The Root Cause Medicine Podcast Health or Hype? Running Myths
Dec 18, 2025
16:44
In this rapid-fire “Health or Hype” installment, Dr. Kate Kresge sits down with performance specialists Dr. Chris Sands, DPT, OCS, and Dr. Gabe Kresge, DPT, to pressure-test the most common running claims through a clinically grounded lens. The conversation moves quickly—but stays evidence-oriented—clarifying where strength training supports running economy, why single-leg capacity matters for load management, how footwear choices should be individualized (especially during transitions), and what the research actually suggests about long-term joint health. They also reframe running assessments as a proactive performance-and-longevity tool, and close with a key injury-prevention principle: for most runners, training load and recovery patterns drive risk more than biomechanics alone.
Clinical Takeaways from This Episode
- Strength Training as a Performance Amplifier (Not a “Bulking” Risk): The guests emphasize that most runners are unlikely to gain meaningful muscle mass that slows them down without a significant caloric surplus and bodybuilding-style programming. In typical runner programming, strength work more often improves running economy, stride efficiency, and neuromuscular coordination (Rønnestad 2014, Llanos-Lagos 2024).
- Bilateral Strength Helps—But Running is a Single-Limb Sport: Squats can be useful for global strength, but running requires repeated single-leg force absorption and production. Unilateral patterns (split squats, step-downs, single-leg hinge work) better reflect the frontal-plane control, pelvic stability, and side-to-side comparisons that matter for durability and efficiency, particularly over long distances (Li, 2025).
- Minimalist Footwear is a Contextual Tool, Not a Universal Upgrade: Barefoot/minimalist shoes may nudge stride length and foot strike mechanics, but the guests stress that this is only helpful when the runner has adequate calf/soleus capacity and introduces changes gradually. Rapid transitions can increase injury risk (Altman 2015).
- Running and Joint Health: “Cyclic Loading” Can Be Supportive in Moderate Doses: Dr. Chris Sands frames the “running ruins your knees” claim as largely hype for recreational runners, noting that well-programmed, moderate running is not inherently degenerative and may correlate with better long-term joint outcomes compared with sedentary patterns—especially when recovery and cross-training are addressed.
- Running Assessments as Preventive Medicine for the Athlete: A running assessment isn’t positioned solely as an injury service. Instead, Dr. Gabe Kresge describe it as a way to identify subclinical deficits, asymmetries, or capacity gaps before they become pain-limiting—supporting performance, longevity, and more individualized programming.
- Most Injuries Track with Training Errors and Under-Recovery: Biomechanics can contribute, but the episode highlights a consistent theme in the literature: volume spikes, poor programming, and inadequate recovery (sleep quality, nutrition, chronic stress load) are common drivers of injury risk at the population level (Hamstra-Wright, 2021).
Dr. Chris Sands, DPT, OCS, and Dr. Gabe Kresge, DPT, are performance and movement specialists with a clinical background in working with runners across rehab, training, and long-term durability. Their approach emphasizes objective testing, individualized programming, and evidence-based decision-making to support both performance goals and lifelong movement capacity. You can find them at https://kineticptpa.com/
Sponsor: Fullscript – a comprehensive care delivery platform for supplement dispensing, patient education, treatment planning, adherence support, and lab ordering with interpretation. (Visit: fullscript.com)
Clinician FAQ: Running Myths, Load Management, Footwear, and Injury Prevention
- Does strength training usually slow runners down?
- In this episode, the guests label that claim as hype for most runners and point to evidence that strength work more often improves running economy and efficiency when programmed appropriately.
- Are squats “the best” exercise for runners?
- The experts say this is partially true: squats can be helpful, but unilateral work more directly matches the single-leg demands of running and helps reveal side-to-side differences.
- Should everyone switch to minimalist shoes?
- They emphasize a strong “it depends.” Minimalist footwear may change mechanics, but tolerance is highly dependent on calf/soleus strength and a gradual transition plan.
- Is running inherently bad for knees and hips?
- The experts frame this as largely hype for recreational runners, stressing moderation, recovery, and cross-training as key contextual factors.
- If a runner isn’t injured, is a running assessment still useful?
- Yes—this episode positions assessments as preventative and performance-oriented, designed to identify capacity and movement risks early.
- Why does poor sleep increase injury risk?
- The guests distinguish acute tiredness from chronic under-recovery—highlighting that consistently poor sleep quality and insufficient recovery capacity can raise injury susceptibility over time.
Timestamps
00:00 – Welcome to “Health or Hype” + episode setup
00:30 – Sponsor: Fullscript
02:03 – Myth #1: Strength training makes runners bulky/slower
03:23 – Myth #2: Squats are the best exercise for running strength
04:41 – Myth #3: Everyone should run in minimalist/barefoot shoes
06:17 – Cushion vs. stiffness: how distance and running type can matter
07:40 – Myth #4: Running breaks down your joints over time
10:33 – Myth #5: No injury = no need for a running assessment
13:52 – Myth #6: Most injuries are training errors, not biomechanics
15:04 – Why chronic under-recovery (especially sleep quality) raises risk
16:00 – Wrap + listener feedback request + disclaimer
Citations
00:30 – Sponsor: Fullscript
02:03 – Myth #1: Strength training makes runners bulky/slower
03:23 – Myth #2: Squats are the best exercise for running strength
04:41 – Myth #3: Everyone should run in minimalist/barefoot shoes
06:17 – Cushion vs. stiffness: how distance and running type can matter
07:40 – Myth #4: Running breaks down your joints over time
10:33 – Myth #5: No injury = no need for a running assessment
13:52 – Myth #6: Most injuries are training errors, not biomechanics
15:04 – Why chronic under-recovery (especially sleep quality) raises risk
16:00 – Wrap + listener feedback request + disclaimer
Citations
- Rønnestad BR, Mujika I. Optimizing strength training for running and cycling endurance performance: A review. Scand J Med Sci Sports. 2014 Aug;24(4):603-12. doi: 10.1111/sms.12104. Epub 2013 Aug 5. PMID: 23914932.
- Altman AR, Davis IS. Prospective comparison of running injuries between shod and barefoot runners. Br J Sports Med. 2016 Apr;50(8):476-80. doi: 10.1136/bjsports-2014-094482. Epub 2015 Jun 30. PMID: 26130697.
- Llanos-Lagos C, Ramirez-Campillo R, Moran J, Sáez de Villarreal E. Effect of Strength Training Programs in Middle- and Long-Distance Runners' Economy at Different Running Speeds: A Systematic Review with Meta-analysis. Sports Med. 2024 Apr;54(4):895-932. doi: 10.1007/s40279-023-01978-y. Epub 2024 Jan 2. PMID: 38165636; PMCID: PMC11052887.
- Prieto-González P, Sedlacek J. Effects of Running-Specific Strength Training, Endurance Training, and Concurrent Training on Recreational Endurance Athletes' Performance and Selected Anthropometric Parameters. Int J Environ Res Public Health. 2022 Aug 29;19(17):10773. doi: 10.3390/ijerph191710773. PMID: 36078489; PMCID: PMC9518107.
- Huffer D, Hing W, Newton R, Clair M. Strength training for plantar fasciitis and the intrinsic foot musculature: A systematic review. Phys Ther Sport. 2017 Mar;24:44-52. doi: 10.1016/j.ptsp.2016.08.008. Epub 2016 Aug 18. PMID: 27692740.
- Sun X, Lam WK, Zhang X, Wang J, Fu W. Systematic Review of the Role of Footwear Constructions in Running Biomechanics: Implications for Running-Related Injury and Performance. J Sports Sci Med. 2020 Feb 24;19(1):20-37. PMID: 32132824; PMCID: PMC7039038.
- Willwacher S, Sanno M, Brüggemann GP. Fatigue matters: An intense 10 km run alters frontal and transverse plane joint kinematics in competitive and recreational adult runners. Gait Posture. 2020 Feb;76:277-283. doi: 10.1016/j.gaitpost.2019.11.016. Epub 2019 Dec 13. PMID: 31884254.
- Li X, Mao L. Characteristics of Lower Limb Dominant and Nondominant Joint Load Changes After Long-Distance Running in Young Male Runners Under OpenSim Environment. Sensors (Basel). 2025 Oct 11;25(20):6301. doi: 10.3390/s25206301. PMID: 41157355; PMCID: PMC12567293.
- Hamstra-Wright KL, Huxel Bliven KC, Napier C. Training Load Capacity, Cumulative Risk, and Bone Stress Injuries: A Narrative Review of a Holistic Approach. Front Sports Act Living. 2021 May 28;3:665683. doi: 10.3389/fspor.2021.665683. PMID: 34124660; PMCID: PMC8192811.
Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine.