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Advice to improve your movement, fitness, and overall health from the world's #1 in orthopedics.

How to Prepare Your Kids for Injury-Free Running

Pediatric rehabilitation expert Yukiko Matsuzaki shares some simple tips to help your child enjoy running and avoid injury.

Advice to improve your movement, fitness, and overall health from the world's #1 in orthopedics.

Do you have a kid who loves to run? That’s great news for many reasons, including the clear benefits to their physical health. But running can also have some unexpected downsides in children.

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“Running is such a repetitive motion,” says Yukiko Matsuzaki, PT, DPT, OCS, SCS, a clinical specialist in orthopedic and sports physical therapy in Pediatric Rehabilitation at HSS. “Unlike basketball, volleyball or tennis, for example, where you're performing different movements and going in different directions all the time, running is just one movement repeated over and over again.”

What’s more, during a growth spurt, kids’ bones grow faster than their muscles lengthen, so their muscles are often tighter as a result, says Matsuzaki. They can also have decreased coordination and weakness. All this adds up to an increased risk for injury.

While research-based guidelines about kids and running are remarkably lacking, Matsuzaki is working to change that. In the meantime, preparation is key. Here are some tips to help your child enjoy running injury free.

1. Focus on conditioning

Because running is a one-legged activity, hip, core and leg strength are key, as is general balance, says Matsuzaki.

To build that, encourage your kids to do the following exercises. One to three sets of 10 repetitions of each exercise (on each side if applicable) a few times a week is enough.


  1. Lie on your back with knees bent and feet flat on the floor.
  2. Gently tighten your core by pulling your belly button back toward your spine.
  3. Press your feet into the floor and squeeze your butt as you raise your hips, so that you create a straight line from your knees to shoulders.
  4. Hold for 20 to 30 seconds, then return to starting position.

Clam shells

  1. Lie on your right side with both knees bent at a 45-degree angle.
  2. Make sure your hips and shoulders are both stacked one on top of the other.
  3. Pull your belly button in to help keep your spine and pelvis steady.
  4. Keeping your feet together, raise your left knee as much as you can without moving your hips or pelvis.
  5. Return your left leg to the starting position.

Monster Walk (with resistance band)

  1. Place a resistance band around your knees.
  2. Get into a half-squat position by pushing your butt back with your knees slightly bent.
  3. Step your right leg out to the right, then follow with your left leg, keeping a constant tension on the band.
  4. Make sure your knees don’t cave in and that the movement comes from the glutes.

2. Choose the right shoes

Kids are more concerned with the newest and coolest and what’s on trend, but that’s not as important as choosing a shoe that matches their specific foot type. Since each foot is unique, Matsuzaki suggests a visit to a specialty running shoe store. Typically, these stores have a treadmill on-site so they can watch your child run and recommend the best shoe to match their gait. If your child already runs, it’s a good idea to bring a pair of their old shoes so the experts can evaluate the wear pattern on the tread.

3. Encourage warm-ups and stretching

Kids are not great at delayed gratification, but if they start a run too fast, they up the risk of tweaking a tendon, pulling a muscle or injuring a bone or joint. A dynamic warm-up before the run allows the heart rate to raise comfortably and gives the body a chance to ease into a sustainable running rhythm.

Matsuzaki suggests walking toe touches, walking with high knees, butt kicks, and jumping jacks.

Static stretching is also vital, but it should come after a workout. “Stretching a muscle before exercise will actually hinder performance,” she adds. “Imagine a hair tie; if it’s overstretched, it doesn’t do its job well. A muscle works in the same sort of way. You need some tension to generate power and speed.”

Post-run stretching helps to loosen the muscles and joints and reduce soreness later. Try static stretches of the quads, glutes, hamstrings, hip flexors and calves, in which your child holds each stretch for 20 to 30 seconds. “I like foam rolling too. I think it’s really good for every runner,” Matsuzaki says.

4. Treat the body right

While many kid runners may be focused on maintaining a healthy weight, it’s also important that they get enough nutrients, particularly carbs, good fats and protein. “A low-calorie intake is highly correlated with injuries,” says Matsuzaki.

Sleep is also important. “We know that teenagers don’t sleep, but they need it to help their bodies recover,” she says. “I tell my athletes to aim for at least seven to eight hours of sleep, and even nine if they’re in competitive training season.”

5. Don’t overdo it

While little research exists on the right distance to run for kids in each age group, Matsuzaki says that even the youngest runners can be involved in a 100-yard “fun run,” where little to no training is necessary. Most tweens can probably safely attempt a 5K, and teens can handle a 10K or, if they’re older, even a 16K with appropriate training.

“In addition to the event itself, you also want to consider the total mileage of training, as well as how ready they are physically, mentally and emotionally,” says Matsuzaki. Kids should enjoy running, and not be pressured by coaches or parents. Each athlete is different in what they can handle, and it’s not just the physical that’s important. “Kids are under all sorts of pressures these days, socially and academically, so ideally running would not cause them more stress,” she adds.

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