“To be alive, fully human, and completely awake is to be continually thrown out of the nest.” Pema Chodron
In 2004, anthropologists Daniel Lieberman and Dennis Bramble published a paper arguing that our ancestors had evolved to run long distances. They argued that humans went through several critical physiological adaptations, from shorter toes to sweat glands, that essentially made us born to run. Specifically, these adaptations improved our capacity to run long distances, enabling us to hunt prey that ran much faster than we did. As we evolved, their speed was no match for our enhanced endurance, which allowed us to hunt and track animals over long distances. We didn’t catch our prey by outrunning them; we killed them due to sheer exhaustion.
Many of us may doubt Lieberman’s and Bramble’s theory that we are engineered to run, but there is a good deal of evidence to support their claim. As children, running is natural and part of play--even toddlers seem eager to try their version of a sprint. Observe any elementary school playground during recess and you will likely see younger children naturally break into a run at some point while playing. But this natural inclination fades in later childhood, and by high school the only running you are likely to see is on a track or athletic field. Some revisit running in adulthood, but not with the spontaneous, natural rhythm of childhood. At that point, running can be a fussy affair of logged miles, strides per minute, and training schedules that prep for upcoming races. By middle age, we must reconcile with our body’s history; the high impact nature of running can easily create injuries or a pattern of repeated strain on the joints.
If we are engineered to run, then why do so many runners develop problems in their joints,
lower back, and spine? And haven’t most of us heard, even from some orthopedists, that running is bad for the knees? Research shows that running, by itself, is not essentially “bad” for the body. We are, after all, built with the necessary equipment—bone structure, joints, muscles, ligaments, and connective tissue--that make running a natural movement. But running is an activity that requires good form and strong muscles to remain safe. What we do spontaneously in childhood needs to be nurtured and cultivated throughout a lifetime in order to avoid injuries.
Our attitudes about running are part of a broader belief that wear and tear of the joints is an inevitable part of life. Many of us assume that the padding in our knees, hips, and shoulders will eventually wear down; we accept stiffness in the joints as a natural consequence of living. Our attitude is understandable, as research suggests that many of us will develop arthritis, a condition characterized by swelling, pain, stiffness, and a reduced range of motion in the joints. But studies have found that the most common form of arthritis, osteoarthritis, is not inevitable, nor is it always debilitating. Rather, the seeds of osteoarthritis are sown early in life, taking root in injuries, lifestyle choices, and attitudes toward exercise.
Osteoarthritis is just one of over 100 forms of arthritis, occurring mainly in the hands, spine, hips, and knees. Once considered a condition solely related to the loss of cartilage--the protective layer that surrounds the ends of the bones--osteoarthritis is now understood as a condition that impacts the entire joint, weakening the bones while creating inflammation and instability. Osteoarthritis takes root long before its symptoms appear. The degeneration of a joint typically starts with weakness in the ligaments due to injury or laxity. Ligaments, which stabilize our joints, have a poor blood supply, so they rely on movement, which bathes them in the blood they need for nutrients. Consequently, their injuries often heal unevenly and much more slowly than muscles, which tend to repair quickly. Without sufficient healing, ligaments lose their elasticity, and in this weakened state, fail to keep the joint stable. Muscles will contract and tighten to compensate for the ligament’s weakness. Unless this imbalance is addressed, the functioning and integrity of the joint will erode, setting the stage for the deterioration of connective tissue, inflammation, and instability.
A healthy joint is one that can move through its full range of motion with proper support from ligaments and muscles that are strong and responsive. Inactivity puts us on the fast track to osteoarthritis. Without regular movement, joints fail to get enough blood flow and nutrients to remain healthy, while the supporting muscles and ligaments become weak and unresponsive. Any level of activity will help to keep the joint lubricated, and exercise that strengthens our muscles helps the joints to withstand the resistive forces encountered in daily life. As with most things in life, inertia gets us stuck, whereas a little bit of friction helps to keep us healthy.
Muscles get stronger when exposed to loads that are beyond their capability. We must consistently load the cardiovascular system, muscles, ligaments, and connective tissue with work that is slightly challenging to experience any improvements in strength. Any activity can make muscles stronger--whether it be walking, running, cycling, lifting weights, or dancing--simply by changing the frequency, intensity, or time. However, the key ingredient in building strength is exposing the muscle to a sufficient level of discomfort. To get stronger, we must be willing to push ourselves out of the nest, to lose our sense of safety and balance by exposing ourselves to a sufficient level of discomfort. Not enough intensity is unlikely to produce any change, whereas too much will overload and strain the joint.
Finding an appropriate level of challenge is a process of differentiating between the aches associated with working hard from the pain of an injury. It is only by regularly pushing ourselves that we learn to appreciate the difference. What seems hard at first may very well seem mildly uncomfortable after several weeks of training. But there is a fine line between too much and too little. Many of us approach exercise with a “no pain, no gain” motto, a belief that is encouraged in our fitness culture even though most sports medicine specialists agree that pain does not make an athlete successful, nor does it make any of us stronger. Rather, pain is a warning sign that, if ignored, can quickly put us on the road to developing osteoarthritis.
So, how do we know what is enough? Most sports specialists agree that, although some level of discomfort is necessary to get stronger, pushing through pain is never acceptable. How we approach exercise goes a long way toward preventing and managing osteoarthritis. Adopting a “no pain, no gain” attitude makes it more likely that we will ignore signals telling us to back off during exercise. Ignoring pain leads to repetitive use injuries that weaken the ligaments, aggravating a compromised joint or setting the stage for osteoarthritis. But avoiding any discomfort during exercise is just as unhealthy as it fails to stimulate the muscles to get stronger. Without the support of active, strong muscles, our joints are unable to withstand the forces from the ground that can make our feet, ankles, knees, and hips hurt. It is just as important to push ourselves out of our comfort zone as it is to avoid pain.
Studies repeatedly confirm that exercise is the most effective medicine we have to prevent and treat issues in our joints. Working within safe parameters, the pain and inflammation of osteoarthritis can be reduced with regular, low impact exercise. You may never be a runner, and you might have injuries that make it unlikely you’ll become one. Lieberman and Bramble’s research doesn’t suggest that we should all be running marathons; rather, it illustrates that our bodies are built for hard work that can be sustained over a long period of time. Joint pain and osteoarthritis are a result of our approach to that work, not the movement itself. Perhaps this research’s most important finding is not that we are born to run, but that we evolved our capacity to move, for long periods of time, covering extensive distances. We are built for endurance, so the real victory may be simply getting out and moving every day, learning how and when to push ourselves, while recapturing that sense of joy in moving we felt so strongly in childhood.
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