No, you didn’t read that wrong!

Osteoarthritis (OA) is one of the most common joint diseases that typically affects the knee and hip of individuals over the age of 40. The idea that physical activity may be harmful for the knee cartilage is a very common misconception among people with OA and health professionals treating the condition.

This can often lead to people avoiding activity and resting which actually worsens the pain associated with OA. Exercise, on the other hand, can improve the health and function of our joints and is the most effective way of managing this condition in combination with weight loss and the right education. 

But what about more demanding forms of exercises such as running? 

We know that our joints love the right amount of load and they require this to stay strong and healthy. Running is a more demanding way to load our lower limb joints compared to other forms of exercise such as walking or cycling.

If you are a runner and you have built up your load appropriately over time, your tissues will have the capacity to cope with this load, and running can be very beneficial for your joints and overall health. If you haven’t run in a while, there are gradual and progressive ways to prepare the body for these more demanding movements.

If you are a runner and you have been diagnosed with OA, you should NOT fear that you will make the condition worse by running, in fact it has quite the opposite effect!

What actually happens to our joints when we run?

The articular cartilage of the knee loves movement and taking weight through the joint in activities such as walking and running. It acts a bit like a sponge, so as pressure is applied to the joint, fluid is pushed out and when this pressure is released it sucks the fluid back in.

This process is assisted by regular exercise and movement to ensure the joint stays nourished and healthy. If you are a runner and you have been diagnosed with OA, you should NOT fear that you will make the condition worse by running, in fact it has quite the opposite effect!

What does the evidence say?

A recent paper published in the Journal of American College of Rheumatology Journal revealed that runners DO NOT have a higher risk of developing OA compared to non runners (Lo et al. 2014). This study has several key findings; 

  1. Runners who engaged in regular running experienced knee pain less often than non-runners. 
  2. Regular running does not increase the risk of developing knee OA among the general population, and may actually have a protective effect against the development of OA. 
  3. There is no reason to restrict participation in running at any stage of life as running does not appear to be harmful to the knee joint. 
  4. People with lower BMI (body mass index) were more likely to engage in regular running. 
So we know that running does not cause or increase the risk of developing OA, but what about those individuals with pre-existing OA? 
  • There is no established link between running and worsening knee pain as seen on investigation over a 4 year longitudinal study. 
  • One study showed a 54% reduction in knee surgery related to OA in runners compared with the general population, showing running as a form of exercise can actually be beneficial to reduce the need for invasive forms of treatment like surgery (Timmins KI 2017).

Most importantly, there are many health benefits of physical activity for your body and the management of OA.

These include;

  • Improving cardiovascular fitness
  • Helping individuals to reduce their body weight (every kilogram of body weight loss reduces the load on the knee by 2-3 times!)
  • Improving muscular strength and performance with functional activities 
  • Improving quality of life, reducing pain and improving joint confidence 

This is massive, and part of the reason why exercise and weight loss is the first line of treatment for OA.

If you want to start running again and you have OA, what is the best way to prepare for this? 

It is best to consult with your physiotherapist if you are interested in starting running again so that they can prepare and guide you appropriately throughout this process. 

An important factor for those with symptomatic knee OA is to stay within the capacity of your symptoms. If you have not run for a long time or potentially never before, we always advise a slow and gradual progression to physical activity with any individual to ensure it gives the tissue and body enough time to adapt to this load. 

We look at several key components for this including;

  • Acceptable pain during activity that settles or returns back to normal within 24 hours. 
  • No increase in swelling or limping post exercise.
  • No effect on sleep or daily function.

If you are looking to get back into running or exercise but don’t know where to start we are happy to have a chat and help you get back to the things you love!

Reference list

Lo, G, Driban, J, Kriska, A, Storti, K, McAlindon, T, Souza, T, Eaton, C, Petersen, N, Suarez-Almazor, M 2014, ‘Habitual running any time in life is not detrimental and may be protective of symptomatic knee osteoarthritis’, Arthritis and Rheumatology, pp 2895. 

Timmins K, Leech R, Batt M, Edwards K 2017, ‘Running and knee osteoarthritis: a systematic review and meta-analysis’, American Journal of Sports Medicine, vol 45, no. 6, pp 1447-1457.