Five preconceived ideas about running, decoded by a physiotherapist – Evening Edition Ouest-France – 09/08/2022

Improper footwear, back pain, osteoarthritis, pregnancy, poorly mastered technique… these fears often make people stop running. However, these are unfounded beliefs, explains Belgian physiotherapist Guillaume Abran.

I am a physiotherapist in a sports clinic (Regional Hospital Center Hue, Belgium) specializing in leg injuries. Besides my work as a doctor, I am also a researcher at the University of Liège (Human Movement Laboratory). I am interested in involving the foot and ankle complex in injury prevention and performance in endurance running. These two aspects of my work allow me to combine the scientific evidence from the scientific literature with the reality on the ground about the care of injured runners.

Running is one of the most popular sports in the world thanks to its accessibility and low cost. This sport has many benefits that are unfortunately offset by the high incidence of injuries, which is twice the number of injuries compared to the average for other sports. The incidence of injury varies greatly across studies, but it appears that approximately 65% ​​of runners will experience at least one injury during that year.

The causes of running injuries are often misunderstood, particularly because of their multifactorial aspect. This misunderstanding leads to the development of false beliefs that often lead to a recurrence of the injury and sometimes to the eventual cessation of exercise.

Our role as a healthcare representative is to challenge these unfounded beliefs in order to promote physical activity and a less sedentary lifestyle in the general population. In this article, I share the key beliefs I should come to grips with in my clinical practice with runners of all ages and levels.

Myth #1: “If I cut myself, it’s because my shoes don’t fit.”

The shoe is often incriminated in the emergence of running injuries. The main arguments are the lack of cushioning of the shoe or the wear condition. The multi-billion dollar footwear industry. Brands are constantly creating new models with additional features and technologies that are supposed to reduce the risk of infection.

To date, the association between shoe type and onset of a running injury has remained poor. In fact, studies that attempted to demonstrate the benefit of cushioning or the effect of wearing shoes on the onset of running injuries failed. On the contrary, shoes with a large cushion seem to put more pressure on the joints. Therefore, the choice of shoe should be individual and result mainly from the comfort that one feels while wearing it.

Myth 2: “My doctor told me I had osteoarthritis, and I can’t run anymore”

Osteoarthritis is a disease of the cartilage that affects a large part of the population. The succession of effects from running is often considered a cartilage-damaging error. However, the scientific literature has a completely different view on this issue.

Although meniscus thickness decreases within minutes of running activity, it returns to normal after only an hour. Other studies show that recreational runners have less osteoporosis than sedentary people. This can be explained in part by the long-term adaptation of cartilage through the effects associated with running, but also by secondary benefits from running (reduced body mass, increased muscle strength, etc.).

Studies also show that running with signs of arthritis does not increase symptoms or cause further cartilage deterioration. So osteoporosis should not discourage running.

Myth 3: “I have back pain, it is not recommended to run”

Back pain is the main reason for restricted participation in activities and absenteeism from work. Back pain is often accompanied by comorbidities such as a fear of movement or a high level of anxiety.

Several studies have shown the effects of physical activity to protect against the onset of back pain, but also to reduce pain when it is already present. Back pain in runners is less common than in the general population and running appears to be a protective factor.

On the other hand, running at a low intensity also increases basal metabolism, but also blood flow to the back muscles, allowing for an improved recovery process.

Myth 4: “If you get injured, it’s because your running style is not good”

Running style is a topic that often sparks discussions among runners. Many unscientific websites offer ways to reduce the risk of infection: “Landing in the forefoot”, “Running at 180 steps per minute”, “Running barefoot”, etc.

However, to date, there is no study with a high level of evidence that has shown a causal link between the coefficient of vital activity and the incidence of running injuries. On the contrary, it appears that abrupt adjustment of running technique can increase the risk of injury by increasing the pressure on areas that were not hitherto accustomed to receiving it.

In general, it is not recommended to modify his running style in an uninjured runner. In the case of an injured runner, the running style will be modified on an individual basis taking into account his individual characteristics, his history of injuries and his current injury.

Myth 5: “Since I got pregnant, I’ve stopped running because it could be dangerous for my baby”

Physical exercise and pregnancy are not always seen as compatible. However, physical exercise during pregnancy has many benefits for both the mother and the baby (for example, reducing the risk of gigantism, gestational diabetes, preeclampsia, lower back pain and enuresis). Current recommendations recommend 150 minutes of moderate physical activity per week for pregnant women who exercised before pregnancy. It’s also possible to get started with physical activity during pregnancy by starting with five minutes in the first week and then adding five to ten minutes each week.

Running is a well-suited physical activity for a pregnant woman, even in the third trimester of pregnancy. Studies show that running does not delay pregnancy, strengthens the pelvic floor muscles and can also reduce the risk of postpartum depression. However, each pregnancy has its own characteristics and it is recommended to have a discussion with your doctor.

So running is a physical activity that has many advantages, which will make you forget about some of the inconveniences it can sometimes cause. It should be advised to stop this practice only in exceptional cases.

Physical vulnerabilities are often part of an athlete’s life. The fatigue and stress that we experience on a daily basis associated with a lifestyle that is not always ideal are two factors that often have limited scope for our work and contribute to our injuries. To reduce the risk of its appearance, a progressive practice with a long-term vision should be preferred.

The original version of this article was published in Conversation.