Writing Sample 3 - Indoor Running Vs Outdoor Running: the Pros and Cons for Health & Rehabilitation

By Jack Rosser - PT, BSc, MCSP, HCPC, FMPA.

Outdoor running is a fantastic way of improving your general health, especially in areas with good air quality like coastal paths, country parks, and countryside villages. The fresh air not only benefits your heart and lungs but your mental well-being also.


Running outdoors, as a weight-bearing activity, has added benefits for building and maintaining bone density, helping to stave off osteoporotic changes later in life.

An English study published in 2017 even demonstrated clinically significant changes in bone density in females who performed 60-120 seconds of high intensity weight-bearing activity, versus those who did nothing at all.[2]

When preparing for an event, running outdoors also conditions your muscles and joints better, versus a treadmill, to the varied terrain you will encounter in a race.

As one of the most inexpensive and accessible sports on the planet, running outdoors gives you less constrictions on equipment and facilities required. No gym membership, no treadmill, just trainers and will power required.

You can even incorporate running in to your daily travel schedule. Try swapping it for those last ten minutes in the car on the way to work. This way, running becomes part of your normal routine and less of a chore.


Running outdoors is often at the mercy of favorable weather conditions. If you are running with specific fitness goals or with the intention of beating a personal best then perhaps a treadmill is worth considering.

Running in wind, snow and rain does have the potential to cause injuries, and can require multiple layers of often quite expensive clothing.

Predictability of environment and a quality-running surface cannot always be controlled or guaranteed. This again presents a risk of injury, particularly for those who lack agility, proprioception, and the ability to react promptly to unpredictable hazards.

For this reason, I prefer to encourage my patient’s in clinic to start with the controlled environment of the treadmill, where they can build confidence, speed, reaction time and proprioceptive control. Then we can progress on to outdoor running more comfortably.

After injury

The key to returning to outdoor running after injury is in being aware of how your body reacts and responds.

There should be full range of motion and little to no joint swelling both before and after you finish. Additionally, no increased laxity is important as this indicates a potential loss of joint stability.

In regards to pain, sometimes it can be very normal to have minor discomfort during and after exercise, however this should go away within 15-20 minutes of finishing that activity.

Final Thoughts…

More often than not, for those who are fit and well, a combination of both indoor and outdoor running is the perfect balance. This keeps us well tuned in to the specific hazards that both have to offer, whilst allowing us to enjoy the benefits of both.

For those who are rehabilitating or looking to make a return to running but not sure how, I would recommend reading my previous article on running form and treadmills. You should also consider reaching out to an experienced Physiotherapist or health and fitness professional in your local area for individualized expert advice and guidance.


[1] Cai, Zong-Yan et al. ‘Comparison of Lower Limb Muscle Activation During Downhill, Level and Uphill Running’. 1 Jan. 2010 : 163 – 168.

[2] University of Exeter. (2017, July 18). One minute of running per day associated with better bone health in women. ScienceDaily. Retrieved November 19, 2021 from www.sciencedaily.com/releases/2017/07/170718084535.htm

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