Active Voice: Is running an appropriate moderate-to-vigorous physical activity for overweight and obese children?
By Bradley J Bowser, Ph.D.

The prevalence of childhood obesity is a major health concern worldwide. In addition to the negative physiological and psychological effects, excessive weight in children has been linked to movement dysfunction and the development of osteoarthritis and other joint pathologies.

To help combat the health risks associated with childhood obesity, the Physical Activity Guidelines for Americans recommends that children and adolescents should participate in 60 minutes or more of moderate-to-vigorous physical activity daily. Unfortunately, some of the recommended physical activities, if not prescribed appropriately, may do more harm than good.

Running is one of the most popular and common forms of exercise recommended to reduce obesity and improve health. It is also a common element in many moderate-to-vigorous physical activities. However, evidence suggests that children who are overweight/obese land with 25% greater peak force and 45% greater peak pressure on the foot during running. It has been suggested that these greater loads are associated with increased foot pain, increased risk of foot fractures, increased sedentary time and less time engaged in moderate-to-vigorous physical activity. It is likely that the loads on the foot during running are also occurring at the ankle, knee and hip joints. A full gait analysis of the lower extremity of children who are overweight/obese running can provide greater insight on the potential risks associated with running.

In our study, reported in the October 2021 issue of Medicine & Science in Sports & Exercise®, we compared running mechanics between 26 children of healthy weight and 16 children classified as overweight or obese. The result of our study indicated that children who are overweight/obese run with shorter steps, decreased hip and knee flexion excursions during early stance, higher ground reaction forces, and greater joint moments. These differences in running mechanics indicate that children who are overweight/obese exhibit a more rigid running pattern. Subsequently, children who are overweight/obese likely experience greater joint loading during running that could potentially result in lower extremity mal-alignments and other potential joint pathologies.

Encouraging participation in physical activity is crucial in reducing childhood obesity rates. Equally as important is prescribing appropriate exercises that do not place a child at an increased risk for developing other types of injuries or pathologies associated with excessive loading or mal-alignments. Progression from low- to high-impact activities may give the bone and muscle time to adjust to the increasing loads, potentially reducing and ideally eliminating the increased risk of pain and injury in children who are overweight/obese. Creating a positive association with physical activity is important at a young age. By reducing a child’s risk of pain and/or injury during physical activity, we may be able to increase the likelihood that children will enjoy and be willing to engage in physical activity throughout their lives.

About the author:
Bradley J Bowser, Ph.D., currently serves as an associate professor in the Exercise Science Department at Shenandoah University in Winchester, Virginia. His research focuses on lower extremity biomechanics. Dr. Bowser earned his Ph.D. from the University of Georgia then completed his postdoctoral training at The University of Delaware Running Injury Research Lab. For the past 10 years, he served as the director of the Biomechanics Research Laboratory at South Dakota State University. Dr. Bowser has been an active member of ACSM, serving as a Northland ACSM chapter leader in the roll of South Dakota State representative, Student Research and Activities Director, and Regional Chapter representative to ACSM.

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