Can Arthritis Catch Up With Runners?

From the WebMD Archives

Jan. 28, 2000 (Atlanta) -- Could running -- the very exercise that keeps millions in good shape -- actually cause damage in the form of painful arthritis as we get older?

Some studies have shown that running can cause leg and knee joints to deteriorate, causing osteoarthritis and often leading to joint replacement surgery. However, a paper published in a recent issue of Current Opinions in Orthopedics shows that an athlete's rigorous, high-impact, high-stress running regimen causes greater risk of severe joint deterioration. But baby boomers who take up recreational jogging probably aren't causing themselves any serious damage.

"Running two or three times a week is fine," lead author Nancy Lane, MD, tells WebMD. "But we also have to look at lifetime exposure. Over time, it could do some damage." Lane advises jogging at a moderate pace -- an 8-minute mile.

How osteoarthritis develops is unclear, says Lane, who is an associate professor of medicine at the University of California, San Francisco. However, damage to the bone surface can start a biological process that results in joint degeneration. Some exercise is believed to be beneficial to the joint because it increases the circulation of fluid that bathes the joint cartilage and helps keep cartilage and muscles healthy.

In the paper, the authors cite a recent study in which older women -- with an average age of 66 -- were followed for nine years. Some were runners, who averaged 41 hours of running a week; others were non-runners who exercised about two hours a week. While the runners decreased their running minutes by nearly 50% during the nine-year period, their overall weekly exercise minutes remained about the same.

There was evidence of knee damage in all the women, says Lane, "but it appeared that those who were active a few times a week in their teen-age and early adult years had a modestly increased risk of arthritis of the hip." This study shows that as individuals age, knee and hip osteoarthritis develops at a similar pace for both runners and non-runners, she adds.

"Overall, this study demonstrates that in normal knee and hip joints, regular recreational running does not increase development of osteoarthritis," says Lane. "However, to put this into perspective, these individuals started running in their 40s, and the exercise was low impact or recreational in nature."


Lane points out that signs of osteoporosis were evident in all the women. Despite staying relatively active, the runners lost bone mass at the same rate as the non-runners. "Age-related bone loss occurs despite continuous activities," says Lane.

The authors also cite a four-year Swedish study, in which women ages 50-70 -- some who had hip replacements because of osteoarthritis -- were interviewed about their sports activities before age 50 as well as overall health status, smoking habits, occupational history, and work at home. The study showed that sporting activities and occupational stresses -- knee-bending and lifting -- until the age of 50 appears to be a moderate risk factor in women for developing severe osteoarthritis of the hip. However, says Lane, these results must be interpreted cautiously, since women had to report from memory what they did 50 years ago.

Timothy McAlindon, MD, assistant professor of medicine at the Arthritis Center at Boston University School of Medicine, tells WebMD, "There have been case-controlled studies in Europe that -- in contrast to the studies [cited by Lane et al.] -- do show increased risk [of knee and hip osteoarthritis] from recreational activities."

The study results cited by Lane and colleagues are "generalizable to people who are similar to those participating in that [particular] study: habitual runners who are lean and appear to be in good health," says McAlindon. "Now, can you generalize that to someone who is over 40, overweight, and decides to start running? Running could do damage to the knees of someone who is very obese."

Running is relatively low-impact compared to activities like tennis and squash, which involve changing direction rapidly -- twisting -- and put more stress on the knee, says McAlindon. "Soccer and skiing are clearly very bad for knees," he says. "What you have to do is temper the message. Running seems to be relatively safe, but other sorts of activities may increase the risk of osteoarthritis, especially if there's impact involved or there's the risk of injury to ligaments."

Vital Information:

  • A high-impact, high-stress running regimen is associated with a greater risk of joint deterioration, which could lead to osteoarthritis.
  • Recreational running, however -- running 2-3 times per week at an 8-minute mile pace -- does not increase the risk of developing osteoarthritis.
  • Scientists do not know exactly how osteoarthritis develops, but damage to the surface of the bone can start a process that leads to joint degeneration.
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