Health Column: Running benefits, but no gain from pain

It’s hard to reproduce the joy that one feels when running. As the late Dr. George Sheehan, a well-renowned cardiologist and contributor to Runner’s World, said many years ago, “Put a pair of good shoes on and you are out the door.” Running is easy to do and requires no apparatus. Put on clothes to fit the weather and, of course, good running shoes. There’s no need for a car, no sign-up at the gym, no waiting for the elliptical. The big advantage — our bodies run naturally and the training effects are easy to calculate. If I ran this week more than I did last week at the same pace, I am in the process of training.

Dedicated runners run everywhere — while on vacation, on lunch breaks, at 5 in the morning before work, after a long day of work to clear the day’s endless chatter; on boardwalks and walkways and through beautiful scenic trails. When the runner’s body is in tune and nature is abounding no matter what season, senses are acute and the runner is one with his world. The more miles, the more the “runner’s high” escalates.

Is running an addiction? It absolutely is, and a good one at that. For me, the more I ran, the better I felt. I ate ridiculous numbers of pasta meals, never gaining a pound. In my long-distance years, my husband and I frequently split a pound of a pasta meal after a good run. We were in our 30s and early 40s, neither of us experiencing an injury that would curtail running for more than a few days.

I had my first severe injury several years ago. I heard a snap in my shin and couldn’t run another step. A tibial stress fracture was diagnosed and I was in a cast boot for four months and ordered not to run. I learned a lot from that experience. I had been fatigued that day. My shoes were worn. I ran on a road that was beveled. During those four months, I saw a personal trainer and learned the importance of aerobic cross training and strength training. My fracture healed and I returned to running, but not with the confidence and zest that I usually felt. I now harbored a fear in my body that I might get hurt again.

So when is it time to stop running and replace it with a different form of aerobic exercise? I asked several people who were forced to stop running in their late 40s and early 50s, and all said they stopped due to knee problems. The impact of running worsened the symptoms and they turned to biking or swimming. My patients who are now in their 50s and still running are more apt to complain of low back or unilateral hip pain. Upon evaluation, these patients usually present with limited motion in one hip and a significant leg length discrepancy. Due to weight bearing mostly on one side, tone in the muscles of the lower extremities becomes unbalanced and a symmetrical activity such as jogging or running becomes subtly asymmetrical. Degenerative changes in the challenged hip worsen and muscles and ligaments in the low back take up the slack and become overworked, leading to instability, or chronic sprain or strain.

In treating older runners post injury in physical therapy, the question inevitably arises whether to start running again. This is a tough question. When our joints are young we get away with misalignment problems in our hips, knees and feet. Degeneration, in our younger years, especially in the hip joints, is minimal and injuries heal faster. As we age into our 50s and above, old injuries, misalignment and joint degeneration seep into the picture, and a decision should be made whether running is speeding up the degenerative process and hindering our activities of daily living due to pain.

We all hear that the 60s are the new 40s. I am not sure our joints know that. Today there are so many modes of exercise to satisfy our craving for aerobic exercise. If you fear running, it might be time to lessen it or stop altogether. Power walking, aerobic dance and water running are great alternatives and score high as cardiovascular exercises.

If you want to give running a try when your injury has been resolved, start on a track with new supportive shoes and do interval training by running and walking. Possibly run the long sides and walk the short sides. Most of all, listen to your body and add strength training into your exercise routine. Increased strength around your joints will add symmetry and support the joints that are being stressed during your aerobic activity. Feel joyful and smile during any exercise you choose. There is no gain with pain as we age.

Dr. Denise Plastiras is a physical therapist with Maximum Performance in Greenport.