Running Up That Hill: The Benefits and Risks of Running, According to Research
By Kaci Baez
Explore the science-backed positive benefits of running, the optimal time to spend running, the dark side of running, the use of AI to decrease injuries and improve performance, and how to find balance as a runner.
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Recent years have brought an increase in global exercise and sports participation. And running is consistently reported in the top five most popular activities, according to the World Health Organization (WHO).
However, the latest research into running shows some new and somewhat surprising insights around the connection between running and health, including the use of AI to decrease the chance of injury, the rising popularity of running clubs, the optimal amount of time to run, and the trend toward running shorter distances in order to avoid burnout.
Running is a highly accessible form of exercise for most people and can be tailored to specific needs and goals; it’s a bit of a “choose your own adventure” type of sport, and you can do it for free. There are many paths people can take when they run: folks can run to meet people via a running program, club, or studio running class; to train for a long or short race; to de-stress in solitude; to catch up on TV shows and podcasts; or to listen to music. You can run inside or outside: it’s entirely up to you (and sometimes the weather).
That being said, running is becoming increasingly more social, with about 93% of group race activities taking place outside. Recent 2024 data from Strava reported a 59% increase in run club participation globally and a shift from pushing to extremes to shorter bursts of running in order to achieve a sense of balance, maintain activity levels, and avoid burnout.
The Physical Health Benefits of Running and the Optimal Amount of Time to Run
Running is a proven mental and physical health booster and has been reported to extend lifespan by about three years and reduce the risk of cancer, heart disease, and type 2 diabetes, according to the Office of Disease Prevention and Health Promotion.
Compared with non-runners, runners have a 30% and 45% lower adjusted risks of all-cause and cardiovascular mortality, respectively, according to longevity researchers. Running, even just for 5-10 minutes per day and at slower speeds less than 6 mph, is associated with markedly reduced risks of death from all causes and cardiovascular disease, according to a 2017 report.
A study led by Yale found that those who exercised had 1.5 fewer days of poor mental health per month than those who did no exercise at all.
To put it simply: the lower our fitness level, the higher our risk of death, from just about any cause. According to the WHO, physical inactivity accounts for approximately 9% of deaths worldwide and is the fourth leading cause of death, after smoking, diabetes, and high blood pressure.
To help reduce death from lack of exercise, some experts say that doctors should "measure" fitness levels, either via self-reported physical activity or objectively measured fitness during routine physical exams. Fitness levels should be considered by healthcare providers just as much as vital signs like body mass index and blood pressure.
How Running Affects Brain Health and Mental Health
“Exercise has a dramatic anti-depressive effect, it blunts the brain’s response to physical and emotional stress. Voluntary exercise is the single best thing one can do to slow the cognitive decline that accompanies normal aging,” David Linden, Ph.D., a professor of neuroscience at the Johns Hopkins University School of Medicine, said in an article.
And exercise can be just as effective as antidepressants, per Harvard Medical School, although they acknowledge that medication may also be necessary in severe cases.
Regular cardio exercise can lead to the growth of new blood vessels to nurture the brain and may also produce new brain cells in certain locations through a process called neurogenesis, which may lead to an overall improvement in brain performance and prevent cognitive decline. The hippocampus, or, the part of the brain associated with memory and learning, has also been found to increase in volume in the brains of regular exercisers.
Other mental benefits of running include improved working memory and focus, better task-switching ability, and improved mood. A 2020 scoping review found that runners had lower anxiety, depression, and hostility levels compared to those who did not exercise.
Another study found that marathon runners, similar to cyclists, had lower levels of anger, fatigue, and depression, as well as a “hardy” and “sober” personality and a higher pain tolerance, and were more likely to be highly self-sufficient and introverted, even when compared to joggers, soccer players, or ultra marathoners. Lower levels of stress, helplessness, and hopelessness have been identified in endurance athletes, which researchers say is likely attributed to their higher levels of “mental toughness,” a trait commonly found in distance runners.
The Dark Side of Running: High Risk of Injuries and the Negative Consequences of Overtraining
Research has associated the rates of running-related injuries to be anywhere from 50 to 90% within the running population, with almost 80% of the injuries due to “overuse,” or training errors, such as sudden increases in volume and intensity. Studies have shown that certain risk factors for developing a running injury include a body mass index (BMI) greater than 30 kg/m, age between 45 and 65 years, non-competitive recreational running, previous injuries, and a high training volume.
Overtraining, training incorrectly, and lack of sufficient recovery time can contribute to injuries, as can the trend of competitive social comparison, perpetuated by prominent tracking mechanisms in classes and fitness apps that enhance social and peer pressure. Leaderboards featuring performance stats, as well as the culture of comparison driven by social media and fitness challenges, has been shown to cause people to overtrain and become anxious about their performance.
Injuries are also reported to be one of the main reasons people quit running (and sometimes exercise altogether). That’s why it’s critical to monitor your training levels and your body accordingly.
Injuries and negative side effects are very common for long distance runners starting at the half marathon level, and the risk of negative physical side effects increase for ultra-marathoners and elite endurance runners. Running for extreme distances has been shown in research to cause side effects including, but not limited to: decreased testosterone, skeletal muscle damage, loss of bone mass, increased knee pain, allergies, and an increased risk for cardiac disorders, including death, although the risk of death is said to be relatively low.
“People who run, love it. But you need the right preparation to be a safe runner and avoid injuries,” Elizabeth Gardner, MD, a Yale Medicine orthopedic surgeon who specializes in sports medicine, said in an article. She recommends getting fitted in-person for running shoes at a specialty running store and including low-impact workouts and yoga in your cross-training routine.
“Cross-training and stretching go a long way toward avoiding running injuries,” she said.
Can AI-Powered Technology Reduce the Risk of Running Injuries?
Running-related technologies are becoming increasingly important tools used by runners at every fitness level. Running watches and apps can guide new runners through training programs and help seasoned runners advance their performance levels and training. Although many running stores offer comprehensive AI-powered 3D foot and gait analysis services, in today’s digital age, a growing number of people would rather order their shoes online and use an app to help guide them along their running journey rather than visit a store in-person.
Running gait apps, which measure foot strike, stride length, and the overall efficiency of your running form, are becoming more abundant due to the widespread use of artificial intelligence (AI). Smart shoes, socks, and other wearables equipped with sensors and AI algorithms can provide continuous monitoring and feedback on a runner's gait. AI-powered gait analysis can be used to detect abnormal gait patterns associated with various medical conditions and can be integrated with other technologies, such as GPS and heart rate monitors, to provide a more holistic view of a runner's performance, ideally to help prevent injury and improve performance.
But researchers say that it’s critical to understand that these running apps come with a margin of error and can at times be somewhat inaccurate because algorithms are trained on specific datasets, and bias can be introduced if the training data doesn't represent the diversity of runners. Experts say that while AI-powered gait analysis apps show promise, they should be used along with other methods, such as lab-based analysis or consultations with experts.
According to a 2024 report, running-related technology use is associated with increased running frequency and volume, but not necessarily a higher risk of injury if users leverage the data for training decisions. Studies show that technology users tend to run further and more frequently than non-users. While some runners may be more prone to injury when using technology, those who use the data to guide their training are less likely to experience injuries.
A word of caution: the use of treadmills is also associated with injuries. In fact, more people are injured by treadmills than any other piece of exercise equipment, according to the U.S. Consumer Product Safety Commission (CPSC). In 2019, there were an estimated 22,500 treadmill injuries, according to the CPSC, and about 2,000 of those involved children under 8 years of age, highlighting the importance of treadmill safety.
How Much Running is Too Much? The Optimal Amount of Time to Run, According to Science
Published information on the “sweet spot” of running yields varying advice in this area, with some experts saying 2.5 hours of running a week is enough, while other reports and experts offer differing information and schools of thoughts. One study found that the benefits of running topped off at about 4.5 hours of running per week, so people who run more than that aren’t statistically likely to live any longer, although the report found that there was no risk associated with running longer or farther.
A 2018 study led by Yale researchers found some surprising results. Scientists analyzed the data of 1.2 million people across the U.S. and concluded that exercising more than 23 times per month, or exercising for longer than 90 minute sessions, is associated with worse mental health. They stated that exercising for 30 to 60 minutes three to five times a week was the most beneficial to mental health. The study reported that subjects who exercised for more than 90 minutes a day or more than 23 times a month actually had worse mental health than those who did not workout at all. The researchers agree that this finding is surprising but believe that obsessive behaviors like over exercising can be associated with poor emotional outcomes, fatigue, and inflammation.
While running and exercise, in general, are recognized as being beneficial to health, some people become addicted to exercise, as described in a 2011 study led by psychotherapist Dr. Marilyn Freimuth. A 1997 study found that about 25% of recreational runners become addicted to the activity, and about 50% of marathon runners feel dependent on the sport.
A 2021 study states that some signs of exercise addictions among athletes include: undertaking exaggerated exercise volumes; lack of control over how much you participate in a chosen form of exercise; experiencing withdrawal symptoms when you stop exercising, and having conflicts with family and friends over exercise.
How to Find Balance As a Runner
The American Medical Association (AMA) offers tips on how to safely enjoy running’s many benefits, which include buying a good pair of running shoes and listening to your body.
“A little bit of stiffness and soreness is part of the training process, but most of us can recognize when a pain or discomfort is more than, ‘Oh, I'm a little stiff today,`” said Dr. Christine Sinsky in the AMA’s published guidance for runners. “If every step hurts, then you need to stop.”
The AMA also advises setting a running goal, following a training plan, warming up properly, taking walking breaks, eating a healthy diet that includes complex carbs, cross-training, and getting enough sleep. In addition, most experts don’t advise increasing mileage by more than 10% each week when working toward a set running distance goal in order to avoid injury.
“I found that doing strength training once or twice a week can help prevent some of the injuries from running,” Dr. Sinsky said.
Finally, it’s important to remember that it takes time to find the right workout routine. Not everyone is physically able to run and those who are able to enjoy running still might not want to run the Boston Marathon, and that’s okay. And, in the quest for optimal fitness and balanced health, it’s all about trying new routines and finding what you enjoy the most.
This content is for informational purposes only and should not substitute actual medical advice. Please consult your doctor for specific health and medical information.
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