Build Strength & Improve Mobility While Minimizing Knee & Low Back Pain.

Whether you're training for a race, running your neighborhood a few times a week, or simply enjoy getting outside for exercise, running is one of the most accessible ways to stay active.

I'll admit that I’m definitely a fair-weather runner (you will NOT see me running outside in the middle of winter!), but for years I couldn't even enjoy casual runs in the summer because my low back would flare up afterwards.

Between having mild scoliosis, carrying a twin pregnancy, and spending years bending over a treatment table as a PT, my body clearly needed some extra support. Over time, I identified the specific mobility, strength, and stability deficits contributing to my symptoms and worked on them consistently. Today, I can enjoy occasional runs again, with my biggest limiting factor now being my aerobic endurance. 😄

Besides addressing my own low back pain with running, I've also helped many clients over the years eliminate pain with running & improve their running performance. While every runner has unique needs, there are a handful of exercises I return to again and again because they address some of the most common movement limitations I see, and they provide a great starting point for building a more resilient body. 

Why Strength & Mobility Matter Even More After 40

Before we jump into 6 of my favorite exercises for runners, let’s address what’s happening in our bodies as we get older.  Starting around age 35, our bodies naturally lose mobility, muscle mass, and power if we don't intentionally maintain them. And while running builds excellent cardiovascular fitness, it doesn't always address the mobility, strength, and stability needed to keep moving efficiently and comfortably.

When certain muscles aren't doing their job, or joints become stiff, other areas often compensate. Over time, those compensations can contribute to recurring knee pain, low back pain, hip discomfort, and other overuse injuries.

To support pain-free running, a well-rounded exercise routine should include

• Thoracic, Hip & Ankle Mobility

• Single-leg Strength & Stability

• Core Strength

• Hip Strength (especially the glute max, glute medius & adductors)

• Soleus (deep calf) Strength

While all these movement categories are important for runners, the exact exercises - and right combination of mobility, strength, and stability work needed - will vary from person to person, based on your body’s unique needs, injury history, and training demands.

*A Special Note for Women in Their 40s & 50s

If you're a woman in perimenopause, these exercises become even more important. As estrogen fluctuates, and eventually declines, many women notice they don't recover from exercise the way they used to. Joint stiffness, tendon aches, muscle soreness, and slower recovery can become more common, even when their training hasn't changed.

This is more than just "getting older” as estrogen helps support the health of collagen, tendons, ligaments, cartilage, muscle, and bone. As estrogen declines, these tissues may become less resilient, contributing to changes in exercise tolerance and musculoskeletal health. Researchers have even proposed the term The Musculoskeletal Syndrome of Menopause to describe the collection of musculoskeletal symptoms many women experience during this transition.

The encouraging news is that strength training, mobility work, balance training, and impact exercise remain some of the best ways to support healthy muscles, bones, and connective tissue throughout perimenopause and beyond.

For some women, Menopausal Hormone Therapy (MHT) may also be an appropriate tool to help manage symptoms and support overall musculoskeletal health. If you're experiencing signs of perimenopause, consider discussing your symptoms and treatment options with a qualified healthcare provider.

Now, on to 6 of my favorite exercises to help support pain-free running!

1. Spiderman Lunge with Rotation & Thread-the-Needle Reach

Purpose: Dynamic warm-up for the hips, thoracic spine, and ankles. I especially love it because thoracic (mid-back) rotation is one of the most overlooked mobility limitations I see in runners. This rotation helps drive arm swing, creates forward momentum and COUNTERBALANCES the pelvis as your leg drives forward, crucial to help avoid excessive strain on your low back and hips.

Try: 10 repetitions each side BEFORE runs

2. Rear Foot Elevated Split Squat (with a Hip Hinge Bias)

Purpose: Improve glute strength and single-leg control, both essential for running pain-free for the long-term.

Try:

• 3 sets of 8-10 reps on each side

• 2-3 times per week

• Get comfortable with bodyweight only first, then gradually progress to using weight that is challenging for the last few reps of each set, while still being able to maintain good form

  
  

3. Bent-Knee Calf Raises

Purpose: Strengthen & improve endurance in the soleus muscle (the deeper calf muscle underneath the larger gastrocnemius), which is one of the biggest force generators in the lower body during running.

Try:

• 3 sets of 15 repetitions on each side, 2-3x weekly

• Instead of standing bent-knee calf raises, you could also try seated calf raises holding a weight on your thigh (right above the knee) for progressive overload to the soleus muscle, performing 3 sets of 10-12 reps

  
  

4. Hip Airplanes with Adductor Press

Purpose: A versatile exercise that challenges your single-leg stability, hip rotational mobility/control AND adductor strength, all at once. Together, these qualities help create a more stable foundation for every stride. Move slowly and focus on CONTROL rather than speed.

Try:

• 2-3 sets of 10 reps on each side, 2-3x weekly

5. Side Plank (Optional Top Leg Lift)

Purpose: Side plank variations are one of the best exercises to help strengthen the GLUTE MEDIUS muscle, which plays a huge role in stabilizing the pelvis during running in order to avoid excessive pelvis drop and increased stress on the hips, knees, and low back. 

Side planks (when done correctly) are also a great core strengthening exercise and can further protect the low back and improve posture & running efficiency. 

Try either:

STATIC hold

• 20-30 seconds x 3 reps each side

• 2-3x weekly

• Performing either a FULL side plank on forearm or PARTIAL side plank on forearm

  
  

OR

Full or Partial side plank WITH top leg lifts (keeping top leg in line with torso/ribcage and not letting leg drift forward)

• 2-3 sets of 5-10 repetitions, on each leg

• 2-3 times weekly

6. Quad/Hip Flexor “Couch” Stretch

Purpose: Maintains quad soft tissue mobility after running as well as hip extension mobility, both essential for keeping your knees and low back pain-free in the long-term.  

Between desk work, driving, sitting at kids’ sports events & relaxing at home in the evenings, most runners (and adults in general) spend much more time sitting than they realize, making this a foundational mobility exercise for almost all mid-life adults.

Try:

• Holding 30 seconds

• 2-3 repetitions each side

• AFTER your run or work-out (or paired with deep breathing right before bed to help you relax & get better sleep)

The Bottom Line

Running doesn't have to become more painful simply because you're getting older. In fact, many runners in their 40s and beyond continue running successfully because they intentionally support their bodies with the right combination of mobility, strength, stability, and recovery.

If you've been dealing with recurring knee pain, low back pain, or simply feel like your body isn't tolerating running as well as it used to, it may be time to look beyond mileage and focus on what your body needs to move well.

Sometimes a few targeted exercises can make all the difference.

Ready to Exercise with More Confidence?

If recurring aches and pains are limiting your runs or workouts, I'd love to help. Through a personalized movement assessment, we'll identify the specific mobility, strength, and stability factors that may be contributing to your symptoms. Together, we'll create an exercise plan tailored to your body, goals, and lifestyle - so you can continue running, exercising, and staying active with confidence for years to come.

As a client, you'll also receive access to my coaching app, where you'll find detailed video demonstrations and exercise instructions to help you perform each movement correctly and confidently. Need feedback between sessions? You can easily send me photos or videos via direct messaging in the app, allowing for consistent feedback & ensuring you're getting the most from your program.

📍In-person sessions available in Lenexa, KS 

💻Virtual coaching available nationwide

Start with a FREE 15-minute Discovery Call to learn how you can start building a stronger, more resilient body.

REFERENCES:

1. Leppänen M, Viiala J, Kaikkonen P, Tokola K, Vasankari T, Nigg BM, Krosshaug T, Werthner P, Parkkari J, Pasanen K. Hip and core exercise programme prevents running-related overuse injuries in adult novice recreational runners: a three-arm randomised controlled trial (Run RCT). Br J Sports Med. 2024 Jun 20;58(13):722-732. doi: 10.1136/bjsports-2023-107926. PMID: 38724071. 

2. Bohm S, Mersmann F, Santuz A, Arampatzis A. Enthalpy efficiency of the soleus muscle contributes to improvements in running economy. Proc Biol Sci. 2021 Jan 27;288(1943):20202784. doi: 10.1098/rspb.2020.2784. Epub 2021 Jan 27. PMID: 33499791; PMCID: PMC7893283. 

3. Boren K, Conrey C, Le Coguic J, Paprocki L, Voight M, Robinson TK. Electromyographic analysis of gluteus medius and gluteus maximus during rehabilitation exercises. Int J Sports Phys Ther. 2011 Sep;6(3):206-23. PMID: 22034614; PMCID: PMC3201064. 

4. Distefano LJ, Blackburn JT, Marshall SW, Padua DA. Gluteal muscle activation during common therapeutic exercises. J Orthop Sports Phys Ther. 2009 Jul;39(7):532-40. doi: 10.2519/jospt.2009.2796. PMID: 19574661. 

5. Wright VJ, Schwartzman JD, Itinoche R, Wittstein J. The musculoskeletal syndrome of menopause. Climacteric. 2024 Oct;27(5):466-472. doi: 10.1080/13697137.2024.2380363. Epub 2024 Jul 30. PMID: 39077777.

6. Mary McMillan R, Ganderton CL, Cook J, Semciw AI, Long DM, Pizzari T. Does Menopausal Hormone Therapy, Exercise, or Both Improve Pain and Function in Postmenopausal Women With Greater Trochanteric Pain Syndrome? A 2 × 2 Factorial Randomized Clinical Trial. Am J Sports Med. 2022 Feb;50(2):515-525. doi: 10.1177/03635465211061142. Epub 2021 Dec 13. PMID: 34898293.