I am a physiotherapist at the Sports Clinic (Hui Regional Hospital Center, Belgium), specializing in foot injuries.
In addition to my work as a clinician, I am also a researcher at the University of Liege (Institute of Human Movement). I am interested in the ankle complex being involved in injury prevention and long-distance running performance. These two aspects of my work allow me to combine the scientific evidence reported in the scientific literature with the reality of caring for an injured runner.
Running is one of the most practiced sports in the world due to its accessibility and low cost.
This sport has many advantages, but unfortunately it is balanced because it is about twice as often injured as the average of other sports. The incidence of injuries varies widely from study to study, but it seems that nearly 65% of runners experience at least one injury each year.
The causes of running injuries are often misunderstood, especially because of the multifactorial aspect. This misunderstanding often leads to the development of false beliefs that often lead to the recurrence of injuries and sometimes the decisive discontinuation of sports practice. Our role as a health care actor is to challenge these unfounded beliefs in order to promote physical activity and adopt a lifestyle that is not sedentary to the general public. In this article, I will share with runners of all ages and levels the main beliefs I have to work on in clinical practice.
“If you hurt yourself, your shoes won’t fit.”
Shoes are often guilty of looking like a running injury. The main argument is the lack of cushioning of the shoe or its wear condition. The shoe industry is billions of dollars. The brand is constantly inventing new models with additional features and technologies that may reduce the risk of injury. To date, the link between shoe type and the development of running injuries remains weak. Indeed, studies attempting to demonstrate the benefits of cushioning and the effects of shoe wear on the development of running injuries have failed. Conversely, shoes with considerable cushioning may even seem to cause greater joint stress. Therefore, the choice of shoe should be personal and primarily result from the comfort you feel when wearing it.
“My doctor told me I had osteoarthritis, I can’t run anymore.”
Osteoarthritis is a condition that affects cartilage, which affects the majority of the population. The series of impacts caused by running exercises is often mistakenly considered harmful to cartilage. However, the scientific literature has a completely different view on this issue.
Cartilage thickness decreases within minutes of running activity, but returns to normal after only one hour. Other studies have shown that recreational runners have less osteoarthritis than those who tend to sit down. This can be partially explained by the long-term adaptation of cartilage due to the effects associated with running, but also by the secondary benefits of running practice (weight loss, muscle strength gain, etc.). Studies show that running with signs of osteoarthritis does not worsen the symptoms or further worsen the cartilage. Therefore, osteoarthritis should not discourage running practice.
“I have back pain. I don’t recommend running.”
Back pain is a major cause of restricted participation in activities and absenteeism. Back pain is often associated with comorbidities such as fear of movement and high levels of anxiety. Many studies have shown the effectiveness of practicing physical activity not only to prevent the development of back pain, but also to relieve pain if it already exists. Runners’ back pain is less common than the average person, and running seems to be a protective factor.
On the other hand, running at low intensity increases not only basal metabolism but also blood flow to the muscles of the back, making it possible to improve the healing process.
“I was injured because I’m not good at running techniques.”
Running techniques are often the subject of lively discussions among runners. Many non-scientific websites offer ways to reduce the risk of injury: “land in front of your feet,” “run at a rhythm of 180 steps per minute,” “run barefoot,” and more.
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However, so far, no studies with high levels of evidence have demonstrated a causal relationship between biomechanical parameters and the incidence of running injuries. On the contrary, sudden changes in running techniques seem to increase stress on areas that you weren’t used to and may increase your risk of injury. In general, it is not advisable to change the running technique of an uninjured runner. Injured runners will make individual changes to their running techniques, taking into account their personal characteristics, history of injury and current injury.
“Since I became pregnant, I stopped running because it could harm my baby.”
Exercise and pregnancy practices are not always perceived as compatible. However, exercise during pregnancy has many benefits for both mothers and babies (eg, reduced risk of giants, gestational diabetes, pre-eclampsia, back pain, and urinary incontinence). Current recommendations recommend that pregnant women who practice sports before pregnancy should undergo moderate physical activity for 150 minutes per week. Physical activity exercises during pregnancy can also be started by starting with 5 minutes of the first week and adding 5-10 minutes each week. Running is a very suitable physical activity for pregnant women, even in the second trimester of pregnancy. Studies show that running does not advance pregnancy, it may strengthen the muscles of the pelvic floor and reduce the risk of postpartum depression. However, due to the specificity of each pregnancy, it is advisable to discuss it with your doctor.
Therefore, running is a physical activity with many benefits), which should make you forget some of the inconveniences it can sometimes cause. Discontinuation of that practice should only be advised in exceptional cases. Physical problems are often part of an athlete’s life. Routine fatigue and stress associated with lifestyles that are not always ideal are factors that often limit our areas of activity and contribute to the appearance of injuries. Progressive practices with a long-term vision should be supported to minimize the risk of emergence.