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The impacts of running: Our expert answers your questions on running

How does running make you feel? For many of us running is a great way to work out - but with its physical and mental benefits can also come aches and pains, such as shin splints or sprains. So we invited our experts back for another live chat on Friday 27th July, this time on the impact of running on our physical and mental wellbeing.

On hand to answer your questions was John Crudgington, Lead Physiologist and sports and exercise science expert at AXA PPP healthcare. Recurrent themes from our latest online clinic include knee and joint problems caused from running...but we also received questions on nutrition, footwear and the best ways to train for a run. Of course, John was able answer all of these queries and more - see what he had to say below:

John Crudgington: Hi everyone. My name is John Crudgington and I am Lead Physiologist at AXA PPP healthcare. I am here for the next two hours to answer your questions on the topic of running and any exercise related queries. Please feel free to post questions and I will look to answer them as soon as I can. Thanks!

AXA PPP healthcare asked: Hi John. We have received several questions via our blog, if you're happy to kick off with those?

John Crudgington: Yes, please carry on.

Simon asked: Hi, how can you overcome Shin splits when running or are there any new treatments as I have had these on and off since I was 16?

John Crudgington: Simon, shin splints are a very common problem as you may be aware and unfortunately the main treatment for them is rest. Try to avoid running when they are flaring up as this will exacerbate the problem and look to introduce non-impact exercises into your training, for example, cycling and swimming. You may find alternating ice and heat treatment offers a degree of relief, but rest is key. It may be worth speaking to a sports therapist or physio if you have had them for a long period of time.

Caroline Medhurst asked: Hi I am planning on running my first half marathon next year. My maximum running distance at the moment has only been 4-5 miles… How do I plan for this?

John Crudgington: Hi Caroline. First of all let me congratulate you on signing up for the half marathon and I wish you luck. When training for longer distances it is important to progress your training over time and allow adequate rest between the harder sessions, especially if you are a beginner. I have attached a link to a site which illustrates a typical training programme. You will see that the training involves a mixture of training methods including interval training, and also focuses on exercise intensity as well as distance.

TobyML asked: I have just recently started to take up running and although I felt good after rest, when I came back from the run it felt like my chest was going to explode - is this normal for when starting out running, and what's the best advice for, say, the first 3/4 weeks of starting to run, i.e. preparation, diet, warm-ups. A park near me is about a 1 mile lap, so it's my aim to start with to be able to do that without pause. Thanks

John Crudgington: Hi Toby. When you say your chest feels like it is about to explode, are you referring to a rapid heart rate? How old are you and do you have any health issues at all?

TobyML asked: No, I'm 36, should have said - it wasn't heart related, I think it was just the fact my lungs weren't use to so much oxygen going in and out of them!!

John Crudgington: Ok. First of all I would ensure you do an adequate warm up consisting of at least 5 min stretching and heart raising activity. It could be as simple as a brisk walk to the park. Just as important is the warm down. It is not uncommon for people to experience a pounding sensation in their head and uncontrollable breathing patterns when they are new to exercise, especially if they don't warm down. Warming down helps you reduce the oxygen debt that your body has established due to the training, so aim to slow the speed of your run and maintain a slow jog/brisk walk for the last 5 minutes of your run. As you do this, look to slow your breathing and take deeper breaths through your nose, as opposed to gasping through your mouth.

Fionad asked: Hi John I'm really worried about my knees while running, my mum has had knee surgery and I'm worried I'll get problems but don't want to stop running. What can I do?

John Crudgington: Hi Fiona. Do you currently suffer from knee pain and if so has it been looked into? What has your mum had done?

Graham Pearson asked: I have been running for about 7 years and starting to get regular twinges in my knees, and occasional pain in my heels. Should I be worried about the long term damage being done to these regions of my body? Thanks

John Crudgington: Hi Graham. The truth is that it is very difficult to predict the associated health outcomes of any sport when undertaken for a long period of time. The first thing you should do is ensure that you are wearing suitable, comfortable footwear and recognising the point at which slight discomfort becomes actual pain - in which case you must stop. If your twinges and heel pains continue or become worse than I would certainly suggest seeking advice. Recognising the cause of the problem and how it is worsened may affect your ability to continue training or you may wish to introduce some other non-impact activities into your regime. Keep a record of when it happens, how often and what activities worsen it as this may help a health professional discover the root of the problem.

Angie asked: Running question for John: How can you run 'properly' so that you don't do any harm to joints and feet? Is there a way of running efficiently that can help you go for longer?

John Crudgington:  Angie, your question is currently the hot topic of debate in the sports exercise and medicine world! Heel-to-toe running, barefoot running and forefoot running are all running techniques that have been analysed and are considered to be efficient running techniques according to recent evidence by different studies. However, what we do know is that comfortable footwear is vitally important as is running on even terrain. You should also build up your distances progressively and ensure to allow adequate rest when necessary. Regular stretching and sports massage may also prove to be beneficial in reducing and managing injuries.

Nick asked: Hi John, I try to go running frequently but I'm one of those people who quickly find an excuse to put off going again! One of the reasons I stop is I am fine when running uphill or on a flat surface but as soon as I go downhill I tend to start getting an excruciating pain in my right knee. I have a pair of running shoes now so hoped this would take some of the pressure away but it doesn't seem to have helped much. Would a knee support do the trick or could it be I need to adjust my 'technique' when running downhill? Thanks.

John Crudgington:  Hi Nick. Often people imagine downhill running to be preferable (i.e. easier) than running uphill, however the force exerted on the knee when running downhill increases dramatically. In running downhill the upper leg is forced downwards and forwards over the knee as the foot is planted, hence increasing the force and in your case causing pain. It may be that you have an underlying knee injury which is only exacerbated in this circumstance, or you may have a technique which is increasing the load placed on the knee even further. If you would like your running technique or 'gait' analysed then look for a local specialist running shop which typically offer these services.

Caitlin asked: Hi John, I find that my knees hurt after running. I've heard that supportive shoes can help, however, is there any other solutions to this problem?

John Crudgington:  Hi Caitlin. As you may have noticed from the other posts, knee pain is a common concern. Comfortable shoes, warm up and warm downs and stretching are all important factor which should not be ignored. The cause of your knee pain will affect the treatment or solution offered. One of the most common causes is inflammation or damage to cartilage within the knee as a result of the impact sustained from running. Ice and heat treatment can help promote recovery to a certain degree but ultimately it's about making sure you listen to your body and allowing enough rest or combining running with other non impact activities.

IamM asked: Hi John, I used to do cross country half marathons but over time my knees started to get sore and I just kind of fell out of the habit of training. I'd now like to get back into it but am worried I may be doing damage to my knees. Slight pain when getting into or out of an armchair, otherwise fine. Was advised it may be down to 'overpronation' but am not convinced. Would it be worth getting my cruciate ligament checked out?

RossTheCook: Hi, I run on roads and I've heard this is very bad for your knees, will this be bad for me and should I try and switch to running on grass etc?

John Crudgington:  Hi Ian/ Ross. Here is a link to a page explaining another common running injury, 'runners knee'. Whilst this may not be the cause of your problems, you will also find links to their causes of knee pain incurred through running. Harder surfaces will increase the impact on the knees and therefore will potentially cause more damage. However, running on softer surfaces like sand can increase the risk of other injuries due to the unstable terrain which results in the foot being placed unevenly and the resulting forced being transferred unequally through the foot. It is a bit of a minefield!

John Crudgington:  Regarding overpronation, this is again a common diagnosis. The only way you will be able to tell if this is impacting your running is if you try a pair of trainers that are fitted for you and you monitor your knee pain going forward. This is a great topic of debate at the moment.

IanM asked: John. A couple of additional questions: I also get a weird pain in my left hip sometimes when on a long run (one hour plus) - I can right it by grabbing my knee and pulling it towards my chest. Does this sound worrying to you? Second question - is it a waste of money to take fish oil and gucosamine sulphate as dietary supplements when training - I always take them during training on the basis that they won't do any harm - but do they actually do any good?

John Crudgington:  IanM-sounds like a hip flexor issue, possibly over tight which once again is very common in runners. Ensure you are stretching them regularly and if it persists then a sports massage will be able to target the problem and you can get some advice on suitable exercises. Omega 3/6 fish oils are good especially if you do not have much oily fish in the diet -they are very good for heart health. Glucosamine has been reported to target connective tissue and avoid recovery, and whilst the evidence is not substantial it is widely considered to be of benefit.

Jen Jones asked: Hi John, I heard when I'm running I should be running on the front of my feet only; is this true or should I be aiming to be using the whole of my feet? Thanks

John Crudgington:  Hi Jen. Please review previous answers, particularly my response to Angie as I believe this will answer your question:  your question is currently the hot topic of debate in the sports exercise and medicine world! Heel-to-toe running, barefoot running and forefoot running are all running techniques that have been analysed and are considered to be efficient running techniques according to recent evidence by different studies. However, what we do know is that comfortable footwear is vitally important as is running on even terrain. You should also build up your distances progressively and ensure to allow adequate rest when necessary. Regular stretching and sports massage may also prove to be beneficial in reducing and managing injuries.

Alan Wren asked: Similar to everyone else really - aside from the fact that after running I get very sore calf muscles - this is after a proper warm up! Is there anything I can do to help ease this? Thanks

John Crudgington:  Alan, sore calf muscles may be considered my some to be part and parcel of the sport of running! However, I would advise stretching regularly, (including hip flexors, glutes, quads and hamstrings) and not just when you are warming up for a run. Also, ensure you warm down and stretch to cool off. Some people do naturally have tighter muscles but hopefully regular stretching may help them improve.

Gavelect asked: I started jogging in the hope of losing a few pounds but it does not seem to be working out to great. I get real hungry after a run seem to eat more, counterproductive I know. What would be a good eating habit to get into before or after a run?

John Crudgington:  Gavelect -yours is a common query. Weight loss should be viewed as an energy in vs energy out equation. Eat to support your training and not in response to it where possible. Aim to eat two hours before training and on return from training eat a meal that is not too high in carbohydrates, plenty of protein and vegetable and smaller portions of foods such as brown rice. Pre training meal can afford to be a little higher in carbs to supplement your energy stores, but ideally you should be eating small and often as opposed to larger meals more infrequently.

Tdot asked: Hi there - I was wondering about shin splints. I've been running regularly for about 3 years and 2 of those years have been having pain up the front of my right shin. It starts right away, subsides mid-run then usually comes back toward the end. Are there stretches for this? I've been told to stop running for 2-3 months but think that's too severe.

John Crudgington:  Tdot -shin splints are a very common problem as you may be aware and unfortunately the main treatment for them is rest. Try to avoid running when they are flaring up as this will exacerbate the problem and look to introduce non-impact exercises into your training, for example, cycling and swimming. You may find alternating ice and heat treatment offers a degree of relief, but rest is key. It may be worth speaking to a sports therapist or physio if you have had them for a long period of time.

Springsteenfan asked: Quick question regarding jogging/running footwear. How do you advise choosing the right shoes? The running shops sell a lot of expensive ones, but I am unsure if they're worth the money. I'm looking to do my first 10k in the next few months. I will be training by pavement running. Can you suggest some basic things to look for? Thanks!

John Crudgington: Hi springsteenfan. Comfort, comfort and comfort! Lightweight trainers will obviously make life easier for you and a degree of cushion will help soften impact. It is worth speaking to the running shops and seeing what they advise, but I would always say the first thing you should look for is that they fit well and feel comfortable.

Nick asked: Hi John, based on your response to Gavelect, is there anything in particular you would recommend drink-wise for before, during and after running?

John Crudgington: Hi Nick. I would have to say..........WATER! Keep yourself hydrated and you set your meals up as required and you should find that there isn't a need for expensive sugary energy drinks.

Lorraine Chapman asked: Hi I run quite a bit but always seem to suffer with tightness in the tops of my hamstrings, what can I do to avoid this?

John Crudgington: Lorraine, make sure to stretch the hamstring, quads AND the glutes and hip flexors. Often if one area is tight it may be that another opposing muscle group is in need of strengthening. The glutes should be working hard when you are running in aiding hip extension and flexion. There are a few tests you can do to test their function but they are best performed by a sports massage therapist for you. If you are running regularly then I would advise massages on a regular basis if possible.

Stephanie Colebrooke asked: I've been told that the impact of road running on your joints and back outweigh the physical benefits of the running itself. Is this really true?

John Crudgington: Hi Stephanie. Running improves cardiovascular health, helps manage weight, improves fitness.......... the list goes on. Yes, it may also increase the risk of joint problems but that really does depend on how you approach your training. A professional runner could run every day, but has a team of professionals to help support their recovery, so this wouldn't be suitable for the normal person. However, combining running with other non-impact activities and regular resistance activity will promote a much improved level of physical health.

Finny asked: Good afternoon. Can you tell me is using a treadmill giving me a similar level of cardiovascular exercise to running outdoors? I prefer to get my exercise in the gym these days and avoid the constant bad weather outside. I also do a bit of swimming - I'm not a heavy exerciser, maybe 1.5 to 2 hours total per week.

John Crudgington: Hi Finny. You may find the transfer from running on a treadmill to running outdoors quite considerable due to the environmental factors. On a treadmill you are not affected by wind, rain, air density, humidity, terrain, hills etc so it is quite different. That said, you will still be benefiting hugely by doing what you are doing so please continue. Treadmills are a great way of improving cardiovascular fitness and just look to increase the intensity or distance when you feel you are comfortably achieving your goal.

Finny asked: Thanks, John. Just read about hydration upthread and it's got me wondering. I read a while back that electrolyte replacement can have a drastic effect in improving stamina. To be honest I just sip tap water occasionally but it makes sense that salts/ minerals must be lost while sweating. Should that be counteracted?

John Crudgington: Hi Finny. You are right that salts and minerals are lost by sweating, but our ability to replenish them from sports drinks is still up for debate. It is suggested that it takes at least 1 hour of sustained activity to have enough of an impact on electrolyte levels to make a difference; however, obviously everybody's exercise intensity will vary. Until further valid research becomes available it is going to be difficult to establish whether sports drinks to actually influence performance.

Ross asked: Is it more beneficial to run long distances slower or fast for less distance? Do you naturally change your heart bpm the fitter you get?

John Crudgington: Hi Ross. It totally depends on your goal. What is your aim? Please note that resting heart rate will improve as fitness levels improve.

Cajgirl asked: I have recently taken up running again as I need to lose about 2 stone, however I only do 5k before my left knee starts to hurt, I have bought some new trainers but it's a bit chicken and egg as I need to exercise to lose the weight but the extra weight I am carrying is hurting my knee (I also swim and cycle once a week. Any advice?

John Crudgington: Cajgirl, my first question would be...do you know that it is the extra weight that is causing the knee pain? If you are unsure then i would speak to a physio/sports therapist for advice, particularly if it's ongoing. I would strongly suggest integrating more non-impact activity into your training, such as swimming, cycling and using a x-trainer. It is also hugely important to do resistance exercises to promote maintenance of lean muscle mass, as this will aid in fat burning and improve muscle tone.

Wendy asked: I find it difficult to run due to my health but I really love to go for a long walk, is this still as good for you? Do you have any tips for getting the best from a long walk?

John Crudgington: Wendy, walking is a great exercise form and is highly undervalued. To get the best from your walk just do the simple things......wear comfy footwear, walk somewhere you enjoy and walk with someone who you enjoy being with. If you find that you can increase the pace to a power walk then even better, but if not then just aim for what you feel is comfortable.

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