Question: I really want to start running again, lose weight and increase my overall fitness. I'm also hoping to enter a few races this year. However, I'm in my 40s and overweight, and have always had a bit of a weak knee. Can you give me any advice on how to start running safely? Should I try and lose weight first or is it okay to just get going?
Answer: I'm a great advocate for exercise and healthy eating to promote physical and mental health and running is the simplest of all sports to take up. You don't need to join a club, you just need a pair of runners and off you go. The benefits are considerable, however there are a few pitfalls that should be avoided when starting up in order to avoid injury. With all the fitnes watches on the market you can easily track your progress.
Start with a decent pair of runners. Stretching beforehand is helpful but consider adding a few cardiovascular warm up exercises such as squats, lunges or star jumps. These dynamic stretches will limber up the muscles and get the heart rate up. If you've been on a hiatus from running or starting afresh it is recommended that you take things slow at first. Perhaps walk for the first five or 10 mins or begin at a very leisurely pace. There is no point hitting the road hard three times a week if it has been many months or even years since you last ran, this is a recipe for injury.
Be mindful of the surface you are running on, most of us run on footpaths that are concrete however, if there is a field close to you it would be best to begin on this, grass or earth surfaces are far more forgiving on the joints.
You mentioned one of your knee joints has always been weaker. Did you ever seek professional advice from a physiotherapist or have a knee MRI scan? Simple preventative measures may prevent permanent damage further down the road. Most people assume knee pain means they have osteoarthritis. However, people who do a lot of running can suffer with iliotibial (IT) band syndrome. It typically occurs on the lateral or outer part of the knee, is gradual in onset and worsens as the distance increases or going up or down steps. Another common cause of knee pain is patellofemoral pain syndrome. This usually occurs on the front of the knee or under the knee cap and is worse on squatting or going up/down steps. Knee straps/tape below the knee and performing regular corrective exercises from a trained therapist will help resolve this pain.
You definitely need to consider your body weight when starting out. The heavier you are the more force is being put through your joints, especially your knees and hips.
Marathon runners know how much easier it is to compete by shedding just a few pounds in body fat. While many people will use running as a means to lose weight the reality is that it needs to be combined with a calorie-restricted healthy diet and ideally some weight lifting to be effective. Going for gruelling runs while carrying those extra pounds will increase your risk of injury. But that's not to say you should get out there and make a start.
Once again, the advice here is take it slow when starting out. I am a firm believer that to avoid injury while running you need to ensure that you have good strength and mobility in key muscle groups. These include the abdominal and pelvic (core) muscles and gluteal (bum) muscles which are very important for stability, good running posture and strength. Which brings me to my final point. We all have different running styles and gaits. Good form is important to help avoid long-term damage to joints. Ideally you should be landing on the mid foot or on the ball of your foot. If you are landing on your heal or toes with each stride a session with a running coach may be needed.
One last word of caution, try not to push yourself too hard or you won't enjoy it.
- Dr Jennifer Grant is a GP with the Beacon Hospital HealthCheck