journal of orthopaedic & sports physical therapy | volume 44 | number 10 | october 2014 | 727

When I first began running marathons and road races in New England in the mid 1960s, we runners never talked about injuries. We rarely had any—at least not any worth mentioning. I recall that I had a “stiff knee” once or twice

a year, but it always resolved itself after several days of slower-than-normal training. I never considered a rest day, because I couldn’t see the

value. I needed to fill my training log with long stretches of 100-mile weeks. My fel-low runners (all 75 of us from the 6-state region) were just as hardy. We enjoyed calling ourselves Stotans, a portman-teau word coined by the Australian Percy Cerutty, coach of Olympic 1500-meter champ Herb Elliott, who invented the word by combining Stoic and Spartan.

Yes, we were tough. We had to be. Because the Boston Marathon started at noon (in mid April), every road-race director believed all races should start at noon, even those held on Memorial Day, the Fourth of July, and Labor Day. The same races had no water tables. We run-ners used the verb “wilt” to describe how we performed, as in, “I really wilted at about the 8-mile mark.” Yet, we never for a moment considered ourselves a prese-lected corps of elite athletes. Of course, we were. We were all lean, mean running machines—graduates of high school and college running programs. None of us ran for health or material reward. We ran because we had survived those prior running programs and learned we were good at it.

That’s why I grin when I read run-ning-injury studies that purport to com-

pare “then” and “now.” The 2 comparison groups could hardly be more different. My friends and I ran before the Big Bang, if you will. Everyone since belongs, roughly speaking, to either the late-1970s Jim Fixx running boom or the mid-1990s Oprah Winfrey running boom, which is still expanding.

Let me emphasize that I am not pok-ing fun at today’s 4- and 5-hour marathon runners. Indeed, they are a wondrous and praiseworthy lot. In our obesogenic era, they inspire friends and colleagues to get off the sofa and start moving. We need more of them. The roads are wide enough for all.

But they are different. They are not just slower, but also far less prepared for the training and racing they undertake. As a result, injuries are commonplace, and physical therapy offices are crammed with patients. I give all these newbie run-ners credit for their energy, fearlessness, and high aims. Unfortunately, these qual-ities are frequently part of the problem.

When speaking at road-race clinics, I often bastardize Nietzsche, noting, “That which makes you strong also wears you down.” By this I mean that many new runners are more motivated, disciplined,

and goal seeking than they are suffi-ciently conditioned. Their reach exceeds their grasp. Runners, fast and slow alike, have incredible determination and com-mitment. This tends to create success in many life arenas: education, career, fi-nancial security. Indeed, reader surveys conducted by Runner’s World magazine reveal significant overlap with the readers of magazines like Forbes and Yachting. But, in running, overzealous adherence to the almighty training plan often back-fires. It causes overuse injuries.

Another of my clinic truisms is, “The first smart runner has yet to be born.” This is a joke, of course, and it usually draws snickers of self-recognition. In the audience, I see a few heads nodding. Make no mistake, running is powerful. It exerts a tremendous force on many. I’m not referring here to the drug-like endorphins and endocannabinoids—the legendary “runner’s high.” I believe the simple cognitive story is what traps us.

One day you can barely walk a mile. Four weeks later, you can run a mile. Two months later, you can finish a lo-cal 6-mile run. Success breeds success. The mind reels in astonishment. The wonder of it! It seems there are no lim-its. You had never before even imagined running a marathon, but now you can’t stop thinking about it. The Internet fuels your fire, overflowing as it is with char-ity running programs and “Yes, you can” web pages.

Maybe you can. With luck, you might continue your series of running achieve-

On the Run: A Runner’s PerspectiveAMBY BURFOOTRunner’s World, Mystic, CT.J Orthop Sports Phys Ther 2014;44(10):727-728. doi:10.2519/jospt.2014.0114

[ editorial ]

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728 | october 2014 | volume 44 | number 10 | journal of orthopaedic & sports physical therapy

[ editorial ]ments. You’ll prove that a strong will is the marathoner’s greatest asset.

Or maybe you won’t. Your mind will repeat your mantra: “Stick with the pro-gram. Stick with the program.” But your body might stage a revolt.

Runners are all warned about the “ter-rible too’s”—that they must avoid running too much, too soon, too fast. But given the thrill and steady progress of their early running successes, they too readily infer that they can keep doing more and more. The first smart runner has yet to be born. We repeat the mistakes of all who have come before us. We get injured.

Now, 4 decades after Frank Shorter’s victory in the 1972 Olympic Marathon, the national running conversation is dominated by talk about injuries. In this environment, the easy universal cure proves tempting. Four years ago, I sat in a National Public Radio studio with Christopher McDougall, author of the wildly popular book Born to Run. I had met Chris several times before and admired his journalism and narrative chops. I knew we would eventually talk about barefoot running. Fine, it’s a good subject, and I did a fair amount of grass,

road, and track running sans shoes in my twenties. But I just about fell off my stool when he said, “No one who runs barefoot will ever get injured.” I didn’t have time to compose a thoughtful response. I just blurted out the first thing that came to mind: “Chris, that’s absurd.”

Still, I’m glad for the debate that Born to Run started, and even happier that it has shifted from the perfect running shoe (or lack thereof) to an exploration of good running form. More important, we’re headed toward a world of person-alization and individual assessment/pre-scription. Running shoe A might help a certain type of runner, but running shoe B seems a better choice for a different runner. Exercise A is better for Achilles tendinitis than exercise B.

I learned about individual differences in my first season of high school cross-country running. While my teammates and I completed all our training runs together, we finished far apart in races. Some of us, it turned out, were more tal-ented and faster than others. Period.

Of course, we should expect the same with injuries. Some runners break down at 6 miles a week; some can keep going

and going. I loosely curate a website at www.100kLifetimeMiles.com. It tracks runners who have logged more than 100 000 miles. I’ve run about 105 000 miles myself, and runners like Frank Shorter, Bill Rodgers, and Joan Samuel-son are north of 150 000 miles. Yet, their prodigious totals pale against the lifetime leaders. Two, both credible, are in the stratosphere, up above 250 000 miles, and going strong.

How have they managed this? I have no idea. But, almost certainly, they were “born to run” in many different ways, from neurotransmitters to mitochondria to bone strength. Others are clearly not intended to run 10 times around planet Earth.

But most can run some—enough for fitness and optimal health. And they can run without major injuries, if we can only provide proven guidelines. It’s a worthy goal. As with a marathon, there will be high points and low points along the way. But the finish line is out there, and we should give it our best effort.

Amby Burfoot won the Boston Mara-thon in 1968 and has been a Runner’s World editor since 1978. t

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