As a runner, I have been told by friends or family that running will “wear out your joints,” that “it causes osteoarthritis,” and that it “is bad for your knees.” Although most of these comments were few and far between, they stuck with me. Since becoming a physical therapist, I started to hear comments like this more frequently. However, this does not line up exactly with my understanding of the human body and how it responds to various stimuli. So I explored the question: Does running cause arthritis and should I be worried?
It turns out the answer is not as simple as these statements and research shows. The percent of recreational runners who had knee or hip osteoarthritis was only 3.5%. These recreational runners were those who have participated in running for 15 years or more. The amount of weekly miles varied depending on the study, but overall were less than 50 miles per week. Competitive runners on the other hand, who ran more than 57 miles per week were found to have a risk of 13.3% for hip and knee osteoarthritis. The study also showed for an average individual who is not very active, the risk is 10.2%.1, 2, 3 What do these numbers mean though?
Recreational runners like myself, are less likely to have arthritis in our hips or knees. So what about those who are further distance runners (classified as competitive), how bad is this risk? The percentage difference between couch potatoes and distance runners is fairly slight. So, should we worry at all? The health benefits and enjoyment of running 57+ miles per week outweigh the risk, providing both physical and psychological benefits to these competitive runners. This is certainly better than little to no exercise and a sedentary lifestyle that we already know can contribute to the development of unhealthy habits and health conditions. Moreover, a study in SPINE in 2005 showed little to no correlation between arthritis and pain4. This was supported by numerous studies of healthy pain-free individuals, which had found imaging results for knee arthritis in healthy, pain-free people 4-14% of the time in those under the age of 40 and 19-43% over the age of 405. This is part of a larger re-examination healthcare has been doing over the last 30 years to study how we understand pain and imaging.
So the answer is keep running. Whether you prefer short or long distances, don’t fret about wearing out your joints as you are doing more good for your body and mind than not. If you are experiencing pain while you run, check out this list of ten common running injuries you may have. If pain persists, schedule a free assessment with one of our experts. Appointments are available in-clinic and virtually through our telehealth services.
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1. Alentorn-Geli E, et al. The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis. JOSPT. 2017:47(6)
2. Driben J, et al. Is Participation in Certain Sports Associated With Knee Osteoarthritis? A Systematic Review. Journal of Athletic training. 2017; 52(6)
3. Refevre-Colau M, et al. Is physical activity, practiced as recommended for health benefit, a risk factor for osteoarthritis? Annals of Physical and Rehabilitation Medicine 2016: 59; 196–206
4. Kjaer P, et al Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40 year old men and women. Spine. May 15, 2005;30(10):1173-1180
5. Culvenor A, et al Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis. BJSM. 2019;53
Erik Krol, ORT/L
Awesome use of the literature! Thanks for writing.
Yes but the number of the general population compare to professional runners are collosal. even if you put 3% as the general population that would still be a greater number of people compare to 13% of specifically professional runners. to put into perspective 3% of the general population are 10 to 1000, whilst 13% of professional runners are 10 to 40 (this is just a perspective). so that’s still a lot. also the general population here are said to be obese or overweight.
Kirk Clegg-Johnson PT DPT OCS
Thank you for your comment. Yes sample size certainly needs to be examined. However, in the studies I am citing it was recreational runners not professional runners who were assessed. This creates a far larger group to assess from. The general population is certainly more likely to be overweight given that this is an issue throughout America. So certainly, this could be a factor. There are many variables unaccounted for, such as technique, which may further affect this correlation. However, the trend seems to hold true.
The more important focus is that arthritis is not actually well correlated with pain. Many studies over the last 30 years have shown that arthritis is an age related change similar to that of hair greying or skin wrinkling, ie harmless in and of itself. This has raised a great deal of fascinating debate in the research as to why some people with arthritis experience pain and others do not. This has ranged from genetic and inflammatory cascade factors, to soft tissue changes and neural changes. However, one thing seems to show commonly is that arthritis changes the force that is transmitted through the joint. The pain experience is likely brought on by these and many other factors combined to determine if your body is able to adapt to the change in force or not. This model also explains why some who have arthritis for a long time do not experience pain until a certain event. There is still much to learn in this area. The take away from the article and my response here is that one should not fear running damaging their joints as it is more beneficial than it is risky.