Back when I was in my twenties and thirties – and it seems a depressingly long time ago – I was quite fit. I generally ran about 20-30 miles a week, worked out with weights in the gym, swam three days out of five and played amateur club rugby reasonably regularly. Consequently I found that I could eat more or less what I wanted without gaining any weight at all.
But as I got older I found I was increasingly troubled by pain from my right foot. It’s a long and tedious story but way back I managed to get my right foot mildly frostbitten during an army exercise. The consequence at the time was that my toenails fell out and, although they did grow back after a while, in cold weather the foot was always mildly painful. As my forties dragged on, the pain slowly increased until it was present all the time and was, on occasion, quite severe.
The effect of this was that I, essentially, stopped running. I still tried to take regular exercise but this was, for the most part, cardiovascular exercise on an elliptical cross-trainer, an occasional swim and bike riding. I still did some weight-training but not as regularly as I should. In short I got fat. When I did go for a run, the pain in my foot became, on occasion, quite excruciating and, because I subconsciously altered my gait to avoid this, I found that I was developing other problems in my legs: my knees hurt; my iliotibial band tightened up; and my hamstrings frequently ‘pulled’.
I had physiotherapy on my foot and knees a few a few times but it didn’t provide anything more than temporary relief and eventually, about five years ago, I took myself off for a rare visit to my GP to see if he could do anything. His view was that the big toe on my right foot had become arthritic. In the short term he prescribed some extremely powerful pain-killers which dealt with the immediate problem but he also referred me to a consultant orthopaedic surgeon for further investigation. This revealed that my foot was indeed arthritic and that a big spur of bone had formed on top of the main joint on my big toe: his recommendation was that he should cut all this away and fuse the joint together. This would deal with the pain and should, eventually, allow me to get back to running (the surgeon, James Calder, was himself a marathon runner).
So I agreed. At the time, my wife’s job came with medical insurance for the whole family so I was able to bypass the NHS waiting list and was booked in for the operation a couple of weeks later. The only interesting thing about the surgery was that, immediately afterwards, the anaesthetist gave me a dose of intravenous diamorphine – i.e. heroin – for the pain. This was rather pleasant and I can see why it’s so popular: it certainly cheered me up.
My right foot: completely screwed.
The surgery was successful, with no complications, and within a couple of days I was shuffling around on crutches and wearing a sexy orthopaedic sandal. The actual operation involved cutting away the joint and then sticking the two ends of bone together with a metal plate and some screws. This looks quite dramatic in an x-ray but, since the initial pain of the operation wore off, it’s been completely trouble free.
About six months after the operation, I began to make a tentative return to running. The results were pretty mixed. I no longer had pain from my foot but, despite the fact that I was only doing very gentle, short, slow runs, I was still getting all the knee, ITB and hamstring problems I’d had before. It seemed that whenever I began to build up even a fairly minimal mileage, all the old leg problems would return.
I got a bit pissed off with this and headed back to the GP. He referred me to our local NHS hospital where I was fortunate enough to get some excellent physiotherapy, focusing on strengthening my knee joints, but the physio was of the opinion that the operation had altered my running gait sufficiently that runs of more than a couple of miles would always be problematic unless I continued full-on with the strengthening exercises. Oh well, it could be worse, I thought.
About three months ago I was chatting with some of my military colleagues at work. A couple of them are big into ultra-distance running (i.e., races of greater than marathon length) and one of them was raving about a book he’d read by Chris McDougall, an American runner and journalist, called ‘Born to Run’. McDougall’s idea is that humans have evolved to be highly efficient and effective runners because early men needed to be able to ‘run down’ the animals they hunted for food. Humans actually have a startling capacity for endurance, greatly helped by our ability to sweat and thus shed excess heat, and this is reflected in the ability of groups of humans, on foot, to isolate and hunt down over long distances animals like deer, antelope and gazelles which – over short distances at least – can run much faster than we can. In theory anyway.
Over the years, McDougall found himself afflicted by all the usual injuries and problems that beset most runners and, I recognised, me. He questioned why this should be so, based on the knowledge that we had actually evolved to be distance runners, and came up with an interesting answer. Running shoes.
For most ‘serious’ runners, shoes have become almost fetishistic objects. Go to a running shoe shop, like my personal favourite ‘Run and Become’ in Westminster, and you will be offered a huge range of different types of shoe, designed to correct, stabilise and control all sorts of supposed problems with the way we run. Being a big-gish sort of chap (I weighed around 190lbs even in the ‘skinny’ picture above) I had always assumed that I needed a lot of padding, support and shock absorption in my running shoes to prevent joint damage, notwithstanding the fact that I have an apparent tendency to ‘over-pronate’ which also supposedly requires correction. It turns out I was wrong.
McDougall takes the view, supported by a good deal of evidence, that the unencumbered human foot is a highly effective shock absorber and that, by carefully wrapping it in layers of rubber, polyurethane foam, gel pouches and whatever else goes into a modern running shoe, we are preventing it from doing its job. This means that we are subjecting our bodies – and legs particularly – to stresses that they have not evolved to withstand, and this is what causes the majority of running injuries. McDougall points to an isolated Mexican tribe, the Tarahumara, whose lifestyle involves routinely running distances of 50 or 100 miles in a single go, with their feet shod only in sandals made from old car tyres to protect them from sharp objects but offering no other support.
I read the book in a single sitting and found it pretty convincing. In fact so much so that I went out and bought a pair of ‘minimalist’ running shoes a few days later and have been wearing them for running ever since. It’s early days yet, of course, but the fact is that apart from a little Achilles’ Tendon soreness after the first couple of times I wore them to run – which is entirely normal because of the need to adjust to running without built-up heel support – I haven’t had any problems with knees, ITB or hamstrings for over two months. I can now run three or four miles without any difficulties and I’m really enjoying it again. The shoes have a rubber sole but very little else in the way of padding or cushioning and allow my feet to feel the ground much better than a traditional running shoe, as well as encouraging a much lighter ‘toe strike’ gait which makes use of my built in shock-absorbers.
There’s a long way to go yet before I’m back to anything like the level of running fitness I’d like to be at but the great thing is that there’s some light at the end of the tunnel now and I’m finally confident that I can get myself back into decent shape after years of false starts. Yippee!
By the way here’s McDougall giving a ‘TED talk’ on the subject – well worth 15 minutes of your time – and you can buy his book here.
Adrian Weale 