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I’m sure we have all heard the following: “Oh you shouldn’t run you will ruin your knees!”. It’s a
common response from non-runners when the topic of running comes up. But is this actually
true? As runners, we should know whether our sport of choice is contributing to joint
breakdown and a potential need for surgery in the future.
Historically, the research regarding knee arthritis and running has demonstrated controversial
and mixed results. However, as more studies are published and larger-scale research is being
interpreted, we are getting a better picture of this relationship. Any time we are considering a
medical question, we would be wise to look for the highest quality evidence and study design.
In general, we should look for studies with quality design and a large sample size of
participants. Luckily, we have two studies to look at with participants numbering 675 and
2,637!
In the first study, the Osteoarthritis Initiative sponsored a 10-year examination of runners and
osteoarthritis. (1) This study had 2,637 participants aged 64.3 + 8.9 years. Additionally, 55.8%
were female. 29.5% of these participants had run recreationally at some point in their lives.
Unfortunately, this study did not specify mileage, years spent running, or running-specific injury
history. However, they were able to determine that among the current and former runners
there was NO increased risk of knee osteoarthritis compared to non-runners. Additionally, they
found that among those without osteoarthritis already, running did not appear to increase the
risk of developing osteoarthritis later.
The next study examined marathon runners specifically for prevalence of hip and knee
osteoarthritis compared to a matched group of US population.(2) This study had a population of
675 runners, mean age of 48 years and an average weekly mileage of 36. These marathoners
had completed anywhere from 5 to 1,016 marathons (whoa!). This study utilized surveys to get
information on pain, personal and family history of arthritis, surgical history, running volume,
PR time, and current running status. Among marathoners, 47% reported hip or knee pain at
some point in training, and 8.8% reported presence of arthritis in the hip or knee. Interestingly
enough, the general population prevalence of hip or knee arthritis is 17.9%! Now that is a big
difference. There was no significant risk associated with running duration, intensity, mileage, or
number of marathons completed. The only predictors for hip and knee arthritis? Age, family
history, and surgical history.
So what have we learned?
At worst, prevalence of knee arthritis is no different between runners and non-runners.
(1)
At best, the risk of knee and hip arthritis among runners is lower than among non-
runners.(2)
Risk of hip and knee arthritis is not associated with running duration, intensity, mileage,
or history of running.(2)
The only predictors for hip and knee arthritis appear to be age, family history, and
surgical history.(2) Perhaps the genetic cards we are dealt are not affected negatively by
running?
Overall, I hope this blog post armed you with some information about arthritis in the knees
and hips when it comes to running. At this point, the research would indicate that you are
helping your body when running and arthritis shouldn’t be a concern!
See you out there,
Ryan
1. Lo, G. H., Driban, J. B., Kriska, A. M., McAlindon, T. E., Souza, R. B., Petersen, N. J., ... & Kent Kwoh, C. (2017). Is There an Association Between a History of Running and Symptomatic Knee Osteoarthritis? A Cross‐Sectional Study From the Osteoarthritis Initiative. Arthritis care & research, 69(2), 183-191.
2. Ponzio, D. Y., Syed, U. A. M., Purcell, K., Cooper, A. M., Maltenfort, M., Shaner, J., & Chen, A. F. (2018). Low prevalence of hip and knee arthritis in active marathon runners. JBJS, 100(2), 131-137.
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