DB'S MEDICAL RANTS

Internal medicine, American health care, and especially medical education

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Start jogging

I always include good fitness articles. As readers know, I have become a zealot on both cardiovascular fitness and resistance training. Some physicians have wondered about the risk and benefits of running. Could the jogging cause osteoarthritis? Does it have other adverse effects? (I suspect those physicians fit more into the couch potato mold). Jogging is back in the running

JOGGING HAS BEEN THE SUBJECT of many medical scare stories in recent years. It has been blamed for everything from sagging breasts to premature wrinkles and damaged joints, and has even been cited as a fast route to a heart attack.

So it is astonishing to learn that some experts are now suggesting that if you make one concession to the post-festive fitness frenzy, it should be to take up running.

Not only is jogging considered good for us because it whittles away fat cells, but it is thought to be helpful in protecting — yes, protecting — our joints. Scientists at Stanford University in California have recently carried out research which suggests that regular running can delay the onset of arthritis by 12 years.

Professor Jim Fries, an expert in healthy ageing, and his colleagues at Stanford’s school of medicine followed 538 runners and 423 couch potatoes for 17 years. They found that only 5 per cent of the joggers experienced osteoarthritic pain during that time, compared with 20 per cent of the sedentary group.

Injuries are more often caused by the shoes a jogger wears than by the action of running. “Most of the injuries I treat are caused by people wearing worn-out or unsuitable running shoes,” says Trevor Prior, a leading podiatric surgeon who treats many top athletes and football players, and works for UK Sport (formerly the Sports Council).

“Trainers have a shelf life of 300 to 500 miles,” Prior says, “after which they lose their support and cushioning and need to be thrown away. You should make sure that you visit a specialist shop when you buy a new pair, as requirements differ. It is natural for most people’s feet to roll inwards (or pronate) when they run, but some shoes don’t compensate for this. If you wear trainers that cause you to over-pronate, you may be at risk of backache, hip pain and knee problems.”

Let me emphasize this point. I started a serious cardiovascular fitness program 3 years ago (when I lost around 30 pounds). For around 6 months I was doing fine, then I developed knee and foot pains. At the time, I was very unsophisticated about shoes, but a friend recommended that I go the a running shoe store. Lo and behold, buying the right shoes greatly helped.

I still had knee pain though. Many runners and most trainers know that runners often develop relative atrophy of the vastus medialis . When this occurs one can develop the patello-femoral syndrome . Shoes helped greatly, but until I started strengthening my quadriceps I still had pain after running.

So what is the moral of my ranting? First, do cardiovascular exercise regularly. Second, invest in a good pair of shoes which fit your foot pattern. Third, if you choose running, do some resistance training, especially focusing on you legs. Your heart, bones and joints will all benefit.

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