Is this a familiar phrase to you? This is one if the most dreadful comments I hear from my patients who have abandoned running due to recurrent injuries. Just this week I had a patient who was in for pain in her right foot due to what she thought may be a stress fracture. She had increased some activity recently with the nice weather and her pain felt very similar to the pain she experienced when she had a stress fracture from running several years ago. She went on to explain that she had recurrent pain from running in her feet and knees from running and was told by a physician that she needed to find another activity with less impact because running was bad for her. She stopped running and has missed it ever since. Was the running bad, or was it the way she was running that was bad? She stopped an activity that she loved because a physician didn’t want to take the time to further investigate the root of her pain and simply told her to stop. She admitted to never having a running form analysis and only tried changing shoe gear and wore orthotics when the problem occurred.
Another similar story came when lecturing to an OR staff on running several weeks ago. A woman had explained to me when she was 20 years old she was told to stop running because she had recurrent heel pain and shin pain and that her feet were not meant for running. She was approximately 50 when I met her. 30 years of not running. 30 years that she will never get back. She had no severe pathology or deformity that would inhibit her from running.
These are only two accounts of the over hundreds of stories I’ve heard from patients who stopped running because of the dreaded “your body was not meant for running” comment.
Is anyone’s body not meant for running? Possibly. But the above examples and probably 99% of the stories I’m referring to are from patients who were given advice from someone who doesn’t understand running. It’s very easy to tell someone not to run and their injuries will resolve. The challenge is to get their injuries to resolve and still allow them to run. This is what I strive for. And in all honesty, it’s not that complex. Getting someone to reset their running form, or begin a running program with care taken to focus on form and training patterns is typically all that is needed to break the chronic injury pattern.
What about severe arthritis?
Obviously severe cases of arthritis can inhibit someone from running. Most of the time it depends on what joint or joints the arthritis is in. Severe knee arthritis can limit runners depending on the severity of it. With that said, I have witness runners with bone on bone knee arthritis running marathons. The key to this is adapting to what you have by incorporating a natural gait. Do these runners need rigid shoes and orthotics? Usually not. By converting their stride to a quick turnover with short shuffling steps, they will undoubtedly reduce the stress to their knees more so then by relying on a rigid insert.
Arthritic pain can also hinder the joints of the foot with most cases occurring in the great toe joint. This condition is referred to as hallux limitus. In advanced cases the joint will either need cleaned out surgically, require an implant, or in severe cases need a fusion. Sometimes the problem corrects itself by auto fusing the joint. Having this condition however, does not mean that you have to stop running. Great toe arthritis is another example of how adapting a natural running stride can reduce pain to the forefoot or toe region. Consider what happens when someone runs with a gait consisting of landing on an outstretched leg with a heel strike. The following situations occur:
1. The heel strikes the ground with leg straight and extended without absorbing any shock
2. The forefoot slaps the ground and instead of absorbing shock and it is working harder to decelerate the body.
3. The body then has to move forward over the foot that was planted. In doing so, and extreme amount of force gets placed onto the ball of the foot that was planted. The great toe joint ends up carrying a force equal to the entire weight of the body and then has to “propel” the body forward.
What about the complex underlying biomechanical component that needs an orthotic?
Too often I hear patients telling me, I need to wear orthotics because –
1. they have a high arch
2. they have flat feet
3. they have shin splints
4. they have knee issues
5. they “pronate”
6. their orthopaedic told them it will help them
and on, and on, and on……
Bottom line, are there true underlying biomechanical problems that exist which would disable someone from running? Probably, but if the person walks without a limp and functions day to day without pain, then they can probably run. Most “biomechanical” deformities will not inhibit someone from running. With that said, if you have a severe diagnosed arthritic problem from an injury or inherited condition or disease that is a different story. But to say you “can’t run” because you had issues in the past and you were told you have a biomechanical problem and are not meant to run, is a fallacy. The human body (specifically the foot) is, as Leonardo da Vinci put it, a “masterfully engineered machine” which has the innate ability to adapt to force and stress placed upon it.
Before you decide to give up running because you were told you “can’t” and you were not meant to, reconsider. The majority of running injuries are due to overuse and can be overcome by adhering to proper training regimens and form. If you can walk, you most likely can run.