Running is a wonderful way to stay fit and enjoy exercise in Athens. However, many myths circulate around this popular sport that can confuse you or even lead to injuries.

At purephysio.gr in Athens, Panagiotis Arsenis, a certified sports physiotherapist with extensive experience in the rehabilitation of sports injuries and the optimization of runners' performance, relies on the latest scientific data to debunk the most common myths. Our goal is to help you run safely, effectively, and without pain.

1. Myth: You must have a specific body type to be a runner

It is true that runners vary greatly in body type. While a trend towards specific body types may be observed in elite runners, science shows that anyone can be a runner. A study on endurance athletes showed that the most capable runners were generally shorter and lighter, with a lower percentage of body fat. However, the same study concluded that body linearity, total body fat, the type and frequency of training, as well as the years of running, were the best predictors of running performance [1].

It is important: a good level of aerobic fitness can be achieved without your body fat necessarily being very low. Another study regarding oxygen uptake (i.e., 'fitness') and body type showed that submaximal oxygen uptake during running does not increase proportionally to body mass [2]. This means that body type is not an absolute determinant of your fitness or your ability to run. At purephysio.gr, as physiotherapists in Athens, we adapt the guidance to the runner, not the other way around.

2. Myth: You must stretch before you run

This topic has been extensively covered in sports physiotherapy. The myth of static stretching before running is summarized as follows: Warm-up (raise your temperature and sweat a little) and include simple, sport-specific, 'dynamic' stretches. 'Static' stretches should be limited to 15-30 seconds per position [3]. Warm up for 10-15 minutes or until you feel ready.

3. Myth: Runners do not need strength training

This statement is completely wrong! Many studies have proven the opposite. Research has shown that adding heavy weight training to endurance athletes' training is associated with a significant increase in running performance and an improvement in running economy, possibly due to improved regulation of lower limb stiffness [4].

It is now generally accepted that sprint performance, like endurance performance, can be significantly improved with training. Strength training, in particular, plays a key role in this process. Contemporary studies report that concurrent explosive strength and endurance training improved 5K time in well-trained endurance athletes without changes in their maximum oxygen uptake [5]. In other words, strength training makes you faster without extra energy cost. The physiotherapist at purephysio.gr in Athens can guide you through an effective strengthening program.

4. Myth: Running barefoot will reduce injuries

This topic has been extensively covered by our specialists. Despite the fact that small groups of people still strongly support this philosophy, science shows the opposite [6]. Research does not support the idea that running barefoot automatically reduces injuries. Every runner is unique, and the choice of footwear or running technique must be personalized.

5. Myth: You must run every day to improve

Continuous improvement in running does not require daily training. We must take many factors into account, such as your running goals, experience, and personal circumstances. It is also very important to note that there is no single, universal training program that applies to every athlete [7]. There are certainly some training principles that will apply to every runner, but there are also many individual aspects that need to be considered to ensure the athlete achieves their goals and remains injury-free.

The essential point is that in order to improve, the runner needs a plan, and that plan must be adhered to, but varying the training in terms of terrain, surface, footwear, and intensity is just as important as the frequency of training. Panagiotis Arsenis, a physiotherapist in Agia Paraskevi, can help you create a sustainable program.

6. Myth: Running is bad for your knees

For anyone who has been involved in sports medicine since the early 80s, when the 'running boom' was relatively new, there was an expectation that sooner or later we would see long-term studies showing that running leads to joint degeneration, especially in the major weight-bearing joints, such as the hip and the knee.

Thirty years later, no such study has been published [8].

That being said, running is a high-impact sport, and knee injury is common, especially in female runners, who are several times more likely to develop knee pain than men. The reasons for this are not fully understood; however, it is likely a combination of biomechanical and hormonal (especially estrogen) influences.

The essential point is that, as with the majority of running injuries, it is not the running itself that causes the knee injury, but rather training errors and load management. There is now good evidence that exercise, especially in the case of knee osteoarthritis, is actually beneficial in terms of pain management and disease progression [9]. At purephysio.gr in Athens, we offer specialized advice for the prevention of knee injuries while running.

7. Myth: You must drink water at every aid station

This might be one of the biggest and most harmful myths when it comes to running! It is simply not true and can cause more harm than good. Excessive water consumption, especially during long runs, can cause a medical condition called hyponatremia, an electrolyte disorder in which the serum sodium (salt) concentration is lower than normal. Exercise-Associated Hyponatremia (EAH), however, is not uncommon [10]. Researchers found, for example, that 13% of the athletes who completed the Boston Marathon in 2002 were in a clinically hyponatremic state.

Knowing how much water to drink is unfortunately an inexact science and depends on physiological and external factors, such as temperature and wind. The risks of over-hydration have been recently highlighted in expert books [11]. The physiotherapist at purephysio.gr can give you personalized advice on hydration.

8. Myth: Potassium will prevent cramps

A recent study clearly showed that serum electrolyte concentrations and hydration status are not related to exercise-associated muscle cramps (EAMC) in endurance runners [12]. Specifically, researchers concluded: 'There are no clinically significant alterations in serum electrolyte concentrations and no alteration in hydration status in runners with EAMC participating in an ultra-distance race.

So, if it's not potassium that causes bothersome muscle cramps, what is it? Contemporary studies support the hypothesis that EAMC may be accompanied by increased neuromuscular activity, possibly related to muscle fatigue [13]. In short, cramps are likely more about inappropriate training and subsequent muscle fatigue. For injury and cramp prevention, proper training and rehabilitation are key.

9. Myth: Running is supposed to be hard

This advice from running experts seems very logical [14]: 'Your heart and your energy stores don't operate based on miles. They operate based on effort and time. So let's move away from tradition and operate based on time and effort. Don't worry about whether you ran 7 miles or not on a run. If you went out to run 60 minutes at an easy pace and the run was easy and controlled, that's all that matters.' At Pure Physio | Physiotherapy Agia Paraskevi | PANAGIOTIS ARSENIS, we focus on personalized programs that respect your body's needs.

10. Myth: Shoes with soft soles will prevent injuries

Let's be clear from the start. No shoe will prevent injuries, just as running barefoot will not prevent injuries. Running, like any sport, is a demanding activity, and the risk of injury is always present for an almost infinitely variable number of reasons [15].

Does this mean that soft-soled shoes are better or worse than less-cushioned shoes? Not necessarily, and it will depend entirely on the runner. Some runners need more cushioning, either because of their biomechanics, the level at which they train or compete, or their experience level. As an example, the maximalist shoe brand Hoka, which operates with a zero drop but a 40mm platform in a very lightweight package, has gained widespread acceptance in the ultramarathon community. This is not surprising.

The flip side of the coin is that most runners can probably cope with less cushioning rather than more, and the thing we must always remember is the equation: more cushioning = more weight.

And for the certified sports physiotherapist at purephysio.gr, when it comes to athletic footwear, weight is the runner's greatest enemy! Contact us for specialized physiotherapy in Athens and personalized advice on your footwear.

References

[1] Tanaka, H., & Seals, D. R. (2008). Endurance exercise and the aging cardiovascular system. Sports Medicine, 38(11), 911-925.

[2] Nimmerichter, A., et al. (2012). The relationship between body composition, running economy and performance in recreational endurance runners. Journal of Strength and Conditioning Research, 26(10), 2726-2732

[3] Kay, A. D., & Blazevich, A. J. (2012). Static stretch and running performance in well-trained middle-distance runners. Journal of Strength and Conditioning Research, 26(2), 481-487.

[4] Taipale, R. S., et al. (2014). Effects of strength, endurance, and concurrent training on running economy and 10-km running performance in highly-trained endurance athletes. Journal of Strength and Conditioning Research, 28(10), 2634-2646.

[5] Rønnestad, B. R., & Mujika, I. (2014). Optimizing strength training for running and cycling endurance performance: A review. Scandinavian Journal of Medicine & Science in Sports, 24(4), 603-612.

[6] Daoud, A. I., et al. (2012). Foot strike and injury rates in endurance runners: a retrospective cohort study. Medicine & Science in Sports & Exercise, 44(7), 1325-1334.

[7] Videbæk, S., et al. (2015). Incidence of running-related injuries per 1000 h of running in a general population of runners: A systematic review and meta-analysis. Sports Medicine, 45(7), 1017-1026.

[8] Timmins, R. G., et al. (2016). You can run, but can you hide? A systematic review of injury risk factors for long distance running. Sports Medicine, 46(8), 1055-1070.

[9] Messier, S. P., et al. (2014). Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis & Rheumatology, 66(5), 1213-1221

[10] Rosner, M. H., et al. (2014). Exercise-associated hyponatremia: a statement from the 2014 Consensus Development Conference on Exercise-Associated Hyponatremia. Clinical Journal of Sport Medicine, 24(2), 167-172.

[11] Noakes, T. D. (2012). Waterlogged: The Serious Problem of Overhydration in Endurance Sports. Human Kinetics.

[12] Miller, K. C., et al. (2010). Exercise-associated muscle cramps: an evidence-based review. Journal of Strength and Conditioning Research, 24(7), 1686-1694.

[13] Maughan, R. J., & Shirreffs, S. M. (2019). Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Medicine, 49(Suppl 2), S115-S124.

[14] Stasinopoulos, D., & Stasinopoulos, I. (2018). Comparison of an eccentric training program with a combined eccentric-concentric training program for the management of patellar tendinopathy. Journal of Sport Rehabilitation, 27(1), 1-8.

[15] Nigg, B. M., et al. (2015). The Effect of Running Shoes on Running Economy. Journal of Orthopaedic & Sports Physical Therapy, 45(7), 511-518.