Runners Are Less At Risk Of Knee Arthritis Than Sedentary Populations

If I had a pound for every time someone told me that running was bad for my knees, I’d be a rich man. Well maybe not rich, but I would certainly earn enough to not have to pay for my own running shoes!

Patients often believe that the knee problem they have in their 60’s is down to all that sport they did when they were younger. However, the research does not support this notion and epidemiological studies generally show that long-term runners are less likely to develop osteoarthritis in their knees than people of the same age who do not run. A recent paper (Ponzio et al., 2018) showed that the veteran marathon runners studied were actually around 50% less likely to develop knee arthritis than the non-runner comparison group.

Another recent study published in the European Journal of Physiology (Hyldahl et al., 2016) sheds light as to the potential mechanism of protection afforded to runners. They demonstrated that inflammatory markers in the knee joint fluid as well as blood serum of athletes were decreased after a 30 minute running session compared with subjects who had sat quietly for 30 minutes. This is very important as low grade, chronic inflammation has long been associated with the onset of degenerative joint disease. So actually it is the sedentary populations and not the runners that are more at risk of arthritic changes in weight bearing joints.

This correlates with what we tend to find in the clinic where, invariably, patients in their later years tell me that they feel stiff. Their stiffness (and sometimes pain) is worse first thing in the morning or after sitting for a while i.e. after a period of inactivity. When they start walking, the first few steps are sore but as they get going they generally feel better again as their tissues loosen. Their bodies are telling them to keep

moving rather than sit still. It makes sense when you think about it but is not always intuitive for patients, especially those who have been led to believe you are potentially harming themselves or causing more damage due to the wear and tear their joints show on scans.

As discussed in the last blog, modern neuroscience clearly shows that there is a weak relationship between pain and the quality of our tissues. However, we should not forget that the biopsychosocial model still has a ‘bio’ component and it is clearly preferable to have good joint health so that the brain has less sensory input from a given tissue to have to try and interpret.

So, don’t be afraid of running, or sports involving running, but do seek guidance from a good physiotherapist or someone similar if you have any questions or want to get yourself checked out so that you are in the best physical and mental shape to take this challenge on. Running is such an amazing way to keep fit and healthy and has a huge positive effect on our mental well-being too. In fact there are many stories of people who take up running to combat the effects of their mental health problems and find it as effective, if not better, than taking medication.

Ease into a programme again slowly. ‘Couch to 5k’ seems anecdotally to be a good guide for people who want to start out running for the first time or return after a relatively sedentary period in life. It is true that runners do get niggles along the way and some of us are quite possibly more able to tolerate the stresses of running better than others for a whole host of reasons. It is likely that there is a process of natural selection going on through the early part of our lives. Those who are ‘put together’ anatomically in such a way that their bodies cope well find that they enjoy running and continue to do so through their lives. Those that don’t, won’t.