I am sure you have read or heard that running will naturally offer greater cardiovascular benefits for the body compared to walking. This is mainly due to the required increase in workrate of the heart to sustain the more intense acivity of running. This greater intensity demands a faster blood flow - good for moving oxygen around the body. This intensity also offers numerous benefits for the heart itself and the overall strength and fitness of the body.

We have written previously about the merits of running - Is Running The Best Exercise For Fitness

A critical consideration is the additional time and effort required to participate in a run versus a walk and whether this extra effort actually causes no activity to be taken.

A lack of time is one of the most common excuses given by people who don’t exercise. This report coming from the American College of Cardiology will be welcoming news for the time-poor non-exercisers:

"Running for only a few minutes a day or at slow speeds may significantly reduce a person's risk of death from cardiovascular disease compared to someone who does not run."

Running is a very popular form of exercise given it is easy to take up - no special equipment is needed other than a pair of running shoes and you can start and end right from your front door. A previous post of ours assessed the merits of running in more detail - Is Running The Best Exercise For Fitness?

The report from the American College of Cardiology states that even a 5-10min run is enough to provide significant cardiovascular benefits and a reduction in mortality risk.

We have written a fair few articles about the barefoot running movement, exploring the debate for and against the merits of ditching the traditional running shoe.

Recent article: Running Confusion - Shoes vs Orthotics vs Barefoot Movement

The very first version of the five-fingered running shoe (a flat, rubber soled slip on style shoe with glove like inserts for each toe) was made by a company called Vibram. Since this first design a lot of other manufacturers have produced a diverse range of flatter style shoes to meet the growing demand for the more ‘natural’ running with less supporting cushion under your feet, AKA barefoot running.

Arguments over the merits of barefoot running have been intense with questionable claims supporting for and against it. The company Vibram has just recently settled a claim of nearly $4million for deceptive marketing about the health benefits of the five-fingered. It seems an estimated 70 million Vibram customers might be getting a payout to some extent.

Read about the Vibram lawsuit here…- http://www.huffingtonpost.com/2014/05/10/_n_5302213.html

Physiotherapists regularly prescribe exercise as a fundamental part of the rehabilitation process, following a muscle or joint injury for example. Running is a very common form of exercise to which many patients will want to progress, when enough function has returned, in order to build up their fitness again. But is running the best exercise for improving fitness?

The short answer is no, in my opinion.

However, possibly a more appropriate answer would likely be that it depends on what your fitness goals are and how you want to define fitness.

Let’s take a look at a local event to help describe what I mean. The Great Ireland Run 10km recently passed earlier in April with the winners achieving some impressive results; men’s first place came in under 30 minutes and the women’s first achieved a 33 minutes and 39 seconds. How do we think the top running athletes prepare for such an event? They will do a lot of running training no doubt but I am certain this is not all they do. Athletes performing at this level need to be in peak physical fitness to sustain the demands they are placing on their bodies and to keep their risk of injury as low as possible.

You may be wondering what do top performing athletes have in common with patient rehabilitation and recreational running. Well, my point is that we can learn from the best in their field and adopt some of the principles used in their training. Naturally our training won’t be nearly as intense or demanding as that of elite athletes so what can we learn from them?

Do you think our early ancestors wore half-length or full-length orthotic shoe inserts? Would their video-recorded gait assessments have revealed more under or over-pronators in the general population?

If we try to imagine how life was back in the day of the caveman we could safely assume that his ability to run both short sprints and long distances was necessary for surviving in a wild environment. Without the ability to track food or flee from dangerous predators the human evolution may not have been possible. What we can also be sure of is the caveman did not run in a pair of Asics trainers with rear-foot gel-cushioning outer soles structured for either a neutral or over-pronating gait . Nope, our early ancestors would have been running barefoot.

Many thousands of years later and despite our advances in footwear design and technology there is a ‘barefoot running’ revolution gaining traction in some circles. The idea is that we as a species have spent more time running barefoot than we have in our fancy high-tech shoes and therefore we are more physiologically suited to running barefoot.

Chartered Physiotherapists are trained to assess an acute (recent) ankle sprain and using a specific set of assessment criteria known as the Ottawa Ankle Rules we can determine if a fracture is likely to have occurred. If we suspect a fracture we can refer you for an X Ray or MRI scan (In Ireland, depending on your health insurance policy, you may need your doctor to sign off on the request). The results of the scan will help us decide how best the ankle should be managed and depending on the extent of the damage, an orthopaedic specialist may need to be consulted in addition to receiving physiotherapy.

Most ankle sprains result in soft tissue injury, usually to the ligament structures which support the ankle joint. The lateral (outer) ligaments are more commonly injured which may result in pain, swelling, restriction of movement and a loss of function e.g. walking properly, or ability to run and take part in sports. If this type of injury is not treated correctly, on-going weakness and instability may result, making further injury much more likely down the road. Simply taking anti-inflammatories is not sufficient.

As human beings we are ambulatory creatures, that is we walk upright and are very reliant on our legs to move us about. How the foot strikes the ground and the knock on effect this has up the lower limbs to the knee, hips, pelvis and low back in particular has become a subject of much debate and controversy in recent years.

Lower limb biomechanics refers to a complex interplay between the joints, muscles and nervous system which results in a certain patterning of movement, often referred to as ‘alignment’.

Much of the debate centres around what is considered ‘normal’ and what is considered ‘abnormal’ in biomechanical terms as well as the extent to which we should intervene should abnormal findings be found on assessment.

In many cases, long term muscle imbalance exists already, an injury then occurs and an orthotic is prescribed to temporarily offload the injured structures to promote healing and recovery. 

In this situation, some biomechanics experts would argue that the orthotics, by placing the foot and ankle in a more ‘aligned' position, can actually help overcome and correct long term muscle imbalance, often with the help of corrective exercises and manual joint and soft tissue mobilisation techniques. This situation often occurs from the late teens onwards.

In a previous post "Should I Go Barefoot Or Stick With Trainers?" Simon explored some thoughts on the barefoot running technique that has become popular in minimalist circles.

Simon's objective review of the different fore foot strike patterns revealed he has himself adopted a slightly altered running position but clearly points out that barefoot running is not for everyone. In his own case, an over-pronator with a leg length discrepancy reliant on the use of orthotics, he makes a good point that barefoot running is probably not the best idea for him.

We all need to take such an honest and reflective view of our own biomechanics and medical history if considering the barefoot running style.

Here are two videos that will add insight and provoke thoughts well worth considering …

For all you runners out there - how aware are you of your running style?

In this short 18 second video chrisjohnsonpt.com demonstrates how a runner with dysfunctional lower body mechanics employs an unusual upper body motion to compensate.

As indicated by the author such a running style is not sustainable.

Continue to view the video.