I am a physiotherapist in a sports clinic, at the regional hospital center of Huy, in Belgium, and specialized in leg injuries. Alongside my work as a clinician, I am also a researcher at the University of Liège, in the Human Movement Analysis Laboratory. 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 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. It also has many benefits, which are unfortunately counterbalanced by a high frequency of occurrence of injuries (about twice as much on average as in other sports). The figure varies greatly between studies, but it would seem that almost 65% of runners will suffer at least one injury during this year.
The causes are very often misunderstood, in particular because of their multifactorial aspect, which has resulted in the development of false beliefs that often lead to the recurrence of an injury and sometimes to the definitive cessation of sports practice.
Our role as a health care actor is to challenge these unfounded myths, in order to promote physical activity and the adoption of a less sedentary lifestyle in the general population. Here are the main ideas that I have to deal with in my clinical practice, with runners of all ages and all levels.
“I hurt myself because my shoes are not suitable”
The shoe is often incriminated in the appearance of running injuries. It is generally criticized for its 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 the type of shoe and the onset of a running injury remains weak. Indeed, studies that have tried to demonstrate the benefit of cushioning or the effect of 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 mainly result from the comfort one feels while wearing it.
“My doctor told me that I had osteoarthritis, I can no longer run”
Osteoarthritis is a pathology affecting the cartilages, which affects a large part of the population. The succession of impacts caused by the practice of running is often considered, wrongly, as 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 after just one hour. Other studies show that recreational runners have less osteoarthritis than sedentary people. This could 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 this sport (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.
“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 against the onset of back pain, but also to reduce it when it is already present. Runners are thus less prone to back pain than the general population: it would seem that practicing 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.
“I hurt myself because my running technique is not good”
Running technique is a subject that often animates debates among runners. Many sites offer, without scientific basis, methods to reduce the risk of injury: “land on the forefoot”, “run with a cadence of 180 steps per minute”, “running barefoot”etc.
However, to date, there is no study that has really 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 technique can increase the risk of injury by increasing the stress on areas that were until now unaccustomed to receiving it.
In general, it is not recommended to change your running technique when you are not injured. And in an injured runner, the modification will be made taking into account his individual characteristics, his injury history and his current injury.
“Pregnant, I stopped running because it could be dangerous”
Physical exercise and pregnancy are not always seen as compatible. However, sports practice during this period has many benefits, both for the mother and her baby (reduced risk of macrosomia, gestational diabetes, pre-eclampsia, low back pain and urinary incontinence).
Current recommendations advise a practice of one hundred and fifty minutes of moderate physical activity per week for a pregnant woman who practiced sport before her pregnancy. It is also possible to start exercising during pregnancy by starting with five minutes the first week, 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 this practice does not advance the due date of pregnancy, strengthens the muscles of the pelvic floor and could 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 that 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.
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