Couch to 5k: Panacea for Inactivity or Road to Nowhere?

What is Couch to 5K?

It is the name of a phenomenally successful NHS app, designed to get people from no activity at all, so, sitting on the couch, to running for a distance of five kilometres

One thinks of  people as sitting on a sofa or chair and being on a couch when in therapy, but no matter….

The NHS Couch to 5k app alone has 5 million downloads.  There are loads of others on the Play Store: at least 10.   On the App you will find a  community of like minded individuals to share tips, stories and advice with, plus celebrity workout buddies.  What’s not to like?

Couch to 5k as a Benchmark of Fitness

It is not that I don’t like the idea of Couch to 5k,  instead,  I’m worried that it’s being seen as a benchmark for improved activity levels.    It can be a benchmark but it is in danger of being the benchmark.  I worry, although I cannot cite evidence for my concerns, that for everyone for whom this programme has been a wonderful gamechanger, there is a person who got injured, another one who couldn’t deal with the demands of running long distances, and a person who couldn’t face it in the first place.

What prompted me to put metaphorical pen to paper was that I heard a piece on the Radio 4 TODAY programme where the host was interviewing people about the rights and wrongs of advertising junk food. The spokesperson for the food industry tried to say that previous attempts to control advertising had lead to a reduction of 1 calorie in people’s dietary intake.

That is of course farcical.  One calorie?  The specificity of her claim renders it down to the status of stupid, albeit seductive,  soundbite.   Definitely a soundbite, not an actual bite of food.  There is probably more calories than that in the hot air she spouted.

Anyway, she said that what people really needed to do for weight management and obesity prevention was do more activity, like Couch  to 5K.   It just rolled off her tongue.  Before or after the Pop Tarts I wonder?

In the same week a 1:1 client of mine told me that her MSK specialist Doctor told her that  she should try to “move on” from her symptoms of sciatica which come on after walking for 10 minutes or so, or after standing on the spot and “do the couch to 5k or go back to badminton”.  Again: couch to 5k as the primary driver of activity in someone with severe and daily life altering sciatica?  I don’t think so.

Let’s not rule it out, but, instead, take things more carefully

Most people quite literally need to walk before they can run.

This isn’t just a metaphor it is very good advice.  The Couch to 5k app advocates mostly walking at first, but entirely omits to point out, that in a nation of inactive people who tend to sit too much, the mere act of walking properly needs attention.

There are plenty of reasons why we should all treat the notion of training for Couch to  5k run with some degree of caution

What is it about Couch to 5k that’s causing my concerns?

Sitting too much and not moving enough has changed the biomechanics of our feet, ankles, knees, thighs and pelvis.  It actually does more than that,  but we’ll leave that for now

Our feet our quite stiff, as are our ankles.   The latter is in part due to a lifetime of wearing shoes.  Our ankles suffer from spending relatively long periods in a fixed sitting position with no ankle movement and not living in a country with squat toilets.   Poor foot and ankle alignment can have a profound effect on running.  Not only that, but it largely goes unnoticed.    After years of relative inactivity, or having a desk job, the feet need to be mobilised and the upper and lower calves need to be stretched, possibly daily before starting to run

Expensive shoes will not solve this

The front of our thighs can be  extremely tight.  The consequence of this, is an inability to correctly extend the legs which is the action you need to shift your body in walking or running.     Most people over 40 that  I encounter in my classes have this going on.  They need to mobilise the thigh muscles and liberate the pelvis before they get going with any running at all.

Massive numbers of us have weakness in the muscles of the bottom (known as the Gluteals, or Glutes for short).   Partly due to sitting, partly due to inactivity and possibly other reasons.  You cannot run properly without your glutes.   You can walk although not ideally, but run?  No way.  Weak glutes = compromised running, increased risk of injury and possible damage to the knees

I should really get out more… because I’ve talked about this before :

Back to the poor old knees: They are blighted by stuff going on in the ankle, foot and in the pelvis.   Poor leg biomechanics will increase the risk of knee problems.   Some of you may have noticed that your knees roll in as you run.  This is often due to weakness in the glutes that stabilise the pelvis : Your Gluteus Medius, that needs to be functionally strong to allow safe, effective running.

The glutes may need a bit of prehab before running on them.  To an extent walking will do this.   However, if your glutes are dysfunctionally weak then walking won’t be enough because you may have “learned” to walk with weak glutes.  Floor based exercise may be the way to go here.

Stiff front thighs, weak glutes can cause something else too .  It can cause the pelvis to tip forwards and the back muscles to overwork often substituting for the glutes in running.  If you get a touch of back pain when you run, this may be an issue for you. The Biomechanist Katy Bowman talks about the pelvic position here.   Conversely stiff, tight backs of thighs can cause the opposite problem: a rounded lower back, tail tucked under the pelvis

Think it’s just the legs? Think again


We are a nation of round shouldered folk right?  This contributes to and is related to having a rounded back.  People run like that, even to the point of having their arms cross the body rather than driving the body forwards by having the arms driving backwards.    The Biomechanist Katy Bowman talks about arm swing here

Having a rounded upper back makes running far harder than it should be because you are not standing tall.  You have to deal with the weight of your body rounded forwards in space rather than stacked on top of your feet and legs.  Your body is kind of falling forwards and you have to expend loads of energy stopping that happen.  Energy you could spend on running with a lovely tall spine.

Stomach muscles

Don’t pull them in

Just don’t


Definitely not whilst running.  It reduces the natural rotational movements of the trunk which you need to run

Perhaps for that dramatic party entrance .  I will won’t give any more ground than that

Nobody is mentioning this stuff and they should.  Not to frighten people away from Couch to 5k, but just to give them a bit of a heads up if running is harder than it looks or when it causes pain.  Pain and discomfort (unless it is chest pain) is not  necessarily a reason for stopping because it is dangerous, but that is always the stock, safe answer.  Instead it is a reason to stop to think “ok what might cause this discomfort?”

Pelvic Floor Dysfunction

So I’m in can of worms territory here.  I want to just give a shout out to people who have issues with leakage when they run and feel terrible about that.

That needs tackling.   Gently, kindly and carefully.  Running may not help and trying to grip the pelvic floor whilst running will make matters worse.    As will tying to do Kegel contractions before, during or after a run.     Running is hard, and bouncy and the pelvic floor needs a lot of love and a work up

I have talked about Pelvic Floor stuff in older blog posts, like this one:


You need Oxygen to run.  This is obvious but how many of us have stopped to consider if we are breathing optimally?

If you are round shouldered and/ or  round backed then the breathing is affected.  Habitually breathing into the upper chest is not ideal.  Breathing if you are trying to grip your abdominals or pelvic floor is next to impossible, unless you breathe with your upper chest muscles.

You don’t have to be a super experienced Yogi to be mindful and aware of the breath .  We should all pay it some attention or consider how our alignment might help or hinder it.

A note on Fat Positive Running

I have worked with plenty of overweight clients over the years. It is in 1:1 sessions where I am more likely to have a discussion about the connection of fat, movement, exercise, pain and injury.    Consistently fat people always blame their fat for everything.  And why wouldn’t they?  Society does.  We are a disgracefully fat intolerant society.

I really wanted to call out the potential pit falls of running when you de-conditioned because all of these things cause difficulties with running.  It is not just the fat.  

I do not live in a fat body so I don’t know what it is like to run and be overweight.  I totally understand that is more work to move more weight.    However, if you are fat,  please try not to blame the fat for any running issues you might have.  Consider the other stuff as well.

Back to the App

I know some of these things are mentioned on the App, but they are not front and centre, naturally.  I’m being negative aren’t I?  The App  really does have to be positive and appear attainable.

However these things matter.  They will possibly affect people new to running  and when those people can’t manage, then they will possibly see themselves as having failed.     If running is always hard because you are having to fight tightness, misalignment, weakness, poor posture then you are less likely to continue and come to enjoy the benefits of a 5k run

You have probably seen that there is a stretching section the app.  They are good stretches but very “high end”. Most people would need an exercise session just to get them to the point of even being able to do those stretches.  I’ve taken a look at some of the injury help stuff too.   I’m dubious.  On the back pain section there was something about activating  TA and pelvic floor.  This is   old fashioned nonsense and the person in the clip wasn’t even lying properly on the floor.

Benefits of Couch to 5kFemale runner in Richmond Park, London

It is a free programme, provided you have a Smart Phone

Running outside is free, needs very little kit and unless you’ve been prescribed certain footwear, most will pass muster.

You can engage with a community of like minded individuals

The programme is carefully split into stages

Stories from real people are provided for its success and there is ongoing research into the benefits of the programme that you can participate in

What is advocated is that most natural of human endeavours: running.

Also advocated is  being outside in nature and fresh air, rather than treadmill running which is a quite different kettle of fish

It is promoted for everyone who is able to move about on 2 legs.  The App is at pains to avoid the stereotyping of the typical fit, thin young runner

My Manifesto: Couch to Mobilising the Body and Stretching it Out, Learning to Move the Various Body Parts, Walking Slow, Walking Fast, Walking Tall and then maybe a bit of Interval Training

Not such a catchy title

  • If you are able, start with walking.   Even that can be too much if you have medical conditions or injuries. Some people may be better on a treadmill so you can hold on.  Others are better swimming or on a recumbent bike
  • Couch to 5k is great for some people but unhelpful for others . If you aren’t very active, possibly set a more manageable goal: walk more, walk faster, do more hills, if you have them to hand!
  • We need to be more gentle with ourselves.   Walk, breathe and look around. Standing tall and walking is probably better for your body than a rounded back, rounded shoulders, head forwards, bottle holding, effort laden run.
  • Try to spend time without shoes on.  This gets the feet to wake up. Believe me, you are going to need  them.
  • Do Pilates (or Yoga, swimming, T’ai Chi, gentle resistance training in the gym) to get the body ready for the work of running
  • Dancing would be a good start because you move the body parts and get away from sitting and being sedentary.  The joints get moved and metaphorically oiled

The correct number of steps each day is not 10,000, it is simply more than the day before.

The correct number of kilometres to run is not necessarily 5.  We just try to be a bit more active, to enjoy it and yes, it needs to be We.  All of us









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