By Guillaume ABRAN, physiotherapist and doctoral student in motricity sciences, University of Liège (Belgium)
Unsuitable shoes, back pain, osteoarthritis, pregnancy, poorly mastered technique… These fears often cause people to give up running. However, these are unfounded beliefs, explains Belgian physiotherapist Guillaume Abran.
I am a physiotherapist in a sports clinic (Regional Hospital Center of Huy, Belgium) with a specialization in leg injuries. Alongside my work as a clinician, I am also a researcher at the University of Liège (Laboratory of Human Movement). I am interested in the involvement of the foot-ankle complex in injury prevention and performance in endurance running. These two aspects of my work allow me to combine the scientific evidence reported in the scientific literature and the reality on the ground of the care of injured runners.
Running is one of the most practiced sports in the world thanks to its accessibility and low cost. This sport has many benefits which are unfortunately counterbalanced by a high frequency of occurrence of injuries, regarding twice as many injuries as the average for other sports. Injury incidence varies widely across studies, but it appears that nearly 65% of runners will experience at least one injury during that year.
The causes of running injuries are often misunderstood, particularly due to their multifactorial aspect. This misunderstanding results in the development of false beliefs often resulting in the recurrence of an injury and sometimes in a definitive cessation of sports practice.
Our role as a health care actor is to challenge these unfounded beliefs in order to promote physical activity and the adoption of a less sedentary lifestyle in the general population. In this article, I share the main beliefs I have to deal with in my clinical practice with runners of all ages and levels.
Myth #1: “If I hurt myself, it’s because my shoes aren’t suitable”
The shoe is often incriminated in the appearance of running injuries. The main arguments are the shoe’s lack of cushioning or its state of wear. The footwear industry is multi-billion dollar. Brands are constantly coming up with new models with additional features and technologies that can supposedly reduce the risk of injury.
To date, the link between shoe type and the onset of a running injury remains weak. Indeed, studies that have tried to demonstrate the benefit of cushioning or the effect of shoe wear on the onset of running injuries have failed. Conversely, it would even seem that shoes equipped with significant cushioning cause greater joint stress. Therefore, the choice of a shoe should be individual and result mainly from the comfort one feels while wearing it.
Myth #2: “My doctor told me I have osteoarthritis, I can’t run anymore”
Osteoarthritis is a pathology affecting the cartilages that affects a large part of the population. The succession of impacts caused by the practice of running is often wrongly considered harmful to cartilage. However, the scientific literature has a completely different view on the matter.
Although cartilage thickness is reduced within minutes of running activity, it returns to normal following just one hour. Other studies show that recreational runners have less osteoarthritis than sedentary people. This might be partly explained by the long-term adaptation of the cartilage by the impacts linked to running, but also by the secondary benefits due to the practice of running (lower body mass, greater muscle strength, etc.). .).
Studies also show us that running with signs of osteoarthritis does not increase symptoms or cause further cartilage deterioration. Osteoarthritis should therefore not discourage the practice of running.
Myth #3: “I have back pain, running is not recommended”
Back pain is the leading cause of restricted participation in activities and absenteeism from work. Back pain is frequently accompanied by comorbidities such as fear of moving or a high level of anxiety.
Many studies have shown the effects of practicing physical activity to protect once morest 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 it seems that running is a protective factor.
On the other hand, running at low intensity also increases the basal metabolism, but also the blood flow to the muscles of the back, allowing an improvement in the healing process.
Myth #4: “If I get injured, it’s because my running technique isn’t good”
Running technique is a subject that often animates debates among runners. Many unscientific websites offer methods to reduce the risk of injury: “Land on the front of the foot”, “Run with a cadence of 180 steps per minute”, “Run barefoot”, etc.
However, to date, there is no study with a high level of evidence that has demonstrated a causal link between a biomechanical parameter and the incidence of running injuries. On the contrary, it would seem rather that abruptly modifying one’s running technique can increase the risk of injury by increasing the stress on areas that were until now not accustomed to receiving it.
In general, it is not recommended to modify his running technique in a runner who is not injured. In an injured runner, the modification of the running technique will be carried out on an individualized basis taking into account his individual characteristics, his history of injuries and his current injury.
Myth #5: “Since I got pregnant, I stopped running because it might be dangerous for my baby”
The practice of physical exercise and pregnancy are not always perceived as compatible. However, physical exercise during pregnancy has many benefits for both mother and baby (for example, reduced risk of macrosomia, gestational diabetes, preeclampsia, low back pain and urinary incontinence). Current recommendations advise a practice of 150 minutes of moderate physical activity per week for a pregnant woman who practiced sport before her pregnancy. It is also possible to start practicing physical activity during pregnancy by starting with five minutes the first week and then adding five to ten minutes each week.
Running is a physical activity quite suitable for a pregnant woman, even in the last trimester. Studies show us that running does not advance the due date of pregnancy, strengthens the muscles of the pelvic floor and might also reduce the risk of postpartum depression. However, each pregnancy has specificities and a discussion with your doctor is recommended.
Running is therefore a physical activity with many advantages, which should make you forget the few inconveniences it can sometimes cause. Cessation of its practice should only be advised in exceptional cases.
Physical glitches are often part of an athlete’s life. The fatigue and stress to which we are subjected daily associated with a lifestyle that is not always ideal are factors for which our field of action is often limited and contributes to the appearance of our injuries. To minimize their risk of appearance, a progressive practice with a long-term vision should be favored.
The original version of this article was published in The Conversation.