When it comes to picking the cardio of choice, older people are often confused between walking and running. There is a case to be made for both, but according to orthopaedic surgeon Dr Pankaj Walecha, the debate often starts with the wrong question: which activity is easier on the knees?
In an interaction with HT Lifestyle, Dr Walecha noted, “What matters is whether the joints, muscles and tendons are conditioned to handle the load being placed on them, and whether that load is being increased at a pace the body can adapt to.”
According to the surgeon, running as a sport has turned into more than just an elite athlete affair in India, as recreational runners, running clubs in cities, and 5K and 10K events have become common. Tens of thousands of people participate in marathons that are held in metro cities.
“However, the increase in first-time runners seems to be following a familiar trend for orthopaedic specialists: the musculoskeletal system of the person who is motivated enough to start running and physically fit to do so might not be ready for the activity,” he noted.
The real issue is not impact, but capacity
Dr Walecha acknowledged that running does place greater demands on the lower limbs than walking. Every stride involves a flight phase and a faster transfer of body weight. But that does not mean running is damaging to healthy joints. It means that running needs preparation.
In his words, “A person who has been largely inactive cannot assume that being able to complete a five-kilometre walk means the knees, calves, Achilles tendon, and hips are immediately ready for five kilometres of running.”
“The lungs may cope before the supporting tissues do. This is one reason new runners can feel perfectly capable during a workout and develop knee, shin or tendon pain afterwards,” he continued.
According to Dr Walecha, walking is often the sensible starting point precisely because it is easier to repeat. Someone returning to exercise, carrying excess weight or recovering from inactivity can build a substantial fitness base through regular walking without immediately taking on the higher demands of running.
“Brisk walking, longer walks, and incline walking can progressively challenge the cardiovascular system while also giving the lower limbs time to adapt,” he added.
Walking is not to be treated as a substitute for strength
Treating walking as a substitute for strength is a mistake that should not be made, cautioned Dr Walecha.
“If someone eventually wants to run, the preparation should include the muscles that control the knee, ankle and hip. The quadriceps, hamstrings, glutes and calf muscles all contribute to absorbing and controlling forces during movement,” he stated.
“Basic strength work such as squats, step-ups, calf raises, hip strengthening and controlled single-leg exercises can therefore be more valuable than simply adding more kilometres.”
This becomes particularly important for people with previous knee pain or osteoarthritis. As per Dr Walecha, a diagnosis does not automatically mean that the joint should be protected from activity. In many cases, the better approach is to find the level of activity that can be tolerated and gradually build from there.
“Walking may be more comfortable during a painful period, while running may need to be modified or temporarily avoided depending on symptoms and function,” he noted.
Problem with trying to do too much too soon
In the words of the surgeon, “For new runners, the biggest problem is often not running itself but doing too much too soon.”
Dr Walecha explained that a common pattern is to sign up for a 10K, start running four or five days a week and increase distance rapidly because the person feels fitter after the first few sessions.
“The cardiovascular system can improve quickly, creating a false sense that the entire body is ready for the same progression. Tendons, bones and other tissues adapt more gradually,” he cautioned.
This is where the run-walk method can be particularly useful, noted the surgeon. Instead of trying to run continuously from day one, a person can alternate short running intervals with brisk walking. The running portions can gradually become longer as the body adapts. It also removes the unnecessary pressure to treat walking breaks as failure.
“For many recreational runners, they are simply a sensible way of managing training load,” he stated.
“The same principle applies to people trying to lose weight,” added Dr Walecha. “Walking may be the better place to begin, particularly if joints are already uncomfortable. Once regular activity and strength have improved, short running intervals can be introduced if they are well tolerated.”
The decision should be based on movement quality, strength, symptoms and recovery rather than a particular number on the weighing scale. Shoes deserve attention, but they should not receive all the attention. A comfortable, appropriate running shoe can improve the experience, but it cannot compensate for suddenly doubling weekly mileage. Nor can changing shoes fix poor recovery, inadequate strength or an abrupt increase in training intensity.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
Dr Pankaj Walecha, MBBS, MS, serves as the Director and Head – Robotic Knee & Minimally Invasive Hip Replacement, Sarvodaya Hospital, Sector-8, Faridabad. He has over 20 years of surgical experience.
