This piece was written by one of our contributors; graduate entry medical student – Leah Crabtree.
A ‘prescription’ to run may be one person’s dream and another person’s nightmare but it is exactly what doctors across the UK are encouraging their patients to do.
800 GP practices across the UK have now registered to become ‘parkrun practices’, meaning they have partnered with a local parkrun event to signpost patients and staff alike to take part in parkrun. (1) The initiative, backed by the Royal College of General Practitioners, places particular emphasis on identifying people who are the least active and have long-term health conditions, in a bid to encourage them to get involved in parkrun. Inactivity is a leading cause of premature illness and death in the UK (1) and while medicine may help relieve symptoms, schemes like this aim to target the underlying causes of inactivity, in a bid to improve people’s health.
It is well-known that health is not solely determined by our physical ‘wellness’. From as long ago as 1977 medical practitioners have recognised the impact of social and psychological factors on health. (2) Being ‘healthy’ encompasses not only whether you have good physical health, but whether you have good mental health as well. So, while running might directly improve your physical health, the act of running in a group, or volunteering at parkrun, may help to improve health in myriad ways, beyond the scope of medical interventions. (3, 4)
We know that just 20% of our health outcomes result from clinical treatment. The other 80% is determined by external factors such as our social networks, physical environments and lifestyle choices. (5, 6) Prescriptions to events such as parkrun may not only encourage physical activity but also provide scope to meet new people, learn a new skill, or make new friends, all while out in green spaces with fresh air.
Social isolation is a significant predictor of poor cardiovascular and mental health outcomes (7) and so the prescription of an event where people can meet other like-minded individuals, make friends or get involved in a welcoming atmosphere may help to negate the impact of loneliness and therefore improve a patient’s health, even if they are not running. Many events have meet-ups after the run so that people can sit and chat, and this may help to improve a person’s wellbeing too.
The idea of giving people ‘non-traditional’ prescriptions is not new, but this new scheme may see a large increase in the ‘prescription’ of exercise and potential health benefits for everyone who attends.
What is Park Run?
Parkruns are free 5km courses that can be run, walked, or anything in between. The only competition is between you and your stopwatch, so everyone, no matter their speed, is welcome. Starting in the UK, parkruns now exist in 20 countries around the world. (8) There are currently more than 500 parkruns in the UK alone, with more starting every month. An amazing 120,000 people run each Saturday, and 10,000 volunteer. The volunteer-led atmosphere is supportive, inclusive and welcoming and provides an opportunity for non-runners to make friends or learn new skills even when not running. All you need is a pair of trainers (and the motivation to start running at 9am!) or the willingness to be one of their many volunteers.
A 2017 survey of 2000 healthcare professionals revealed that, of those who prescribed parkrun to their patients, 93% prescribed it to help improve physical fitness. Interestingly still, 78% did so to improve mental wellbeing, 62% to improve quality of life, and 52% to help their patients make friends. (9) This survey highlights the wide potential benefits of non-traditional prescribing, and the increasing awareness that medical professionals have about the wider benefits of social activities.
Running is one of the UK’s most popular pastimes, with almost 4 million people estimated to run each month. (10) It is free, requires very little equipment, and can be done individually or in a group. The health benefits of running have long been known about: it reduces blood pressure, (11) maintains bone strength (12) and can boost your metabolism for a whopping 14 hours after a run. (13)
But do I need to run for hours to get any benefits?
It could reasonably be expected that the more you run, the healthier you are, but evidence from a 2019 systematic review of 232 papers showed that any amount of running, even just once a week, leads to significant health benefits. (4) The study found that heart disease, cancer and even death were all reduced by running. Interestingly, they also found that those benefits only increase the more you run up to about 50 minutes per week. Increasing your running beyond 50 minutes a week doesn’t make a significant difference in life expectancy or overall health. Therefore attending a 5km parkrun just once a week will improve your health and wellbeing without the need for any additional kilometres! (Good news for those of us who’d baulk at the idea of a ‘long run’…)
Beyond physical benefits, a number of studies have shown that running can also have antidepressant effects. (14-16) The exact mechanism is still not completely understood, but it seems probable that physical activity modulates serotonin, dopamine and noradrenaline levels in the brain which improves our mood in a positive and sustained manner. (17) Running also helps to reduce the activity in our frontal cortex, the part of the brain involved in thinking (and over-thinking…), which can help people cope with daily stress. (18) All-in-all, running is a pretty fantastic activity!
To run or not to run?
Parkruns are the perfect opportunity to get people running in a non-competitive, supportive environment. They also provide opportunities for non-runners to meet people, learn new skills and become involved in their local community. So, while a prescription to ‘get out and run’ might be some people’s worst nightmare, it seems as though parkruns might provide the perfect opportunity for people to improve their health in every sense of the word.
If you don’t want an official time, you can just turn up to any Park Run at 8:50am and run! The organisers do encourage you to sign up, however, which is a really simple process. Simply register at www.parkrun.org and print off your barcode. That way, you can see your time, see any improvements, and compare against friends and family (only if you want to, of course!). The barcode is yours to use forever, and is linked to an online record of your Park Run achievements.
A huge benefit of Park Run is that pretty much anyone can take part: adults, children, babies in a pram and even dogs are all encouraged! Many courses are wheelchair-friendly, and every course has a ‘tail runner’ who will always finish last- irrespective of how slowly you fancy walking/running. All you need is a pair of trainers and some comfy clothes, and you’re set to go! If you’re at all concerned about whether or not you can take part, check out the FAQs on the Park Run website, directly contact your local Park Run, or talk to your GP about any health concerns you may have.
(1) Iacobucci G. Prescribe parkrun, not drugs, GPs are told. BMJ. 2018;361:k2746.
(2) Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129-36.
(3) Iacobucci G. Sixty seconds on . . . parkrun. BMJ. 2018;361:k2767.
(4) Pedisic Z, Shrestha N, Kovalchik S, Stamatakis E, Liangruenrom N, Grgic J, et al. Is running associated with a lower risk of all-cause, cardiovascular and cancer mortality, and is the more the better? A systematic review and meta-analysis. British Journal of Sports Medicine. 2019:bjsports-2018-100493.
(5) Family Action. Social Prescribing in Secondary Care.2018. Available from: https://www.healthylondon.org/wp-content/uploads/2018/11/Social-Prescribing-in-Secondary-Care-How-to-guide-Nov-18-1.pdf. [Accessed: 04/12/2019]
(6) Community Works. Social Prescribing Extended Pilot Interim Monitoring Report 2017. Available from: http://www.bh-impetus.org/wp-content/uploads/2017/11/Social-Prescribing-Extended-Pilot-Monitoring-March-2017-Final.pdf. [Accessed: 04/12/2019]
(7) Leigh-Hunt N, Bagguley D, Bash K, Turner V, Turnbull S, Valtorta N, et al. An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health. 2017;152:157-71.
(8) Reece LJ, Quirk H, Wellington C, Haake SJ, Wilson F. Bright Spots, physical activity investments that work: Parkrun; a global initiative striving for healthier and happier communities. Br J Sports Med. 2019;53(6):326-7.
(9) Survey reveals healthcare professionals prescribing parkrun to boost the nation’s health. (2017). [Blog] blog.parkrun.com. Available at: https://blog.parkrun.com/uk/2017/12/04/survey-reveals-healthcare-professionals-prescribing-parkrun-to-boost-the-nations-health/ [Accessed: 04/12/2019]
(10) Stamatakis E, Chaudhury M. Temporal trends in adults’ sports participation patterns in England between 1997 and 2006: the Health Survey for England. British journal of sports medicine. 2008;42(11):901-8.
(11) Wen H, Wang L. Reducing effect of aerobic exercise on blood pressure of essential hypertensive patients: A meta-analysis. Medicine. 2017;96(11):e6150-e.
(12) Rector RS, Rogers R, Ruebel M, Widzer MO, Hinton PS. Lean body mass and weight-bearing activity in the prediction of bone mineral density in physically active men. J Strength Cond Res. 2009;23(2):427-35.
(13) Knab AM, Shanely RA, Corbin KD, Jin F, Sha W, Nieman DC. A 45-minute vigorous exercise bout increases metabolic rate for 14 hours. Med Sci Sports Exerc. 2011;43(9):1643-8.
(14) Brené S, Bjørnebekk A, Åberg E, Mathé AA, Olson L, Werme M. Running is rewarding and antidepressive. Physiology & Behavior. 2007;92(1):136-40.
(15) Blumenthal JA, Babyak MA, Doraiswamy PM, Watkins L, Hoffman BM, Barbour KA, et al. Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosomatic medicine. 2007;69(7):587-96.
(16) Zhang Z, Chen W. A Systematic Review of the Relationship Between Physical Activity and Happiness. Journal of Happiness Studies. 2019;20(4):1305-22.
(17) Lin T-W, Kuo Y-M. Exercise benefits brain function: the monoamine connection. Brain sciences. 2013;3(1):39-53.18. Wollseiffen P, Schneider S, Martin LA, Kerhervé HA, Klein T, Solomon C. The effect of 6 h of running on brain activity, mood, and cognitive performance. Experimental Brain Research. 2016;234(7):1829-36.