treadmill.
If you’ve ever felt a little dizzy, or like you’re still moving, after getting off the treadmill, it’s most likely because you didn’t start a cool down at the end of your run. Stopping suddenly after an intensive workout can cause light-headedness because your heart rate and blood pressure drop rapidly. Therefore, a gradual slowdown is required.
 
A proper cool-down dramatically reduces the chances of running injuries. Additionally, the cool-down helps the recovery after a run and increases the workout’s effectiveness.
Furthermore, it lowers the heart rate and breathing gradually, relaxes the muscles after intense training, and helps to eliminate lactic acid and other metabolic waste products from the muscles.

Besides the physical aspect, the cool-down has a relaxing effect on our minds after intense running.

A proper cool-down after running includes two parts:

1. Jogging and/or walking
   It is recommended to walk for at least 7  minutes, depending on the intensity of your workout.
   If you can monitor your heart rate, make sure to end the cool-down phase after your heart rate goes below 100 bpm.
2. Static stretching
   Static stretches improve your flexibility and range of movement. Also, speeds the recovery by bringing more blood and oxygen to your muscles.

More information on how to do a proper cool down in the post: “Cool down after running is essential, here is how to do it properly”

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Tips for Running on a Treadmill – Frequently Asked Questions:

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You planned to run today the 8 miles in your training program, but you are not feeling well. So, to run or not to run when feeling sick?

It is well-known that we runners can be obsessed with our running. Every missed training seems to us like the end of the world, especially when we are training for a marathon, an Ironman, or another goal race.

Sometimes it seems to us that if we will miss three days of training, a catastrophe will come, and we will not reach the starting line, or maybe we will not achieve the result we wanted.

The following guidelines will help you decide when you should rest and when you can continue training when feeling sick.

Better safe than sorry is the most important rule about running when you are sick.

Your running performance won’t decline if you miss a day of training or even three days of training.
On the contrary, be smart and patient, and your body will thank you for it in the long term.

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Disclaimer: This post is not medical advice and is not intended to provide diagnosis or treatment for any medical conditions. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns.

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1. Can I run when I have a cold?

The answer is it depends. Symptoms associated with the cold, such as sore throat, nasal congestion, cough, and generally feeling unwell, are usually safe to run.

In short, you can use the ‘neck check’ rule.  If all of the symptoms are above the neck, then it is safe to run. However, when the symptoms are below the neck, then you better rest.

If you are not sure about the symptoms, it is better not to take a risk, and you should skip running.
And, of course, asking your doctor is the best way.

When having a head cold, easy jogging and a hot shower after it can help remove the congestion and make you feel better for a few hours. That is because when running, our body releases adrenaline and endorphin, which may decrease cold symptoms such as nasal congestion.

Anyway, if you have a fever skip running.

2. How to adjust your running training plan when you feel sick?

1. Reduce the speed and intensity of the workout, or change the training program and switch between the easy training days and the intense days. As the effects of the common cold can make it difficult to breathe and thus limit the ability to exercise.
   
2. If you feel pretty good despite the symptoms, then:
   • Do  a longer warm-up
   • Avoid interval training and speed work
   • Run a shorter distance than usual
   • Dress well according to the weather
   • Remember that the level of effort is more important than the numbers on the clock, especially on days when you don’t feel well. So, a heart rate monitor watch can help you stay at the appropriate level of effort (heart rate zone).

3. Running with the flu or a serious cold?

If you suffer from symptoms of the flu, such as muscle aches, fever, or weakness – DO NOT RUN!
Running with fever and pain is not only dangerous, but it can also make you sicker and lose more days of training.

Fever is a sign of the body fighting a virus or bacteria in the body. When having a fever, running will only cause the body to overheat and increase the symptoms. This, of course, can cause an immediate or long-term danger to your health.

In general, running weakens the immune system, especially in the 20 hours after an intense workout. Therefore, your body will be more sensitive to viruses and bacteria that, in any case, will make you feel bad, and you need to be careful not to make things worse.

Also, running with the flu uses body resources for running instead of fighting the virus, which will slow down the body’s recovery time.

So, It is recommended not to run when you have the flu or suffer from fever and pain.
However, it is essential to take a few days to rest for a full recovery and return to normal activity.

Remember, it takes at least 10 days to lose your physical fitness. Therefore there’s no reason to worry if you do not run for a few days.

The same rule also applies when and after having Covid-19.
I.e., avoid running until the symptoms have resolved.

How long should I wait after the flu before returning to running?

There is no rule for that. The time before returning to running is individual and also depends on the severity of the flu you had. If it is not severe flu, you can get back to training at least 24 hours after you feel well and without a fever.
However, it is recommended to start with a low-intensity workout and pay attention to your body while running.

Common mistakes that we should avoid:

➤  Do not try to “compensate” for the training you missed when you get back to running.

Your immune system is still sensitive, and your body probably is not yet ready to run at high intensity. The first training sessions after you feel better should be easy, and you should avoid intense workouts. After 3 days of slow and without long runs, try gradually increasing the pace and distance.

➤  Patience

No one wants to be sick and lose a lot of training. However, by listening to your body and being patient, you can avoid suffering weeks of flu symptoms instead of 2-3 days.

If you are patient, you can get back running as soon as possible. Also, if you set realistic goals while you are sick, you can go through the disease more smoothly and calmly.
Ignoring your health will only make you spend more days without running, and it just doesn’t worth it.

➤  In case you feel bad while running

If while running you feel bad, you better stop running or at least slowdown and shorten the run.

➤  Training with a running group

In case you train with a running group, it is recommended to get back to running alone for a short time. Because in a group, we may compare ourselves to others and have a pressure that will prevent us from listening to our body while recovering from illness.

4. Listen to your body

When you have a cold or feeling kind of bad, you should also listen to your body and use common sense to decide whether to slow down and rest.

In case you are not in a condition to run but feeling well enough to do a light exercise, you can do activities such as pilates or yoga for runners. Such activities enable you to stop exercising in case of feeling worse.

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Running With a Cold Frequently Asked Questions

Will running with a cold make it worse?

Running at a moderate pace won’t prolong your illness or make your symptoms worse, but it may not shorten them, either. One possible benefit of easy running with a cold: If you’re generally well-hydrated, a workout can break up congestion. However, your congestion could worsen if you’re dehydrated.

Is it bad to run when you have a sore throat?

According to the above ‘neck check rule’, if all of the symptoms are located above the neck, such as sore throat, runny or stuffy nose, or sneezing, then a short and easy running probably won’t do any harm. In fact, it might even help as the body release epinephrine, a natural decongestant. However, you should listen to your body while running, and stop running in case of any symptoms such as dizziness, nausea, or profuse sweating.

Should I run with a chesty cough?

The chest is below the neck, so following the above ‘neck check rule‘, if it’s associated with a fever or other symptoms like a productive cough or chest congestion, you should consider taking some time off from running.

How long after exposure to flu do symptoms appear?

The flu symptoms, such as muscle aches, fever, and weakness, can begin about two days (but can range from 1 to 4 days) after the virus enters the body. Some people can be infected with the flu virus but have no symptoms. Anyway, if you suffer from symptoms of the flu, then DO NOT RUN!