Chances are we all either know someone who has pain from running or while running or we have it ourselves. There are a number of different things you can do for running prevention, but there are so many conflicting things you hear on the internet about what to do. Listed below are the top 5 frequently asked questions we, as physical therapists, get asked the most.
- What type of shoes should I wear for running?
- The type of shoe that is best for you to run in is whatever is most comfortable. There can be a large variation in running shoes due to everyone having different size/shaped feet and many other factors that may be genetic like limb length and hip shape. Some people prefer to run with a heel to toe strike pattern where others naturally adopt a more mid or forefoot strike. Both strike patterns will stress different muscles so if you have been running one way most of your life you should be careful about switching as your body will take awhile to get acclimated to the new pattern.
- Regardless of which type of foot strike pattern you use when running, be sure that the shoes have a wide enough toe box for the shape of your foot by taking out the liner when trying them on and making sure no part of your toes are hanging over the edge of the liner. The belief that you must “break in” a shoe is also not quite true, while it may take a few runs for you to feel “normal” in the new shoe they should be comfortable right away – if they aren’t comfortable when you try them on, find another pair.
- Why can’t I just run? Shouldn’t running more be enough to keep me strong?
- While it might seem to make sense that running should keep you strong enough to stay healthy while running there are a number of factors that complicate this. Running is largely composed of movement only going forward and therefore will only adequately stimulate muscles used for this pattern. When you are running though, your body has to resist forces in the other two planes of motion (side to side and rotational movement) and these muscles are largely responsible for keeping you stable and balanced.
- Like we discussed above regarding varied movement your body will adapt to the stresses it is exposed to the most, in running this is forward/backward motion. Over time the other muscles will become weaker and not able to properly resist outside forces you may experience during a run that can lead to various injuries. There is also something called tendon stiffness that helps the body absorb and release forces to help propel you during walking and running. Tendons require high load activity to be adequately stimulated and made stronger – running is not a HEAVY enough stimulus. Without strength training, over time and as you age they will weaken and be unable to keep up with increased training volumes and predispose you to injury.
- Do I have to stretch?
- If running is the only type of activity you perform regularly you will most likely need to perform some kind of stretching to maintain health long term. I’m sure you’ve heard the phrase “use it or lose it” and it definitely applies here. Running only stimulates the muscles in a very small, repetitive range of motion and over time if you don’t perform activity in larger ranges of motion you will become stiff.
- You need to challenge your body throughout your available ranges of motion as it is a very energy efficient system and will quickly “discard” things that aren’t frequently used – in this case, your flexibility. While this may not be initially bad – eventually some scenario may come up that pushes your body beyond its limits and that is where injuries occur.
- Is there a difference if I run outside or on a treadmill?
- Overall the mechanics of running are mostly similar between running outside on a flat road or surface versus running on a treadmill. Of course trail running would be vastly different due to frequent changes of direction, variable obstacles to avoid, and frequent changes in degree of incline. There may be slightly different forces present at the knee and ankle joints when running on a treadmill as well as differences in muscle recruitment in the legs. These would need to be further explored during a formal physical therapy plan based on your individual needs.
- Comfort level also has a large effect on changing mechanics on a treadmill and with increased experience there are less differences noted. As long as you can run on a treadmill without pain it is a viable option for training especially during the winter months to avoid detraining or having to take a break when the weather turns.
- Do I need to wear orthotics to make the pain go away?
- Orthotics may be recommended by your doctor due to foot pain but ideally they are only used for a short period of time as you address the underlying issues. It is very rare to have a true structural issue with your feet that would require a long term orthotic. Your feet should be capable of supporting themselves provided you have adequate strength and flexibility through the foot and ankle musculature, which can be improved through the exercises in this guide.
- By wearing an orthotic long-term your feet do not have the strength to support themselves and will rely more and more on the external support provided by the orthotic. A graded return to running would be recommended if attempting to transition out of orthotics as your foot will need a good amount of time to adapt to the lack of support it was used to prior.
