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Does Running Cause Osteoarthritis?

What is Osteoarthritis?

Osteoarthritis, or OA, is a degenerative joint disease that affects many Canadians. The joints in our bodies contain cartilage that protects bones during joint movement. Osteoarthritis is when this cartilage breaks down or becomes damaged.  This leads to pain, swelling and stiffness in the joint and loss of normal joint function. Once cartilage is damaged, it cannot regenerate itself—which is why OA is a chronic issue once it develops.

OA is most commonly found in knees, hips, and hands.  It can affect other joints as well. While OA is relatively common, certain risk factors can put people at a higher risk of developing OA. Examples of risk factors for OA are genetics, older age, being overweight, or a previous joint injury.

Are Certain Activities, Like Running Associated with OA?

Many people believe that running can cause OA in knees or hips. Running is a high-impact activity in which increased joint stress is absorbed by articular cartilage with each stride. Athletes and runners are often concerned that these joint stresses will lead to OA over time. Additionally, individuals previously diagnosed with knee or hip OA might wonder if running can cause their OA to worsen. 

The Evidence

Research shows that recreational runners may actually have a lower risk of developing knee and hip OA compared to sedentary individuals or non-runners. Running at a recreational level can be safely done for general health exercise and will not harm hip or knee joint health—but rather, may support joint health.  For individuals who already have OA, recreational running is not associated with OA progression or worsening of symptoms.

However, running at high volumes and high intensities, such as in competitive or elite long-distance running, can increase the risk of developing OA. 

Benefits of Running

Staying active, including running, has many benefits for both physical and mental health. Cardiovascular exercise can reduce your risk of cardiovascular disease, stroke, hypertension, and can help to maintain a healthy weight. It can boost your mood, increase energy levels, help manage stress and improve your sleep. It has even been shown to slow cognitive decline associated with aging and increase your working memory and focus. Recreational running can also reduce the risk of developing knee and hip OA. 

Once knee or hip OA has already developed, physical activity is just as important. Many doctors recommend weight loss to help manage the pain, for which running can be useful. Staying active can help manage joint pain and reduce the stiffness experienced in OA. People with knee or hip OA can often partake in recreational running to help manage symptoms.  This should be done under the supervision of their doctor to ensure it is being done safely. 

Bottom Line

Recreational running is a great way to take care of your physical and mental health. When done safely, recreational runners are not at an increased risk of developing osteoarthritis. 

If you’re new to running or have risk factors for developing OA, start slowly and gradually increase your running volume over a few months. Listen to your body, and if you are experiencing pain/symptoms, talk to your doctor or physiotherapist.

This post was co-authored by Meredith Stadnyk , a fourth year medical student at the University of Alberta and Dr. Yuliya Koledenko, a family physician with special interest in obstetrical care. 

The post was reviewed and edited by Erin Manchuk, BScPharm, BCGP and Stephanie Liu, MD, MSc, CCFP, BHSc.

References

Alentorn-Geli, Eduard et al. 2017. “The Association of Recreational and Competitive Running with Hip and Knee Osteoarthritis: A Systematic Review and Meta-Analysis.” Journal of Orthopaedic and Sports Physical Therapy 47(6): 373–90.

Bastick, Alex N., Janneke N. Belo, Jos Runhaar, and Sita M.A. Bierma-Zeinstra. 2015. “What Are the Prognostic Factors for Radiographic Progression of Knee Osteoarthritis? A Meta-Analysis.” Clinical Orthopaedics and Related Research 473(9): 2969–89.

Driban, Jeffrey B. et al. 2017. “Is Participation in Certain Sports Associated with Knee Osteoarthritis? A Systematic Review.” Journal of Athletic Training 52(6): 497–506.

Lo, Grace H. et al. 2018. “Running Does Not Increase Symptoms or Structural Progression in People with Knee Osteoarthritis: Data from the Osteoarthritis Initiative.” Clinical Rheumatology 37(9): 2497–2504.

Timmins, Kate A., Richard D. Leech, Mark E. Batt, and Kimberley L. Edwards. 2017. “Running and Knee Osteoarthritis: A Systematic Review and Meta-Analysis.” American Journal of Sports Medicine 45(6): 1447–57.

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