Which Running Tests Are Worth the Investment for Performance and Injury Prevention?

One exception: Keep up with your yearly physicals (during which you may have some blood work done) as a baseline. From there, your doctor may also suggest other specific tests (like a DEXA scan, which looks at bone density, for those with osteopenia or a history of broken bones).

That said, keep reading for what runners should know about some of the most popular fitness lab tests out there right now, how each can support your goals, and which type of runner is more likely to benefit from investing in each one.

Consider a gait analysis

A gait analysis—which involves being recorded from different angles while running on a treadmill to look at form, including foot strike and body alignment—is especially useful for runners with chronic injuries like shin splints, patellofemoral pain, or IT band issues, says Robinson.

“The gait analysis can show things in your running mechanics that are making you more prone to injuries and especially certain types of injuries,” says Robinson. This analysis may also ID weaknesses or muscle imbalances and things like overstriding, overpronating, or a low cadence.

Runners looking to improve efficiency may also benefit from this test. “There can be ways to improve your biomechanics to improve your running efficiency,” like working on optimizing hip extension, which is important for minimizing vertical excursion (or too much up and down movement rather than straight ahead).

N’Namdi Nelson, C.S.C.S., an exercise physiologist at NYU’s Sports Performance Center adds that beginners can benefit from a gait analysis: “The activity you’re going to be doing is running, so why not do a running analysis to assess your biomechanics to see exactly what’s going on in your gait, and identify things that you may be doing incorrectly and ways that you can improve it?” This will not only set you up for success in the sport of running in terms of performance, but help you avoid injuries before they show up in your stride.

Where to get it: Running labs like at universities and medical centers or at a local physical therapy clinic

Typical cost: Starting at about $150 (or free with your physical therapy appointment, depending on insurance)

Consider a functional movement screening (FMS)

When doing a functional movement screen, a coach or trainer will typically put you through movements (e.g. a single-leg squat, push-up, and step-over) and watch how your body moves. If your hip drops to one side or your knees cave in on that squat, for example, that could indicate weakness in your core stability, Robinson says, which could affect your injury risk in running. The facilitator will then give you specific exercise recommendations to strengthen those weaknesses.

Nelson recommends the FMS for beginners in particular. “It’s going to give us more information as to what’s going on in the body,” he says. “So for example, if we see weakness in certain muscles or a decrease in flexibility in certain joint ranges, then we can try to get ahead of it and try to correct it, decreasing your chances of sustaining some type of running-related injury.”

Where to get it: Some places, like NYU, HSS, and the Columbia RunLab, offer running analyses which combine a gait analysis on a treadmill with a movement screen like the FMS so it’s one stop shopping. Nelson says that having information from both of these inputs—the gait analysis and FMS—can be helpful when making correlations.

You can also often get an FMS at a gym as part of an initial training evaluation, and it can be useful on its own. (If you’re choosing between a gait analysis and an FMS, Robinson argues the former is more beneficial as it’s more specific to runners.)

Typical cost: Included in the above services, with rates changing depending on insurance and/or location

Consider a metabolic profile test

This type of test typically includes a VO2 max test, lactate threshold evaluation, and metabolic efficiency testing. It involves a finger stick capillary blood test, as well as running on a treadmill at increasing intensity with a mask on to measure how much oxygen you’re consuming, as well as CO2 output and heart rate.

VO2 max measures your aerobic capacity. It can give you a sense of your cardiovascular fitness, which can be helpful as a benchmark to try to improve (often via short, intense intervals).

This test can also help you determine your max heart rate, and training zones based on that.

“Lactate threshold is basically the point at which your body starts to go from aerobic to anaerobic and starts to really ramp up its levels of lactate,” says Robinson. “The lactate threshold basically tells a runner the pace at which they could run a short distance, like a 5K or 10K, which can be useful when you’re talking about training paces.”

Importantly, lactate threshold is something you can train and improve, Robinson adds. Knowing your threshold allows you to train in the proper zones to increase it. For example, if your lactate threshold is nine minutes per mile, then training with runs at that pace could help to improve that, Robinson says. (And then if you repeated this test months later, you can see if it improves.)

As for metabolic efficiency, Robinson says this can help you strategize fueling for long races—and it’s also trainable. This test profile measures how many calories you use per hour and the breakdown of fat versus carbohydrate at various exercise intensities.

“We have a lot of fat stores in our body, but our body has very limited carbohydrate stores,” he says. So, if the test reveals that you’re using mostly carbs for long runs, for example, you’ll run out of fuel quickly and knowing this would help you ID exactly how much nutrition you need to bring along.

Robinson says this test is most useful for runners trying to improve efficiency and pace. For example, if you want to run a sub-four-hour marathon, this test can be useful to one, see if you’re able to achieve that goal at your current fitness level, and if not, figure out which zones to train to get there.

The test can also be useful for those who deal with cramping when they run. “Usually cramps are a fueling issue more so than a true dehydration issue,” says Robinson. “So the metabolic profile can be useful for fueling to see why someone might be cramping, or for someone that hits a wall at mile 20 or 21 in the marathon, that could be a fueling issue, and the metabolic profile can definitely help clue you into strategies to help.”

Where to get it: At NYU, this test is called the “Sports Performance” evaluation and includes a gait analysis, stability and mobility screen, and VO2 max, with the option to add lactate threshold testing. At HSS, it’s Metabolic Testing and includes all of the metrics (VO2 max, lactate threshold, metabolic efficiency, and also running economy). You also may be able to find similar tests at other universities, medical centers, and running labs.

Typical cost: Starting at about $450, depending on tests included and location

Use your wearable data

Robinson acknowledges that many wearables now provide lots of info that you’d get as part of a formal gait analysis, like cadence, vertical oscillation, and stride length, in addition to metrics like VO2 max. “They’re pretty accurate now,” he says, adding that they can be more accessible and less expensive (assuming you’ve already paid for the wearable) than additional testing.

Still, sometimes people need help with interpretation of this data and they don’t know what to do with it on their own. “Seeing an exercise physiologist or a running coach could help them interpret some of the data,” he says.

Typical cost: Free (after the cost of a wearable, which typically starts around $200)

Consider a blood panel

As long as you pass your yearly physical, additional blood work probably won’t tell you much more about your running performance, according to Nelson. “You can identify some nutritional deficiencies and things like that that may affect your performance, but those things may also be highlighted in your yearly physical,” he adds.

However, for those really into data and optimization of health and performance, a full blood panel might be helpful, so long as you know what to do with the information (or have someone to interpret the results). This additional screen may look into nutritional biomarkers beyond your typical blood test at a physical, like omega-3 levels, electrolytes like calcium and magnesium, and many other health-related metrics that are related to heart health, immune regulation, and more.

The one biomarker both experts agree is wise to get tested for all runners is vitamin D. “I do recommend that runners get their vitamin D checked regularly because if you are low in vitamin D, then that can put you at risk for bone injuries such as stress fractures, and vitamin D deficiency is extremely common, especially in places where you don’t get as much sunlight,” says Robinson.

Other than that, if you’re having specific issues or have concerns about your overall health, consult with your doctor to see what biomarkers, if any, should be tested.

Where to get it: Your doctor should be able to run additional lab tests if you have a medical need for them, but you can also try a direct-to-consumer service like Function or Inside Tracker.

Typical cost: Free one time a year with most insurance providers (for the basics), but around $500 for the DTC services.