Running Can Be More Dangerous than Smoking: How to Prevent Jogging Injuries?

By Last updated on April 5th, 2020 Last updated on April 5th, 2020 No Comments

When done smartly and with precautions, running can be one of the most rewarding exercises one can partake in. However, there are serious dangers in jogging—both to your cardiovascular system and lower legs. Here’s how to avoid them.

Like many things in life, running can be a blessing and a curse. With proper form and pacing, running can be a renewable source of fulfillment; when done improperly, running can be detrimental — in extreme cases, even fatal.

Evaluations of the risks of running go from relatively mild (the Copenhagen City Heart Study has shown that the fastest, most frequent runners are more likely to die prematurely from jogging than their sedentary, non-jogging counterparts) to almost incomprehensible (an unofficial comment by a cardiologist said that running every day for 20 years is worse for your heart than smoking for the same time frame.)

The big-picture reason why running is dangerous lies in the nature of the exercise: it is prolonged and repetitive, a combination that makes even the small errors serious in the long run. You might lift a weight far beyond your normal range once, and you might not get an injury; run with improper form for 30 minutes a day, 200 days a year, and your body will eventually break down.

Protect Your Heart: Watch the Temperature

Sweat and hot temperature are no news to an experienced runner. In fact, many runners appreciate the feeling. However, failing to manage your temperature can hurt your heart.

Hypothermia is a condition when your body loses heat faster than it generates it. This can lead your body temperature dropping low enough to interfere with your heart’s function. In extreme cases — or when chronically untreated — hypothermia can cause a complete failure of your heart. We don’t want that.

How does hypothermia happen? Basically, your body has self-regulatory mechanisms (sweating, breathing) that try to keep us alive and healthy in all situations. However, when you suddenly change the variables (start running after a long break, run in different conditions, try a new program), these mechanisms can turn against us.

In running — given you don’t have a related medical condition — hypothermia mostly occurs due to excessive sweating, which happens when:

  • You put on excessive clothing, especially when running in cold weather
  • You run in the sun
  • You push your pace to the extremes

Another risk factor is running in strong wind. Strong blows of wind can drastically reduce the temperature of your body.

Hypothermia also is more likely to occur to people of older age or when you’re exhausted.

Guidelines on how to avoid hypothermia:

  • Don’t run in extremely cold, hot or windy conditions
  • If running in cold weather, make sure your outfit contains heat and includes layers of moist absorbing clothing
  • Run in the woods, where there’s a lot of shade
  • Approach running gradually. If you feel symptoms of hypothermia (shivering, low energy, slurred speech), take it down a notch

Keeping Bones Intact

Running is a non-stop shock therapy for your bones and joints. So, if you do decide to go for a jog, it’s in your best interests to at least do it correctly. Studies estimate that up to 80% of runners experience injuries such as patellofemoral pain syndrome (better known as the runner’s knee), shin splints and stress fractures.

Runner’s Knee

Patellofemoral pain syndrome is not exactly a condition, but rather a collection of symptoms associated with a number of potential conditions in the knee area. It is reported that up to 25-30% of all injuries observed in sports medicine are related to the knees, and that it “accounts for 33% and 18% of all knee injuries in female and male athletes, respectively.”

As the name suggests, runner’s knee is most common among frequent runners. However, patellofemoral pain syndrome can develop from a number of activities that put stress on the knees (such as soccer, long-distance walking/hiking, skiing, cycling or playing tennis.)

In the most simple of terms, the syndrome occurs when your kneecap does not run smoothly up and down the trochlea—its dedicated “track.”

According to a Harvard Health Blog article by Kay Cahill Allison, runner’s knee manifests as a chronic, dull pain, activated by a certain motion.

“My left knee hurts. When I put weight on it with my leg bent, like when I get out of the car, I feel a dull pain in my knee,” Allison writes.

Patellofemoral pain syndrome surfaces as dull, aching pain around or behind the kneecap. The pain is usually felt when moving (walking, jumping, running, sitting up and down.) It is not uncommon for patients diagnosed with the runner’s knee to hear popping in the knee when standing up or simply bending the knee. Sometimes, the pain is accompanied by swelling and grinding in the knee area.

In more particular terms, the runner’s knee can be caused by a number of factors, such as:

  • overuse
  • trauma to the kneecap
  • misalignment of the kneecap
  • complete or partial dislocation of the kneecap
  • flat feet
  • weak or tight thigh muscles
  • inadequate stretching before exercise
  • arthritis
  • a fractured kneecap
  • plica syndrome or synovial plica syndrome, in which the lining of the joint becomes thickened and inflamed

Due to the number and the varying nature of the runner’s knee pain, the treatment can be very different in terms of approach and intensity. For everyday prevention, an acronym RICE reminds a set of techniques that can and be practiced by anyone feeling pain around or behind their kneecaps:

  • Rest: Avoid repetitive stress on the knee.
  • Ice: To reduce pain and swelling, apply an ice pack or a pack of frozen peas to the knee for up to 30 minutes at a time and avoid any heat to the knee.
  • Compression: Wrap your knee with an elastic bandage or sleeve to restrict swelling but not too tightly as to cause swelling below the knee.
  • Elevation: Place a pillow under your knee when sitting or lying down to prevent further swelling. When there is significant swelling, keep the foot elevated above the knee and the knee above the level of the heart.

Can Surgery Be an Effective Treatment to the Runner’s Knee?

In short, no. It is the last alternative you should be considering, and even then, there’s inadequate evidence that it could produce a significant, lasting change and pain relief.

A 2012 review of 27 clinical studies where the runner’s knee was treated with surgical intervention reported “no additional improvement in PFP symptoms and function over 9 months after surgery.”

And even for hand-picked patients who were considered good candidates for the surgery, failure rates of 20-30% have been reported.

Shin Splints or “Medial Tibia Stress Syndrome”

The shinbone (medical term—tibia) is the major bone “connecting” your knees to the feet. When an inflammation occurs in the muscles, tendons, and bone tissue around your tibia, patients feel sharp to aching pain—a condition called shin splints. Shin Splints can often be an early sign of a developing stress fracture or a condition called “exertional compartment syndrome.”

Much like the runner’s knee, shin splints develop due to repetitive stress and overuse to the shinbone. Any activity that involves repetitive leg movements (jogging, swimming, cycling, tennis, hiking) can contribute to the condition.

Prevent Jogging Injuries

Shin splints often occur after an aggressive change in the patient’s exercise patterns. For example, when patients dive head-first into a new sport, or dramatically increase the load of their current exercises—that’s when the pain in the calves usually appears.

The pain itself is mostly described as “sharp and razor-like or dull and throbbing.” It may surface during or after the exercise, and can be aggravated by touching the sore spot.

Surgery is only employed to treat shin splints in individual cases where the patient does not respond to non-surgical treatment. The effectiveness of surgery for shin splints is unclear. The surgery involves opening the “fascial plane” to allow for more space.

How to Prevent Injury for Joggers?

While there’s no hard evidence to whether all running-related injuries can be prevented, there are several proactive steps that can prevent a disaster:

  • Regularly buy shock absorbing footwear. For jogging, you want to equip yourself with shoes that are highly shock-absorbant. According to the American Academy of Orthopaedic Surgeons, running shoes lose 60% of their shock-absorbing qualities after 250 to 500 miles of running, so people who run 10 miles per week should consider replacing their footwear after 9-12 months of use. When choosing your running shoes, you also want to opt for ones that provide stability and cushion for your foot.
  • Choose the right running surface. The environment you choose to go jogging in is important not just in terms of weather conditions — the surface your feet are repetitively hitting is just as important. Soft surfaces, like a running track, grass or dirt are least shock-inducing, thus least detrimental for your joints. Avoid running in the hills, as the upwards/downwards angle is damaging to your body. If you’re running on a track or other curving trajectory, make sure to switch the direction you’re running to make sure you have pressure on both feet.
  • Try barefoot running. While an alternative prevention and treatment method, barefoot running has been gaining popularity among regular joggers. Barefoot running is unlikely to solve knee problems, but many claim that the practice has helped them fix shin splints and reduce foot pain. The idea behind it is that barefoot running helps spread out the pressure across the entire lower leg and trains a wider range of supportive leg muscles.
  • Only make incremental changes. While a “just-do-it” attitude may do wonders for your motivation, our bodies don’t appreciate sudden changes. In terms of increasing your exercise intensity or the range of exercises performed, always strive for baby-step changes. This way, you’ll give your body the time it needs to adjust and avoid overuse.
  • Rest. Most problems associated with running and other sports that lead to leg overuse are caused by inflammation in certain parts of your legs. The best solution is to simply give your body enough time to rest and heal.
  • Do cross-sport exercise. One of the best things you could do to prevent injury is to train your body in cross-discipline sports. If you’re a runner, for example, start actively swimming—at least once a week. If you play tennis, go for low-weight strength exercises. Consult a physician to develop a cross-discipline exercise regimen that will benefit you the most.


Any sports activity that involves repetitive movement is dangerous to our health. Running, in particular, can be an extremely risky hobby when done improperly.

One of the biggest dangers of running is its detrimental effect to the heart. Due to the way our bodies manage body temperature, wearing the wrong clothes or running in the wrong weather conditions can be unhealthy to the heart.

Musculoskeletal injuries in the knees and lower legs are no rarity, either. Running puts repeated stress onto our legs, so it’s only natural that inflammation and knee problems occur. Luckily, there are proven proactive steps one can take to prevent that.

Dr. Matthew HC Otten

Dr. Matthew HC Otten

Director of Orthopedic & Orthobiologics
Fellowship-trained & Board Certified in Sports medicine
Director Angiography at Harvard Clinical Research Institute
Michigan Stage University Alumni