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Are You Ready to Run?

Running Seems to Be Growing in Popularity, But How Healthy or Safe Really Is This Sport?

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Posted: Wednesday, November 13, 2013 11:00 am | Updated: 11:13 am, Wed Nov 13, 2013.

You see them everywhere: alongside the road, on trails and paths, on hot summer nights, cold winter mornings, even in the rain.

Runners — they are a determined group and one that seems to be growing in popularity.

Maybe it’s the availability of free smartphone apps, like C25K (couch potato to 5K), that guide people through a gradual training process, but people who never thought they could run any considerable distance are proving themselves wrong.

If you’ve always wanted to take up running, but told yourself it wasn’t a good idea — you’re too old, it would ruin your knees, you already have arthritis — you may want to reconsider.

Angela Passanise, D.O., an orthopedic surgeon and sports medicine physician with Mercy Hospital Washington, has been a runner for more than 20 years. She believes running is an excellent form of exercise, and one in which just about anyone, young or old, can find success.

There are a couple of exceptions, however, plus the usual caveat that before beginning any new exercise regimen, everyone would be wise to talk about it with their doctor.

“Anyone with a previous hip, knee or ankle injury . . . should be cautious about running,” warns Dr. Passanise. “And if you’ve had total knee, hip, ankle or joint replacement surgery, you will have been told not to run.”

At the same time, Dr. Passanise admits that in her late 20s, she was an ACL reconstruction recipient, but has continued to run.

“I have run seven marathon and maybe 40 half-marathons,” she said. “It’s maybe not the smartest thing to do, but you should just be cautious.”

Another exception is people who are morbidly obese (a body mass index of 35 or more). They would be better off starting with a walking program or some other form of exercise that would help them bring down their weight first, said Dr. Passanise. This is because the extra body weight will put additional stress on the joints, causing greater potential for injury.

“I would suggest doing more speed walking or swimming or using an elliptical machine to get your weight down before you start running,” she commented.

Some Surprising Health Benefits

That being said, running is an excellent exercise to help people with weight reduction and control, said Dr. Passanise. It also has some other health benefits that may surprise some people.

First, it helps improve bone density, or in other words, it makes your bones stronger.

“After age 28 or 30, people start to lose bone density,” Dr. Passanise said. You can build it back up doing weight-bearing exercise like running.

Running also has been found to decrease depression and diabetes, she said. And while it may sound contradictory, studies have found that moderate running (between 20 and 30 miles a week) can actually improve joint condition.

“ . . . in terms of cartilage thickness and lubricant content,” explained Dr. Passanise. “It’s because of the impact of the load forces the knee is receiving.”

It’s probably no surprise that running is an excellent form of exercise for the heart.

“We recommend that patients do some form of cardio exercise three days a week, for 30 minutes each day,” said Dr. Joe Polizzi, a cardiologist with Mercy Hospital Washington who is himself a runner.

“And running is an easy way to do that. You just go outside and do it — you don’t need a gym or any equipment. You just enjoy the weather.”

Dr. Passanise agreed.

“All you need is a good pair of shoes and you can head out the door,” she remarked. “With things like swimming, you need a pool; soccer, you need a team; but there’s no extra equipment needed for running.”

One very important thing runners do need — “properly fitting shoes,” said Dr. Passanise. She recommends going to specialty shoe stores where they can properly fit the shoe to your foot, even watch you run to see which shoe would be best for you.

Another tip — get a new pair of shoes every 300 to 500 miles, she said.

Dangers of Running

Along with the health benefits of running also come a few potential dangers. At the top of the list is running too much too fast, which can lead to an overuse injury.

“You need to be cautious in how quickly you progress,” said Dr. Passanise. “You should never increase your weekly mileage by more than 10 percent. And you should never increase your distance and your pace at the same time, because that increases your risk for injury.”

“You really need to listen to your body,” Dr. Polizzi added. “If something hurts, don’t do it. I learned that the hard way.

“If you run too much, too fast and break down your joints, then you can’t do anything,” which is worse than taking it slow.

Runners also should be very cautious about running in extreme weather, said Dr. Polizzi. That includes very hot and humid days, as well as very cold.

“Running on Aug. 1 when it’s 90 percent humidity and 100 degrees puts undue strain on your body,” he said. “We worry about dehydration and stroke.”

But running when it’s 25 degrees outside may not be any better.

“Hard, physical activity done in bitter cold can raise your blood pressure and cause constriction of the arteries,” Dr. Polizzi explained. “If you have a heart problem and don’t know about it, you could have an event.”

That’s why shoveling snow can be so dangerous, he said. Shoveling snow in 70 degrees wouldn’t be nearly as strenuous as it is in the colder temperatures.

Myths of Running

There are a few myths of running, too, including the belief that running causes arthritis. Dr. Passanise said there is just “no good study that has found that.

“Moderate running, 20 to 30 miles a week, does not increase risk (of arthritis) for healthy people,” she noted, explaining that what she means by healthy are people who have been cleared by their physician and who have not had a previous injury or trauma to their joints.

Another myth is that running by itself is enough exercise. For the best health benefit, running should be coupled with weight lifting/training, said Dr. Passanise.

“It can only help build and tone the muscles around your joints, which will have a protective effect.”

She recommends weight training once a week or more. Exercises include things like leg press, hamstring curls and straight leg raises, which can all be done either with machines found at a gym or at home using ankle weights.

“You don’t need machines,” Dr. Passanise said. “You can do things like standing squats or lunges.”

Dr. Polizzi, who in addition to running also lifts weights, does cross fit exercises and uses an elliptical trainer, said the body and heart benefit from variety of exercises, that way no one particular area is overworked.

“It’s about a lifestyle,” he remarked. “For overall body health, you can exercise your heart in a number of different ways.”

Finally, it’s a myth that everyone who runs is in excellent health or has a “magic bullet” of health protection, said Dr. Polizzi.

“Many people who come in with heart attacks are runners,” he said, although runners typically do have better outcomes.

If someone runs, but neglects other parts of their overall health, such as diet, they are still at a great risk for problems.

Getting Started

Getting started with running is easier than people may think, even if they’ve never run distances before.

Dr. Passanise recommends starting slowly with a program that alternates between running and walking.

“Rotate between walking and running for a certain amount of time or distance, and then gradually increase,” she said.

“You can find an app to help or go online to find a program.”

People who need or want more help could get involved with a local running group, which can be found through Internet searches, by talking to people at a running shoe store or just asking around. Calling the YMCA might be a good place to start.

“Runners are very helpful to other runners and people just getting started,” Dr. Passanise remarked. “They will educate you.”

The social nature of running groups can be another health benefit, she added.

Treadmill v. Outdoors

When it comes to running on a treadmill compared to outdoors, Dr. Polizzi said this is mostly a decision of personal preference, but there is one thing to keep in mind.

“If you run on a treadmill, it’s setting the pace for you,” he said. “You’re not going to go faster. But if you’re outside, you may be running faster than you would be on a treadmill.

“The treadmill is almost like an assistant,” he remarked.

Pace and Distance

Runners who get hung up on their pace or distance may be missing the point of running. There is no distance or running pace that is ideal for everyone, said Dr. Polizzi.

“It’s more about heart rate,” he said. “A slow jog for one person may be ideal, but for someone else, that’s not enough.”

The exercise heart rate someone needs to attain for cardio health varies for everyone, he noted. It’s very age specific.

“Younger people need to reach higher heart rates.”

Dr. Polizzi suggested talking with your doctor to determine your ideal exercise heart rate. Once you know it, there are simple devices you can buy to measure your heart rate while you are running.

Even as a doctor, he has found it very difficult to measure his heart rate after a run and almost impossible to do during a run.

Dr. Passanise said running at a faster pace may help you burn a few more calories, but not a lot more.

“Pace is really about the competitiveness,” she remarked.

“If you run a 10-minute mile or a 7-minute mile, your calories (burned) are about the same.”

The general rule of thumb is that you burn 100 calories for every mile you run, she said.

The same goes for distance — no particular length is ideal or should be a goal for everyone.

Dr. Polizzi said running marathons or even half-marathons are not necessarily ideal. It depends on the person and the approach he or she takes.

“It’s a very strenuous amount of activity, on the other hand, if a person is very healthy with cardio . . . it’s not a bad thing to do.

“I wouldn’t recommend training for a marathon,” he said. “It’s not going to create the goal we want. Our goal is to create a lifestyle.”

For anyone who is interested in running those distance races or even just thinking about taking up the sport of running shouldn’t let preconceived ideas stand in their way, said Dr. Passanise.

“Anyone can do it,” she said. “But you do have to make a decision in your head that you’re going to do it. It’s the mental decision.”

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