That is the position I have held for most of thirty-seven years of coaching. Writing this article, I went looking for the evidence behind it — and largely did not find it. So this is partly an argument and partly a retraction, and I think the retraction is the more useful half.
The position goes like this. Running is a skill, not a default human activity. It is a sequence of single-leg landings at two to three times bodyweight, repeated a thousand times a mile. Before you do that, you should be able to hold a position, control a single-leg descent, produce force through a lunge, and absorb load without collapsing.
Posture, then core, then glutes, then lunges, then dynamic work, then drills, then running. Earn each one.
I still coach that way. But I have been telling people it prevents injury, and I can no longer defend that claim.
The obvious evidence for a prerequisite hierarchy would be that people with poor movement quality get hurt more when they run. It is a testable claim and it has been tested extensively.
Peterson and colleagues, 2022, in Sports Medicine – Open: a systematic review and meta-analysis of 30 prospective studies, 3,404 non-elite runners, testing more than 100 discrete biomechanical and musculoskeletal risk factors for running injury.
Twenty-five separate meta-analyses. Two produced statistically significant results — slightly lower knee extension strength and lower hip adduction velocity in those who went on to be injured — and the authors describe both effects as trivial to small and advise treating them with caution. Everything else came back null.
Their conclusion: recommendations for injury prevention in non-elite runners cannot be made on the basis of biomechanical and musculoskeletal measurements alone.
That is not an ambiguous finding, and it is the single largest test of the thing I have been asserting.
Screening tools fare no better. Moran and colleagues meta-analysed 24 prospective studies of the Functional Movement Screen in the British Journal of Sports Medicine. In the population where the evidence was strongest — male military personnel — the pooled risk ratio was 1.47, which they classify as a small association. For football the evidence recommended against its use. For running, along with several other populations, evidence was limited or conflicting. Their conclusion: FMS composite scores do not support use as an injury prediction tool.
I have never used the FMS specifically. I have used my own screen, which has been validated by nobody at all, so I am in a weaker position rather than a stronger one.
Mostly one thing, and it is not a movement pattern.
Van Poppel and colleagues reviewed 29 prospective cohort studies using multivariable analysis. Previous injury is the strongest predictor — previous running-related injury in long-distance runners with moderate-quality evidence, and previous non-running injury in short-distance runners with high-quality evidence. Higher BMI, higher age, male sex, no previous running experience and lower running volume followed, with moderate-quality evidence.
Note that last one. Lower running volume associated with higher injury risk in short-distance runners — the opposite of the intuition that more running means more damage.
And the load-management story, which is what most coaches have moved to as the sophisticated alternative to movement screening, is shakier than it is usually presented. Fredette and colleagues reviewed 36 articles covering 23,047 runners: overall injury rate 26.2%, and evidence about weekly distance, duration, frequency, intensity, or recent changes in those parameters was conflicting. They explicitly caution against recommending optimal parameters or progressions.
So the field's confident position and the field's replacement for that confident position are both weaker than advertised. That is worth sitting with rather than skipping past.
I have said, in workshops and more than once in conversation, that if your running form is poor you would be better off walking — better for your joints and better for your health.
The second half of that is wrong and I should not have said it. Running carries a stronger association with reduced all-cause mortality than walking at equivalent time commitment, and the injury-versus-benefit calculation does not come out where I was implying. Telling a sedentary person not to run until they meet a standard I invented is not a neutral act. Most people who stop running do not go and do something else.
The first half — better for your joints — is at least arguable in a specific person with a specific existing problem. As a general claim it is not supported either.
Quite a lot, once you stop claiming it prevents injury.
This is the strongest evidence-based case for anything resembling my hierarchy, and it points somewhere slightly different than I had it pointed. If prior injury is the dominant predictor, then the population where preparatory work has the best case is not beginners — it is people returning from injury, where restoring capacity before reloading is defensible on grounds the literature actually supports.
My hierarchy is probably a rehabilitation and return-to-running framework that I have been over-applying to everyone.
Being able to control a single-leg descent, produce force through a lunge and hold position under fatigue makes you a better runner. That is not an injury claim and does not need to borrow one. Nobody demands trial evidence that strength training improves running economy before doing it — and in that case the evidence is actually good.
Gastrocnemius and soleus are the most undertrained muscles in most recreational runners, and soleus in particular. Achilles tendon forces in running run to several times bodyweight, and soleus carries the bulk of the support and propulsion demand at typical running speeds. Meanwhile the average sedentary adult who drives to work has calf capacity built for almost nothing.
Interestingly, this is one of the few areas with a specific injury signal in the data: Hollander and colleagues found men at higher risk of Achilles tendinopathy than women (risk ratio 1.86), and eccentric calf loading is the best-evidenced conservative treatment for it. So the calf case rests on capacity, on tissue tolerance, and on one of the few injury findings that replicates.
Every stride has an absorption phase, and it is the half nobody trains. I have written about this separately and the mechanism is sound. What I would not now claim is that training it prevents running injuries — that specific trial evidence in distance runners is thin, as it is for almost everything else here.
High knees, heel flicks, skips, lateral hops, zig-zags. These teach coordination, elastic timing and ground contact quality. They are how you learn to run rather than how you avoid getting hurt, and that is a perfectly good reason to do them.
On the specific and popular version of form intervention: Anderson and colleagues meta-analysed 37 studies on changing step rate. The biomechanical effects are well established — a 5–10% increase reduces peak knee flexion, hip adduction, patellofemoral stress and braking impulse. The effect on injury? Insufficient evidence to conclude. Strong on mechanism, unproven on outcome. That is the shape of this entire field.
Start running. Do not wait to earn it. If you are healthy and want to run, the risk of not running is higher than the risk of running imperfectly.
Build slowly, and expect the first months to be the vulnerable ones. Not because progression rules are well established — they are not — but because inexperience is one of the few risk factors that does show up.
Do calf work twice a week. Straight-leg and bent-knee, both. This is the one I would push hardest.
Strength train. For performance, for bone, for everything else it does. Not because it will stop you getting hurt.
If you have been injured before, take that seriously. It is the strongest predictor there is, and it is the situation where preparatory work has a real evidence base behind it.
Because the alternative is what this field mostly does: hold a coaching position for decades, never test it, and describe it as evidence-based because it is coherent and because the people who follow it seem to do well.
I have watched a great many people stop breaking down after doing preparatory work. That observation is real. It is also exactly what a coach with selection bias, regression to the mean and a plausible story would observe, and I have no way to distinguish those from inside my own practice. Thirty-seven years of watching is thirty-seven years of uncontrolled data.
The honest position: I coach a prerequisite hierarchy because I think it produces better runners, because it is the right framework after injury, and because I believe in it. Not because the literature says it prevents injury. It does not.
What I would ask of anyone selling you a movement screen — including me — is which prospective study it is based on. The answer is usually none, and the honest ones will tell you so and explain what they think it is good for instead.
Educational content, not medical advice. If you have a current injury or a history of one, get assessed before increasing running load — that is the situation where the evidence genuinely supports individual attention.
Which applies to my own positions as much as anything else. If yours keep failing, the question is what is actually driving it.
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