To Run or Not to Run

To Run or Not to Run?

How often have you walked past a runner and wondered whether they should be running or not? I often see parks full of runners and wonder why these people are running themselves towards a premature knee or hip replacement. Quite frankly, some of these people should have sought professional advice from a podiatrist before embarking on their personal crusade.

Running to run or not to run
Running to run or not to run

Certain predisposing factors can determine the ease of which someone can run. I will quickly discuss these factors and some of their ramifications.

Leg Angulation

Leg angulation is the major influencing factor on the feet of an individual. Your parents have a ‘big say in this’. Your leg angulation is something you can’t do anything about, but too often I will see a personal trainer “flogging” someone with running drills not understanding why this client is finding the activity difficult. For example, let’s take a thirty something male/female, with “knock knees” or genu valgum, wanting to complete the city to surf. Because the major stabilisation joint of the foot doesn’t possess any muscle attachments, this joint is extremely susceptible to leg angulation. Hence the knock kneed runner forces the foot to ‘pronate’ or ‘roll in’ to end range every step he/she takes. This not only places rotational forces through the foot, knee and hip but excessive ‘shock’ forces up into knees, hips and back. If footwear is inappropriate ( say a pair of Nike Frees) then this person will be paying the school fees of the local orthopaedic surgeon in 10 years’ time.

This person has two choices, change your foot to suit your activity or change your activity to suit your foot type. A change of activity might involve short distance running, X-trainer, cycling, swimming or circuit training. Too often this person will be ill-advised and literally run themselves towards the operating table.

Treatment for this person involves biomechanical video assessment, correct footwear and custom foot orthotics.

Ground Surface

As primitive human beings we were designed to be walking on soft forest floors i.e. mulch leaves. When I walk out of my Surry Hills Practice, I fail to see an abundance of this ‘stuff’. Concrete footpaths, asphalt roads, tiles and floor boards greet my every step. These surfaces fail to ‘push up’ into your foot and cushion the impact. Flexible custom foot orthotics can provide the necessary cushioning and support your feet need.

feet working hard

I prefer to run on soft grass. As boring as running around an oval is, it might save your knees and the need for top cover private health insurance! Treadmill, soft sand and track running also have advantages, with soft sand running best suited to certain foot types.

These are just two factors influencing the decision to run or “not to run?” I look forward to discussing other issues with you in the near future.

 

Nerissa D'Mello​​

Clinical Lead Physiotherapist
Nerissa’s interest in physiotherapy began after experiencing multiple injuries growing up. Being in and out of clinics sparked her curiosity about how the body heals and inspired her to help others return to what they love. Early hands-on experience with a Scottish rugby club during her masters strengthened her passion for musculoskeletal and orthopaedic rehabilitation.
 
Now the Clinical Lead Physiotherapist at Quay Health, she has a strong interest in helping patients recover without surgical intervention when possible. Her treatment style combines hands-on techniques with exercise prescription, grounded in the latest research to promote lasting recovery.
 
Some of the techniques Nerissa uses are dry needling, VALD ForceDecks and Dynamo for data-driven rehab, taping, and shockwave therapy for stubborn tendon injuries.
 
She enjoys treating a broad range of patients, regardless of age, fitness, or background, and is currently expanding her expertise in women’s health.
 
Patients can expect a thorough, personalised approach focused on understanding their goals, hands-on treatment, and education in a supportive environment.
 
Outside work, you can find Nerissa training for her first full marathon, playing tennis, smiling at your dog, and trying to keep up with all her downloaded podcasts.
 
Clinical interests include:
 
  • Shoulder injuries, including rotator cuff and instability
  • Ankle sprains
  • Tennis and racquet sports injuries
  • Neck and upper back pain
  • Rehab from postoperative hip and knee replacements
  • Women’s health 
 
Languages spoken other than English: Conversational Hindi
 
Nerissa is available at Quay Health. Call 1300 782 943 to make an appointment or book online.

Riccardo Erba​

Senior Physiotherapist

Riccardo’s passion for physiotherapy started while working with patients recovering from strokes, multiple sclerosis, and brain injuries. Seeing how vital movement is inspired him to explore the connection between the brain and body. Over seven years, he developed a holistic approach combining manual therapy, education, and sport-focused rehab.

His treatment style is evidence-based and tailored, blending hands-on therapy with corrective exercises and advanced technologies. Riccardo believes every patient deserves a personalised plan that balances pain relief and long-term improvement.

He uses techniques including spinal manipulation, mobilization with movement, dry needling, Class IV lasers, shockwave therapy, and VALD ForceDecks.

Riccardo enjoys helping clients who want to understand their bodies, relieve pain, prevent injury, and improve performance.

Outside work, he loves hiking, climbing, and following ball sports of all kinds.

Clinical interests include:

  • Headaches and neck pain
  • Shoulder and elbow conditions
  • Hip and knee rehab
  • Shockwave and laser therapy

Languages spoken other than English: Italian

Riccardo is available at Quay Health. Call 1300 782 943 to make an appointment or book online.