Dr Parker

Dr Parker is a Lecturer in Physical Activity and Health. She is also a runner. A slim woman, in a blue t-shirt, Dr Parker spoke with great enthusiasm and knowledge about a sport that she loves. Injuries have prevented her from running competitively but, as she came to tell me, for her running means much more than running fast.

Running is a huge area of research, but the science behind it is a little bit wobbly, so I might not have very definite answers to some of your questions.

Over the years I have worked with different types of runners. I also teach this kind of thing to students so I’m familiar with the research that’s out there. I can try and give you some insight.

Running and science for me have sort of gone side by side. I ran a bit at school and through university, but that was just for fun. I didn’t do races, and I didn’t train. When I did my Masters, I signed up to the local half marathon as a challenge. I never expected to carry on afterwards, but the girl I lived with was a runner. She persuaded me to join a running club. I went along and got sucked in.

I ran the London Marathon that year. Because of that, I ended up writing my dissertation on marathon runners. That got me interested in research. It made me think that I would like to carry on working in academia longer term. I didn’t necessarily plan to have an academic career before that, so you could say that running has got me where I am today.

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I ran competitively for a long time. I only stopped because of injury. Now I run recreationally.

Being injured wasn’t easy. I saw a lot of physios, and wasted a lot of time trying to solve my injury problems. Gradually, I had to accept that I had done my competitive bit, and that I could only run for fun. I found that frustrating for a while. I used to get disappointed with my level of performance, or I would go and watch my friends, and wish that I was racing.

It’s been a slow process, but now I’m at peace with it. I don’t push myself like I used to. It’s nice not having to drag myself out of bed at 05:30 if I don’t want to, but I still go out for a long run sometimes just because I enjoy it.

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Running has given me a lot in my life. A lot of my friends came from running, and I love the sense of achievement that you get from finishing a race. When I was a student, I never imagined that I could run ten miles, or a marathon. So when I actually achieved those things, I felt that I could achieve almost anything with a bit of effort and hard work.

Running is part of my identity, and I like feeling that I am part of a community. I like giving advice to other people and getting advice back. I like that sharing. I would much rather run a personal best than win a race. I also love the team aspect of running. In cross-country or relay races it’s all about the team. In other team sports your individual performance can get a bit lost. Running gives you a bit of both.

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I’ve been to lots of nice places with my running. I don’t know if I could rank them but a couple of years ago, I went to San Francisco. I saw a lot of the city by running up and down the hills, over the Golden Gate Bridge, and down the other side. I loved it there.

I’ve also been to Alaska. That was real running territory. There was beautiful scenery everywhere I went. Boulder was also nice. Boulder’s in Colorado and it’s a bit of a Mecca for runners. It’s at altitude, not high altitude, it’s only about a mile high, but I had never been to altitude before and I really noticed it. You try to run up a hill, and you end up desperately breathless.

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My first marathon has probably been my biggest challenge. I was basically a novice, and I didn’t think that I could possibly finish it. I had a couple of injuries building up to the race so it wasn’t easy. I didn’t enjoy the training very much but the day was amazing. At the end I was in tears of pain, but I also knew that I had just run a marathon. I felt a huge sense of achievement.

There are a lot of physical experiences when you’re running a marathon. Some of them are painful. There’s also an internal mental process. People often daydream, or try and distract themselves from the task. You also get external thoughts where your attention is focused away from what you are feeling. You might focus on task relevant things like the route that you are taking, the mile markers, the feed stations, and what other people are doing around you. You also get things that are irrelevant to the task like the atmosphere, the spectators, the weather, or anything else that your attention gets caught to. Those aren’t necessarily performance related, but they’re all part of the event.

Our research suggests that plenty of focus on external factors reduces the level of discomfort that people feel. Psychological factors can help reduce discomfort, but ultimately physiological factors will determine whether you hit the wall. Condition, training, fuel, hydration – all of those factors come into it.

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Over the years, I have done a lot of research with runners. I’ve been involved with parkrun and I have also worked with different Couch to 5K groups. I’ve seen the challenges that people face, and the benefits that they get from running first hand. My own personal running journey, and my research journey, have gone hand in hand. The two help each other, don’t they?

When you try and pin down how running helps mental health, there are a myriad of factors. All of them are very hard to establish, but together they all seem to be part of the answer.

There is evidence that exercise is beneficial for both anxiety and depression. But it won’t be the same for every person. There are lots of biological mechanisms at work with depression, so the research is not really clear cut. It’s hard to identify what is going on in the central nervous system, and how that impacts what’s going on in someone’s brain.

There are lots of theories around endorphin release, but the evidence is mixed on that. It is not clear whether chemicals that actually cross the blood-brain barrier are the same as those that you find in peripheral blood after exercise. That means that you could have endorphins present in your body after exercise, but they might not actually cross over into your brain.

There is lots of animal research suggesting that exercise helps to regulate chemicals like serotonin and dopamine in the body. That’s how lots of anti-depressant drugs work. But we’ve only got rodent research suggesting that it could be happening. It’s not been properly established in humans.

As humans, we have a parasympathetic nervous system. This is a special part of the bigger nervous system, and tends to get mixed up when people suffer from anxiety or depression disorders. There is some research showing that exercise is important for keeping this system in balance. We’ve evolved to be physically active, so exercise could play a role in keeping our body’s systems healthy. That’s hard to prove, and the reason that exercise helps people with anxiety might also be psychosocial.

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Do you know about the five ways to well-being?

These are five evidence-based factors that contribute to well-being, one of which is physical activity. The other four parts often come as part of the package, if you do exercise. Running certainly has all of them.

The first element is sociability. It’s important to be part of a group, and a lot of people run as part of a club or team. That’s quite powerful.

Another element is learning, and finding things out. When you run, you learn how to train, you learn how to race, and you learn how the body works.

The next element is being present to what is going on around you. It’s fairly well established that running gets you out into the countryside, and helps you connect with the world around you. That definitely contributes to well-being.

The last element is giving. Often, in a running environment, helping other people is part of what you do. A friendly word can make someone else feel better, and it’s always nice to be told that you’re doing well. Giving back to others is a human instinct, and a biological need. Something like parkrun is amazing for that.

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Running is one of the most effective ways to manage weight, blood pressure and diabetes. We all know this, but motivating people is hard.

The key for getting people to take up, and then continue running, is enjoyment. It’s the hedonic principle, and it’s actually very simple. We like doing things that we enjoy. That’s human nature. If people have negative experiences when they run, then they won’t keep going when they don’t have to. Something like parkrun can make going out for a run enjoyable. It’s not like going to run 5km on your own is it? It’s there every Saturday, and gives you a bit of structure.

Some people are amazingly disciplined. They can see that running is good for managing their weight, and they will make themselves do it, even though they don’t enjoy it. Others might only get out once a week, but at least they’re doing some exercise.

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A lot of my work has been with the cancer population. When I did my PhD, exercise wasn’t really on the agenda as part of the cancer rehabilitation program. Gradually, there has been more research and more awareness. I’ve talked to nurses and doctors and health professionals, and some of them will now advise patients to take exercise after their treatment is over. I’ve also worked with quite a few cancer charities and they’re superb at making exercise part of their campaigns, and providing exercise advice and facilities for patients. We’ve certainly come a long way.

Cancer is obviously not just one disease, there are over two hundred different types, and it’s in the commonalities between them where exercise, perhaps, is beneficial.

After any cancer treatment, patients often suffer from fatigue and physical function loss. Some level of exercise often helps with those kind of things.

Fatigue is fascinating. Cancer related fatigue, especially, is debilitating. It’s not like the fatigue that you or I get after a long day. Traditionally, the advice has been to rest. It’s counter-intuitive that you should exercise when you feel low on energy, but as our research took shape, we began to realize that if you exercise a little bit, you can prevent a vicious cycle from developing.

After chemotherapy your muscles can be very weak and your cardiovascular system will be damaged. Essentially, people are broken by the treatment. They’re weak and tired so they rest, but you also have to exercise to regain any functionality. If you don’t, you just get weaker and weaker, so you get more tired, and then you rest more. All of a sudden, you can’t walk upstairs. It’s awful.

If you can do some progressive physical activity alongside the rest, like little walks, you can prevent some of that decline. I’ve talked to some patients years after their therapy is over, and they still have some lingering fatigue. The evidence suggests that this could last up to ten years for some patients. It’s very persistent.

In terms of disease markers, there is evidence that exercise can prevent recurrence through hormonal pathways in some cancers. A lot of the evidence is still on rats and mice for this, but the epidemiological studies back it up. There is some relationship between physical activity and longevity post-cancer treatment, and (once you control for weight and diet) exercise does appear to have an independent effect. But that’s all emerging research. We have to be careful not to make it sound more promising than it really is.

We don’t want to give people false hope, or encourage them to exercise more than is sensible. Exercise is just one factor. It won’t override the other factors that contribute to cancer progression.

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A lot of my running memories are happy. I just love running. I remember a friend told me that more of their runs had been positive than not. Probably that’s true for me as well. Even if a run is hard and painful, you get that feel good factor from it at the end. You always feel pleased that you did it.

I don’t really have any goals. Because I still struggle with injuries, whenever I get into a regular pattern of training, something flares up. So I decided a while back to stop setting any goals or having any aspirations. I just want to enjoy running when I can and then, if I don’t think about it, I might find that I start to feel better. Then I’ll set a goal. There are still lots of things that I would like to do.

I still love sprinting, even though I’m not very good, and I love doing 100m intervals. It feels good to just run fast. I feel like a child again, or like a spaniel racing up and down. I enjoy the playfulness of running. It’s a non-serious thing to be doing. I suppose it’s a little bit frivolous.

Generally running is a pleasure. I enjoy the fresh air, the trees and the grass. I enjoy not thinking about work or other bits of life. I used to think that I would never be able to run again. Now when I do, I feel so lucky.

For lots of people, running can be quite unpleasant. If you’re really fit, running is easy. But if you’re not fit, or are overweight, running is hard. But there is lots of research on what we call the ‘affective rebound’. That means that even if a run feels hard you get a rebound of pleasure after you have stopped. Bang! Your mood goes up. That sometimes is the magic bit that makes people go outside again.

© Copyright Arthur Knaggs 2019