Finding the Balance: Part 3 - Running and Walking.
Humans have evolved to walk and run, our biomechanics are based around these fundamental movements. As I have mentioned before in other posts, however, there aren't that many people that can do even fairly moderate running regimes without getting injured within a few months. Is this because running is a bad exercise? No. Running and walking are probably the best forms of exercise a person can do.
Running is the ultimate test of how well you move as a human being, so if you feel pain or get injured doing it, you are not moving very well, sorry to say. If you feel pain walking, then you are really not moving well.
The above graph proves how important walking or running is to health and such graphs don't occur for other forms of exercise either. Mortality rate has a very close relationship to walking and running, and whilst exercise more broadly does reduce mortality, the correlation is not nearly as stark. The trouble is that if you are injured, you simply can't do 10 000 steps a day and many people who try end up injured also. So why are people getting injured running and even walking?
Next time you go for a walk or jog in the park, have a look at the way other people are walking and running. It will be particularly noticeable when people run, but you'll probably see that everyone has a subtly different gait (the way they walk and run). Some people's gait might even be extremely different. This fact is generally just accepted as just something that is individual to each person, and obviously there will be some differences according to height, weight, gender, race, etc. But should our gait be so noticeably different from person to person?
The answer, I think, is no. When I watch wild animals move, I don't see the same thing, they all seem to move the same, according to their species. The only other animal I generally notice gait or movement differences in are dogs, and they just happen to be our closest animal companions. So what is going on?
Nature vs Nurture
Gait is determined broadly by the 2 factors that govern virtually everything else about us, nature vs nurture. Our gait can be compromised by our genetics and by our lifestyle. When it comes to our furry companions, the differences in gait can be mainly put down to genes, although dogs share our lifestyles in many ways, and therefore it seems likely they may share some of the reasons for biomechanical issues also.
Dogs have been bred into all shapes and sizes by people, and sometimes the in-breeding required to produce certain characteristics has caused problems in certain breeds. Some breeds like Shar Pei's develop breathing problems, West Highland White Terriers can develop eczema, and others like German Shephard's can develop biomechanical issues like hip problems.
It was once thought that genetic traits passed down to offspring could only be the result of a deep lineage, e.g. my grandfather was tall, my father was tall, and this was passed down to me. It was thought impossible though that things like obesity, bad posture, and joint pain couldn't be passed down unless it was deep in the family history or produced by the behaviour of the parents themselves in the upbringing of the child.
Something called epigenetics has called much of this into question, however, and has turned the scientific world slightly upside down when it comes to inherited characteristics in recent years. It turns out that it may be possible that you can inherit acquired characteristics from your parents that occurred in their lifetimes. This means that if you develop obesity in your and there was no history of it in your family, your genetic make-up can change during your lifetime and you can pass this on to your children. It is theorized that the same goes for postural and gait characteristics, meaning that if you sit at a desk all day until you are 35 and develop bad posture, then have a baby, you can pass on genes for a desk-posture position to your child, or at least make it more likely they'll develop this postural problem given certain environmental conditions.
While the recent studies about epigenetics are astounding, this doesn't let everyone off the hook for their weight or their biomechanical problems. I think it is still much more likely that the majority of the issue lies in people's lifestyles and their everyday activities.
While we have many lifestyle habits in common - too much sitting being the major one - we also have vastly different lives in many other respects. We have different habits, hobbies and interests, and jobs. All these things place different adaptive stress on our bodies and this often changes our gait in specific ways, which leads to the different ways we all walk and run.
For much of our evolutionary history humans would not have differed so much in how we lived our lives; we were all foraging and hunting, period. And this is the same pattern you see everywhere else in the animal kingdom; lions run, hunt and sleep, kangaroos graze and hop, fish swim, monkeys climb trees. If they are all of the same species, they do pretty much exactly the same things as each other.
Another factor to take into consideration is that other animals have a much higher survival pressure and they tend to die much younger than if they had all the creature comforts to hand as we do. A cheetah with a gait problem can't hunt and starves, a deer with a sore knee gets preyed upon and eaten.
So is it any wonder then that the ministry of funny walks and runs is mainly populated by human beings and our best furry friends.
Born to Run: Luck and Lifestyle
Why is it then that some people get injured after a few short runs and others can seemingly run all day? Someone like Courtney Dewalter, for example, (a famous ultra-runner from the US) last year managed to win the American section of the Big Backyard Ultra in which she ran for 283 miles in a time just shy of 57 hours! Yet some people of the same stature and weight can hardly run to the bus stop without getting injured. What's going on?
You wouldn't believe it but medical science has surprisingly little evidence as to why this is the case. Obviously technique has a large part to play, but I can assure you that many runners have the same basic technique but they still get injured at different rates. Beyond technique, however, modern medicine can only take its best guess and don't appear very interested in helping how to fix it, so people can do what they were born to do, run.
The answer to the question of why some people get injured and others don't is almost wholly a technical one, however, the problem goes much deeper than people imagine. The fact is that even with the best running coach in the world, it is impossible for them to get most people to have the gait and general technique of Courtney Dewalter. She is without doubt lucky. For whatever reason, her biology has allowed her to run with great efficiency in a way that prevents her feeling pain and injury when she runs (at least for now). Other people, because of their genes, their lifestyle, previous injuries, etc., physically cannot go through the same ranges of motion in their gait without significant training - as their fascia and other connective tissue have developed many restrictions in their adaptation to their specific lifestyles - and even then it may likely never happen. Their biological adaptations are so deep and engrained that running great distances is now impossible.
I'm hearing you ask, "Why would I want to run 283 miles anyway?". Well this is not the point, basically the more engrained your maladaptation to running becomes, it then becomes a maladaptation to walking, and even standing, and that is when people end up in surgery or simply in pain or less mobile (increasingly less) for the rest of their lives. The further your body gets away from the ability to walk and run, the worse it will feel in a biomechanical sense, and I'd also argue in a more general health aspect too.
So What to do About it?
This is a question I have pondered very hard and long over. My whole method of training is to try and change posture and gait, but it does require a significant amount of time and effort. Some, doing similar work in this field tend to remark, "well, what better way to spend your time than to practice being more functional, so suck it up and get cracking". However, I wonder how much this falls on deaf ears of people who simply don't have the luxury of the time or the circumstances to perfect this practice. While I think it is a great way to spend my time, I am not so judgmental to think that this would suit everyone. So what do we do about this problem of walking and running for health? How can as many people as possible access the health benefits of walking and running.
My best guess would be that almost everyone needs to do walking and running as a form of exercise at some level, and that the volume and intensity will depend on the individual. If it is at all possible, I do think some running should be done, even if it is just a few minutes a week. Such activity strengthens bones, cartilage, ligaments and tendons, making you more robust and less injury prone. So it simply is not an option to rid yourself of running and walking altogether.
Back in 2011, I ran my first marathon and after the race and all the training for it, my lower back, hips, and ankles were in a sorry state. I wondered if I would ever run any real distance again, but the next year I read a book called "Born to Run", which highlighted how a Mexican tribe essentially went on ultra-runs on a daily basis in sandals made of car tyres and rarely got injured, especially compared to people wearing nice cushioned trainers. I thought I'd give the sandals a go and bought some on the internet, which was just a thin piece of hardened rubber that I had to cut to the size of my foot with a pair of scissors and some string to thread through it to wrap around my ankles.
Anyway to cut a long story short, I trained in these for about 7 months and then ran another marathon. This time I suffered no ill effects whatsoever. How?
Firstly, I built up the distance very slowly in training. In the first week I ran for a minute or two around the car park, the next for 4 minutes, then 8 minutes, and so on. The sandals made me feel the ground beneath me; I had to run lighter, and there was no way I could heal strike when running. I still felt some pain in the initial stages of training, particularly in the toes, but this pain taught me to strike in the forefoot slightly differently, and as the technique improved the pain went away (except when a sharp stone got in the way, ouch!).
I was pretty impressed, and I had no pain running for probably another 4 years. However, although my running technique was as sound as I could make it, I still had years of squash and other activities that had made my body maladapted to running. If you had looked at my posture back then for example, you would have seen pronounced alignment issues, especially from front on. I had an over-developed right arm, a compressed rib cage on the right side, and various other issues which made it impossible for me to have a truly efficient gait cycle. But bear in mind that simply by changing my technique through wearing unsupportive footwear, I went from running with pretty unbearable back, hip, and ankle pain to no pain at all for 4 years! I even ran an ultramarathon in this time before the ankle pains started to come back.
The purpose of this little story is to show that with some basic technical changes and some practice things can get better and get better real fast, as long as you don't overdo it in the beginning and build-up slowly. If I wasn't so inclined to do lots of running, that simple change could have alleviated pain while running for decades. Running done in moderation over this time could have helped me gain significant health benefits if I would have otherwise been largely sedentary. So I don't think it is therefore unrealistic to think that people who have not run for years could get back into it without the big changes in posture and gait I would advocate in training.
My advice would be to do it like I did it; don't start with a 30-minute run, do 1 minute around the car park, twice a week. If that doesn't hurt you, try 2 minutes the following week, and so on and so forth. You'll probably find a threshold you are comfortable with that can optimise the strengthening and health benefits of running without the joint damaging effects of running too much with bad gait. You can also play around with the intensity. These days, I do 6 sets of 60m sprints at least once a week on top of at least one other run over a longer distance at a steady pace. You may only want to start with a gentle jog and then try to go a little faster. I am a little weary of prescribing sprinting, though, as I think a deeper knowledge of biomechanics and technique would be useful for majority of people to do this safely. Indeed, a lot of people can't sprint even if they try.
If your problems with pain and injury are more severe than this, then walking, using the same methodology would be a great practice.
I addressed the question of footwear in a previous blog post, so I won't go into too much detail here, but I do often get asked what the best kind of shoe to wear is, especially as I often wear quite funky-looking minimalist shoes with hardly any support. The truth is that it doesn't really matter, as long as your technique and gait are good.
If your technique and gait is bad, then the more cushioned and supportive the footwear, the better. If you are looking to spend some time improving your technique, then a minimalist shoe - or barefoot if you are very brave - is an excellent way of getting the bio-feedback required to make technical changes.
It is pretty difficult to run with poor technique in minimalist footwear without feeling the effects. This is obviously terrible for someone with injury issues, but it also helps you pinpoint areas of concern, and the pain can give you clues on what areas of your gait need fixing. For this reason, I tend to run much less than I used to, but usually in minimalist shoes. I really enjoy running trails, however, and although I can do this in minimalist shoes, it does make things a bit riskier in terms of pointy rocks and the potential for losing grip on slippery surfaces, so I am doing some runs in more regular running shoes so that I can enjoy nature on my runs too. Your feet can get pretty sore running rocky trails in minimalist shoes, and I am not sure this is doing that much good.
I have focused mainly on running in this post because it is the easiest example to use as it is an activity that many people can identify with pain and injury. However, almost everything here can be applied to walking too. With the advice in these last two sections, just replace running with walking. Walking in minimalist shoes, for example, will have the same negatives and positives; they'll help you in your walking technique, but long walks, or walks over rough terrain, may make things worse. The rules of running volume and intensity can also be applied to walking, and I think many people do this naturally anyway, just perhaps without so much attention to detail as I illustrate here.
Ultimately, if you really want to go down the rabbit hole of trying to improve your gait, you can reverse many of your pain and injury problems. There probably is no better way to train, however the attention to detail and dedication required is significant, but like anything in life the effort really pays off. You can follow this site and my YouTube channel of the same name to help you achieve this.
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