Nick London looks at new research which confirms a position he has held throughout his career.
For as long as I can remember, the conventional wisdom has been that running, as good as it may be in terms of its other health benefits, isn’t good for knee joints. Spend your life pounding the pavements, hills or treadmill and the belief was that you would increase your risk of developing knee osteoarthritis.
Flying in the face of that conventional wisdom is the fact I have rarely seen runners, even extreme distance marathon runners, with severe joint wear in later life. So it’s good to see recent research which confirms what so many orthopaedic surgeons have long suspected: running does not increase the risk of arthritis. That’s not to say it’s impossible for long distance runners to develop osteoarthritis, but a survey of almost 4,000 runners found that running was not a significant risk factor in the development of arthritis.
Damaged knees vs healthy knees
We do need some clarification here. Running won’t be a major factor in the development of arthritis in healthy knee joints, but we see a different story in patients with damaged joints. Suffer a rugby, hockey, football or netball knee injury in your young or early adult life, for example, and you will be at high risk of developing premature osteoarthritis should you take up long distance running later in life.
The same is true in heavily overweight or obese patients with early to moderate osteoarthritis. Taking up running at this point is going to put the individual at increased risk of their arthritis progressing much more rapidly than if they weren’t overweight.
It all comes down to the combined effects of repetitive impact and repetitive loading. A normal, healthy, pristine joint appears to be very resilient to those effects, which is why people are able to run mammoth distances without damage. In a damaged joint, however, the impact and loading are able to have a far greater disruptive effect.
It’s a contrast that sounds self-evident, but it’s good to see a position I’ve always maintained supported by evidence.
Listen to your joints
Of course, it’s not always evident that you have damaged your knee, so how are you supposed to know whether running will have an additional damaging effect? The key is to listen to your joints. If your knees start to swell and you experience pain, then you need to realise that you are neither Sir Mo Farah nor Peter Pan. Adjust your activities accordingly, perhaps by switching running for a lower impact exercise such as walking or swimming, and you’ll support your knee joint in supporting you.
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