Physical Therapists Using Clinical Analysis To Discuss The Art And Science Behind Running and The Stuff We Put On Our Feet

Post Page Advertisement [Top]


The Monday Shakeout: The Science of Running with... Backpacks?
By Matt Klein

We have written a lot of DPTs here at Doctors of Running. One that stood out as a bit unique was this discussion on backpacks and running a few years ago by our founder Matt Klein.

Despite run commuting during many parts of my life, I have never invested in a serious running pack. I used a scrappy school packback that I added extra elastic to in order to lock down the front straps better when I was working at running stores in Portland, Oregon. When I commuted to clinic during my residency training, I used a cheap Nike commuter pack that bounced around and had little place for storage. The challenge with doing this is there was some extra adaptation time required. I now know why and there are a couple things to consider when running with a pack. 

Having something around the chest/thoracic area requires some degree of compression to keep things from moving too much. That compression means less room for rib expansion and thus increased work from respiratory muscles (Faghy & Brown, 2016). I did not know this at first but found that initially running with a serious pack (run commuting) made me feel more winded. When I stopped doing this, usually when I returned to school or changed jobs that were farther than I could realistically run to, I always noticed that it was easier to breathe. There is evidence out there that working on improving respiratory muscle performance can actually improve performance in those running with packs. One way I have done this recently is using the POWERbreathe device, but any resistive breathing training device will work. These are small portable devices that can be used anywhere. I have found great success using these with ultra marathoners dealing with neck and thoracic pain due to carrying packs. The packs put a great deal of pressure in this area and some people require a little extra training to be able to handle this. 

Carrying a pack inventively means carrying more weight. This changes mechanics while running and can increase stresses in certain areas, particularly the hips and ankles (Huang et al., 2020; Malcolm et al., 2017; Scheer et al., 2018). Carrying weight outside of your body immediately changes the center of mass. Until you are used to this, it can throw off balance and stability (Huang et al., 2020). This is not a major problem on road, but on trail it can be where footing is challenging. This can also be improved or exacerbated secure the pack is, which is another reason to make sure the straps are locked in and everything stays in place. If the pack is not secure, this can not only throw off balance, but can increase stress into and strain the shoulder musculature (Huang et al., 2020). So for those new to packs and planning to use them on trails, I would suggest using them on the road first to acclimate and dial in the fit. The second part of the change in weight means more stress on the ankles and hip particularly with hills. The increased weight will require more calf and hip elasticity and strength, which is something to be aware of if training in steep or rolling areas. Those with Achilles issues should adequately prepare their calf muscles and Achilles tendon with strength (especially eccentric) and mobility work to ensure that you prepare your tissues for the new work they will experience.

Finally, carrying more weight means you probably won't run as fast initially. There is plenty of evidence to suggest initial decreases in running economy when using a pack (Malcolm et al., 2017; Scheer et al., 2018). This is a great reason to keep whatever pack you use light and whatever you carry with you to a minimum. The benefit of this is that using a pack can act as a form of additional training. Anecdotally, the times I have consistently run with a pack have always preceded massive breakthroughs in performance for my road/track racing. Like any training tool, one must allow time to adapt and not overtrain to seem some benefit. The biggest reason for a pack however is for storage. There are many distances/events that require far more than a couple gels and water bottles, and a running pack is perfect in that it has the versatility to carry a great deal or a little. Regardless of the pack you choose, always use the smallest and least amount you need during racing as that will have the least impact on your running economy and body.


Faghy, M. A., & Brown, P. I. (2016). Training the inspiratory muscles improves running performance when carrying a 25 kg thoracic load in a backpack. 
European Journal of Sport Science16(5), 585-594.

Huang, L., Yang, Z., Wang, R., & Xie, L. (2020). Physiological and biomechanical effects on the human musculoskeletal system while carrying a suspended-load backpack. 
Journal of Biomechanics108, 109894.

Malcolm, P., Panizzolo, F. A., Speeckaert, J., Kim, J., Su, H., Lee, G., ... & Walsh, C. J. (2017). Effect of slope and speed on kinetics of jogging with a backpack. In 
Proc. 41st Annual Meeting of the American Society of Biomechanics (ASB).

Scheer, V., Cramer, L., & Heitkamp, H. C. (2018). Running economy and energy cost of running with backpacks. 
The Journal of sports medicine and physical fitness59(4), 555-560.


How Much Does Doctors of Running Make? Report #5

Changes We're Excited to See
Why Heel Bevels are Natural
Do Heavier Runners Need Different Shoes?
Shoe Rotations for Different Runners
Strength Training to Prevent Injury - A Case Study
On the Impacts of Different Stacked Shoes
The Importance of Heel Bevels in Shoe Design
Low vs. High Drop Shoes
Why is Proprioception Important to Runners?
My Favorite Flat Feet Shoes of 2023
Best Running Movie Scenes of All-Time, Part 2
Best Running Movie Scenes of All-Time, Part 1
What a Week at DOR is Like
Reflections on Saucony's Running Economy Study
Sustainable is Only Going to Work if It's Good
A Simple Guide to Footwear and Foot Health
Best Flat Feet Shoes by a Flat Feet Runner
How Long Do Shoes Last?


*Using the link to purchase helps support Doctors of Running. Thanks so much!

Ultraspire Fitted Race Belt: The best way to carry your phone and goods on the run. No bounce and various sizes for waist. (Also recommend the Naked belt)
Saysky Running Gear: We were really taken aback by this Scandinavian company's ultra-thin, durable performance clothing
Skratch Recovery, Coffee Flavor: Mental and physical boost post run. Coffee flavor is excellent and goes great straight into a fresh brewed cup
goodr Sunglases: Run in style with goodr's super fun sunglasses.
Feetures Socks: Massively grippy socks that will make you feel more one with the shoe
Amphipod Hydraform Handheld Water Bottle: Perfect for long runs when you need hydration in the summer
Trigger Point Foam Roller: Help get those knots out post-run and feel better for tomorrow
Theragun Massager: This small version is great on the go for working tired legs
Ciele Hat: Our team's favorite running hat of choice!
Fractel Hats: Our team's wider fitting running hat of choice!


Facebook: Doctors of Running
Youtube Channel: Doctors of Running
Instagram: @doctorsofrunning
LinkedIn: Doctors of Running
Strava: Doctors of Running
Podcast: Virtual Roundtable
Pinterest: Doctors of Running


Check out the Doctors of Running Podcast to find more reviews, interviews, and running features from the team.

Visit our Podcast Page
Find us on Apple
Find us on Spotify

Please feel free to reach out, comment and ask questions!
Contact us at

How Much Does Doctors of Running Make? Report #5

Bottom Ad [Post Page]

// ]]>