16/10/2022

Good morning to all and especially those pounding the pavements in preparation for the Dublin marathon. This blog isn’t solely for you, but with the biggest marathon in the country fast approaching I thought running topics this month would be appropriate. Today I’ll touch on 3 areas:

1. Benefits of running
2. Misconceptions regarding running and joint damage
3. Getting the running dosage right when you start or return after a break 

I think it’s fair to say the benefits of exercise in general are widely known and accepted. In fact, there has been a strong movement in the past 15 years to recognise that exercise is medicine. Distance running has been shown to improve all aspects of cardiovascular health, psychological wellbeing, muscle strength and endurance and bone health to name but a few. The research studies in this area consistently show that muscles and tendons of runners are in a better condition than those who are inactive, which is unsurprising. A couple of years ago I spotted a study which did surprise me, or at least it made me consider the value of running in a different light. In 2017, researchers in Australia found that the health of the lumbar discs was significantly better in long distance runners / joggers compared to inactive individuals, and that greater running distances lead to better results. Further research since then has supported these results. What does it mean? Well, it suggests that running improves the resilience of the discs in the lower back, making it less likely they will be the cause of back pain.

This brings is us nicely on to the common question of whether running on the road / footpath causes “damage” to the joints. Generally when I am asked this question it is with reference to the the cartilage of the knee. Similar to the improvements in lumbar disc health with running, knee cartilage has also been shown to improve and many studies have concluded that runners are not at a higher risk of osteoarthritis. The cyclic and predictable motion involved in straight-line running are likely part of the reason why it is low risk for injury. In contrast, activities and sports which require twisting and rotation produce less predictable movements at speed which can result in the joint tissues becoming suddenly or gradually overloaded, leading to injury. 

Where running does carry a risk for injury is when too much is done, at one time or over a relatively short-period of time. For example, if somebody was starting a New Years resolution to run everyday and they had been doing no exercise or perhaps a different form of exercise such as swimming, then a joint or tendon would become quickly overloaded, resulting in pain and/ or injury. Similarly, if you had been accustomed to running 5km 3 times a week for a few years and then decided to do a half-marathon (20km) one Sunday, a joint or tendon would become suddenly overloaded and problems would follow. So, what’s the answer to getting started running or increasing in a safe manner?

I would suggest writing down the following:

1. How often in a week you do sustained activity or exercise on your feet (at least 20 minutes)
2. How hard do you work during that activity (rate it out of 10, where 0 is no effort and 10 is maximum effort)
3. How long have you been doing the activity on a consistent basis (without interruption for illness, holiday etc.)

From this information you can start to make a judgement on how much running you could start with or increase to on a weekly basis. It is difficult to give a recipe that would cover all starter scenarios or for those who are increasing, so perhaps it is something I can go more into depth in the next blog. My main advice when judging how much you should do is do less than you think is right for 2-3 bouts of activity and then increase gradually (5-10% in speed or duration) every 3rd bout of activity. I think it is somewhat in human nature that we overestimate how much we could do, particularly when we are feeling motivated to progress. It is much preferable in my mind to do less for a short period of time and stay active then overdo it and end up out of action. 

Till the next blog, stay active and stay well!

Lonan Hughes

Chartered Physiotherapist

Lonan Hughes

Chartered Physiotherapist