Marathons, Myths & Mental Health

Marathon season is well underway, and this Sunday sees the culmination of many months of hard training for the inspirational runners of the London Marathon.  From elite athletes to keen amateurs, to fun-runners in fancy dress, the London Marathon is always an incredible event that encapsulates the best qualities of running – overcoming adversity, community spirit, performance, personal achievement and fun! 

Running is a popular and effective method of achieving the World Health Organisation recommendations on physical activity (150 minutes of aerobic activity per week) and keeping fit. However, there is a common myth that discourages people from participating in running, which is the belief that, in the long term, running causes increased ‘wear-and-tear’ in the knees.

While it is relatively common for runners to experience minor injuries and niggles, especially when training for an event such as the Marathon, most of these are usually only short-lived and can be easily remedied with some TLC and a few tweaks to the training plan. But what is the long-term impact of distance running?  More specifically, is running really harmful for the knee joints?

There is a growing body of evidence which advocates that running does not have a causative link to the development of knee joint osteoarthritis (OA).  A recent study (Ponzio, 2018) investigated the incidence of joint OA in the hips and knees of marathon runners. The study concluded that there was no correlation between the development of osteoarthritis and running duration, intensity, mileage or the number of marathons completed. Further to this, the evidence showed that US marathon runners actually displayed a significantly lower incidence of OA when compared to the general population. Another recent article of interest (Miller, 2017) found that cumulative loads from running are surprisingly low, and proposes that running from a young age may trigger knee cartilage to adapt and actually become stronger! Based on this evidence, it does appear unlikely that running would cause increased degeneration of the knee joints. We now understand that osteoarthritis is less to do with ‘wear-and-tear’ and more linked with lifestyle factors such as obesity, poor diet and – ironically – lack of exercise! This isn’t to say running will never cause knee pain – doing too much, too soon can certainly make the joints complain – but the benefits of running seem to far outweigh the risks, when a sensible approach is taken. 

Aside from the physical health benefits, regular exercise such as running has also been demonstrated to exhibit a significant impact on mental health. The positive impact of regular exercise, including running, on mental health conditions is well documented (Mikkelsen, 2017).  Long-distance running has been shown to be as equally effective as, and longer-lasting than, prescription anti-depressant medication in reducing the symptoms of depression. Furthermore, a regular running routine appears to improve sleep quality and decrease insomnia (Kalak, 2012). Community running events such as Parkrun are becoming more popular and inclusive, providing a great form of social support and fun which are likely to have a positive impact on our mental wellbeing.

Remember, you don’t need to be able to run a marathon or even a mile; just taking a brisk walk is a good place to start! That said, it seems that the road to good health is a Marathon, not a sprint…

Thank you for reading; hopefully, this blog will have helped to bring to light the benefits of running and gone some way to de-bunk the myths about running and ‘worn-out’ knees.  To all of the runners at this weekend’s London Marathon, we wish you the very best of luck and a strong tail-wind!