Were we born to run?
Everybody’s out on the run tonight
But there’s no place left to hide…
Come on with me, tramps like us
Baby we were born to run…
(Springsteen B, et al)
The ‘Fun Run’ season is upon us. City To Surf is in 2 weeks and the Sydney Running Festival with a marathon, half marathon and Bridge Run is a month after that and there are many more running events every weekend in between.
With all these running events happening all over Sydney thousands upon thousands of us are out there pounding the pavement.
I often hear, around this time of the year, that running, especially on the road, is “bad for you.” That distance running causes osteoarthritis of the knees and hips and degeneration of the discs in the lower back.
But is the belief that distance running wears your joint out based on fact?
The evidence would seem to suggest otherwise.
A review by Cymet and Sinkov in the Journal of the American Osteopathic Association, highlights the lack of evidence that running is bad for your joints. In fact their opinion is-
‘ the preponderance of data seems to indicate that moderate levels of running do not increase the risk of osteoarthritis of the knees and hips for healthy people and this activity might even have a protective effect.”
What many people overlook is that the human body is self healing and adapts readily to stresses placed upon it so it should be no surprise that tissues like muscles and the cartilage in our joints will adapt and strengthen to loads placed upon it, like running.
A study in the American Journal of Preventative Medicine, by Chakravarty et al, stated that-
‘Data suggest that long distance running may not be associated with increased progression of knee osteoarthritis in the absence of knee injury, obesity, proprioceptive or poor muscle tone.’
And does running promote degeneration of the discs in your lower back (lumbar spine)?
We know that loading of the lumbar spine can speed up disc degeneration in some situations (like prolonged sitting) but there is no evidence that running accelerates disc damage. There is some recent data that suggest that running might be capable of stimulating and even strengthening the matrix material that makes up the disc. A study published in SPINE Journal by Brisby et al suggests that dynamic loading, like running and walking, has the effect of building up the cells and protein structure of the disc.
But what about other supposed running related injuries like calcaneal spurs, Achilles tendinopathy or plantar fasciitis?
There is a growing body of evidence that suggests that the increase in lower limb running injuries has paralleled so called ‘advances’ in running shoe design and especially so for the PCECH (pronation control, elevated cushioned heel) type of shoe.
Prior to the 1970’s and for most of human evolution runners have proceeded barefoot or used minimal footwear. After the advent of the padded and controlling running shoe there has been a proportional rise in lower limb injuries.
This observation agrees with my own personal experience as a runner. I have run competitively since 1968 and in my early running career it was virtually unheard of for a runner to get an overuse injury like Achilles problems or shin splints. And when I was in training we would run 100-150Km per week in shoes that had less cushioning than an old pair of Dunlop Volleys.
According to Richards et al, who published a study on this in the British Journal of Sports Medicine-
‘ The use of cushioning in running shoes is based on the following assumptons- 1) that impact forces while running are a significant cause injury (2) that running on hard surfaces is a cause of high impact forces (3) that a cushioned shoe can reduce impact forces to a less injurious level (4) that the potential of the cushioning itself to cause injury is minimal.’
However the evidence for this is very limited and the prescription of the PCECH type running shoe is not ‘evidence based’.
Evidence suggests that our biologically natural running gait has transformed from a predominantly fore-foot strike on landing to a heel strike. Landing heavily on your heel is not what nature intended, no matter how much padding your shoe has. Landing on your heel while running is inefficient and greatly increases the impact forces on your lower limb and the force actually increases with the amount of padding in the shoe. Furthermore padded running shoes increase ground reaction forces, dampen the nerve feedback from our lower limb and foot joints and ligaments and weakens the small muscles that support our foot arches.
As crazy as it sounds there is a growing consensus between scientists and researchers that the modern running shoe may actually be the cause of many of the problems we see in runners today because they interfere with the natural way humans have evolved to run over the millennia.
As a result we have seen a growing trend to a return to a more natural style of running and a proliferation of ‘minimal style running shoes’ that allow for a more natural running gait. Harvard Professor Daniel Lieberman is a big proponent of the natural running style and his research strongly suggests that this is the way that humans are designed to run.
So Bruce Springsteen was right all along when he sang- “ Baby, we were born to run.”