Should I run on a treadmill or outside?

When it comes to running, most runners have their preference as to their favorite running surface.  Some enjoy running on a treadmill.  A treadmill helps to maintain your desired pace, keep track of your calories burnt, and is accessible in any weather condition.  Others enjoy running outside on asphalt or in the grass. The freedom of running outside and the idea of not being confined to the claustrophobic space of the treadmill are what may entice you to these running surfaces.  With health and exercise becoming very hot topics in today’s society, there are many more people flocking to gyms and beginning exercise routines.  The cardio equipment in the gym is some of the most popular equipment people tend to gravitate toward.  A popular question that arises for these gym goers is: Is it better for me to run on the treadmill or run outside?

A study in 2003 conducted by Dr. Milgrom titled Are overground or treadmill runners more likely to sustain tibial stress fracture?, wanted to help answer this question as it relates to a popular running injury, tibial stress fractures.  With the use of precise instrumentation that helped measure the forces on the runner’s tibias the researchers came to a conclusion for their proposed question.  The results showed that compression and tension strain rates were 48%-285% higher in overground runners versus treadmill runners.  Basically the results showed that people who run outside are more likely to sustain tibial stress fractures than those runners who run on a treadmill.

Even though this study shows that treadmill runners are at a lower risk, it does not mean they cannot sustain the same overuse injury.  Stress fractures occur when the force placed on the bone exceeds the body’s ability to heal those forces, resulting in small microscopic fractures in the bone that will cause a runner pain and prevent them from running.  With any study there are other variables that probably accounted for this conclusion.  As stated earlier, with a treadmill the machine keeps you at a sustained pace whereas outside you can change your pace at your own pleasure.  Maybe when your outside you take longer strides thereby placing greater stress on your bones than when you’re running on a treadmill taking shorter strides.  This then brings up the question whether it is the running surface or one’s body mechanics that are causing the stress fractures.  This is where a physical therapist can help assess your running mechanics and determine if your mechanics could be the cause of your problem.

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Possible Running Injuries

Runners are predisposed to many musculoskeletal injuries for a variety of reasons, listed below are the more common injuries you may encounter as a runner:

  • Stress fractures
  • IT Band Syndrome
  • Plantar Fasciitis
  • Ankle sprains
  • Medial Tibial Stress Syndrome (Shin Splints)
  • Compartment Syndrome
  • Patellofemoral Pain Syndrome (Knee Pain)
  • Muscle strains
  • Meniscal injury

Role of Physical Therapy

Physical therapists are musculoskeletal and movement experts that have the ability to evaluate and treat the many injuries a runner may sustain.  As stated above, runners can sustain injuries for a variety of reasons, but what are these reasons?  It could be the runner’s mechanics, improper footwear, the need for bracing or shoe inserts, lack of strength, lack of motion, poor motor control, the runner’s training regiment, or even the running surface.  A physical therapist has the knowledge and training to identify the source of your problem to help resolve your pain.

As movement experts, physical therapists can evaluate your running mechanics.  If your problem is your running mechanics it could be your stride length, your base of support, your foot strike during landing, your ability to push off your foot, or even your foot type (Yes, there are foot types!).  All of these poor mechanical issues can be treated by a physical therapist through gait retraining, bracing, footwear evaluation, or the prescription of shoe inserts.

In addition, physical therapists can evaluate your strength, range of motion, balance, and motor control to determine if these potential deficits are contributing to your problem.  If so, a physical therapist can provide you with the proper exercise prescription, manual therapy, and movement education to address your deficit.

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