Many people mistakenly assume that running will result in the development of knee osteoarthritis, especially in the later decades of life. Additionally, people wrongly surmise that a diagnosis of knee osteoarthritis means you must stop running so as to not make it worse. Research has shown that not only does running not cause osteoarthritis but can actually decrease the risk of developing it! Furthermore, running can actually help to manage existing knee osteoarthritis symptoms.

What is knee osteoarthritis anyway? Osteoarthritis is a common form of arthritis, or inflammation of a joint. Knee osteoarthritis is an often age related condition that can result in the degeneration of cartilage, osteophyte development, and joint space narrowing in the knee that typically develops slowly over time. This joint inflammation can then result in pain, however, many people can be pain free despite an x-ray showing their knee has osteoarthritis. This can all sound very scary (no wonder people think they shouldn’t run anymore) BUT luckily there are many ways to effectively treat and manage pain associated with knee osteoarthritis and aerobic exercise (like running) is one option.

So, then why does running not cause osteoarthritic changes to the knee? Many longitudinal studies have shown that runners are NOT at increased risk for knee osteoarthritis compared to non-runners. There are several reasons researchers speculate why this may be the case. One reason may be that running helps maintain a healthy body weight, as obesity is a known risk factor for developing knee osteoarthritis. Another potential reason is that engaging in a regular physical activity can improve strength, mobility, and joint proprioception which in turn protects the joint over time.

And, how could running help manage the pain associated with a degenerative knee?  Studies observing the effect of running on those with a known diagnosis of knee osteoarthritis have shown not only no worsening of symptoms or concerning findings on an x-ray, but actual  improvement in knee pain compared to non-runners. A characteristic of knee osteoarthritis is the thinning of the cartilage that surrounds the joint surfaces. Luckily, a benefit of regular exercise like running is that it can promote cartilage thickening and can prevent the loss of cartilage proteoglycans, which help to absorb compressive loads. Also, exercise has been found to be an analgesic (a pain reducer) by way of stimulating changes in the brain and spinal cord.

There are many risk factors associated with arthritis, some being modifiable (e.g., body weight or strength) and some non-modifiable (e.g., age or genetics). Physical therapy is a proven non-invasive intervention for the management of modifiable contributions to knee osteoarthritis. If you have knee pain, osteoarthritis and/or a runner, here at Beacon Physical therapy we are here to help support you and improve your movement.

References:

1. Lo GH, Driban JB, Kriska AM, McAlindon TE, Souza RB, Petersen NJ, Storti KL, Eaton CB, Hochberg MC, Jackson RD, Kent Kwoh C, Nevitt MC, Suarez-Almazor ME. Is There an Association Between a History of Running and Symptomatic Knee Osteoarthritis? A Cross-Sectional Study From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken). 2017 Feb;69(2):183-191. doi: 10.1002/acr.22939. PMID: 27333572; PMCID: PMC5179322.
2. Lo GH, Musa SM, Driban JB, Kriska AM, McAlindon TE, Souza RB, Petersen NJ, Storti KL, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Nevitt MC, Suarez-Almazor ME. Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative. Clin Rheumatol. 2018 Sep;37(9):2497-2504. doi: 10.1007/s10067-018-4121-3. Epub 2018 May 4. PMID: 29728929; PMCID: PMC6095814.
3. Plack LA. CAN RUNNING CAUSE OSTEOARTHRITIS? ACSMʼs Health & Fitness Journal. 2015;19(1):23-28. doi:10.1249/fit.0000000000000093
4. Williams PT. Effects of running and walking on osteoarthritis and hip replacement risk. Med Sci Sports Exerc. 2013 Jul;45(7):1292-7. doi: 10.1249/MSS.0b013e3182885f26. PMID: 23377837; PMCID: PMC3756679.
5. Running Safely With Knee Osteoarthritis | Arthritis Foundation. www.arthritis.org. Accessed December 30, 2022. https://www.arthritis.org/health-wellness/healthy-living/physical-activity/other-activities/running-safely-with-knee-osteoarthritis

6. Physical Therapy Guide to Osteoarthritis. Choose PT. Published August 26, 2021. https://www.choosept.com/guide/physical-therapy-guide-osteoarthritis