The Link Between Running and Arthritis - Page 2
The Jury Is Out
A small number of studies have suggested a correlation between exercise, including running, and osteoarthritis. One of the studies had serious methodological flaws while another, a 2000 study in the Journal of Clinical Epidemiology, only found a positive association between osteoarthritis and increased levels of exercise in a limited subset of subjects.
Although the majority of research disputes the link between arthritis and running, the jury is still out on a link for those who run both long and/or fast. One such study examined the occurrence of hip arthritis in elite runners and found a greater incidence in those who ran over 65 miles a week. Although the researchers also found that faster running pace was even more a predictor of hip-joint cartilage degeneration, they did not indicate a specific pace for which risk increased.
The act of running may not be the actual cause, arthritis can happen to runners. Says Dr. Luke, “Runners can develop osteoarthritis for a variety of reasons, including a history of previous injury or from a number of biomechanical and anatomic risk factors.”
The onset of arthritis is usually gradual, developing over a period of years. Typical symptoms include an increase in joint stiffness and popping and cracking that may or may not be associated with pain. In addition to pain during or after running, Dr. Luke’s red flag for runners is pain with daily activity.
Dr. Marc Safran of Stanford Sports Medicine advises runners with signs of osteoarthritis, “Osteoarthritis is progressive and irreversible and runners should make intelligent choices when it comes to modifying a running program to preserve the joints.”
Not content relying only on the traditional physical exam, Dr. Luke at the Run Safe clinic prefers using a treadmill to assess runners’ biomechanical form, watching for people who “run heavy” and can’t absorb the impact of running. Anatomic risk factors also include a knock-kneed or bow-legged gait.
Obtaining an accurate diagnosis from a sports-medicine physician is the first step when faced with the symptoms of knee, hip or ankle osteoarthritis. Conservative treatment is often the next step, and entails physical therapy focused on strengthening the leg muscles, particularly the quadriceps, glutes and hamstrings, which has proven helpful in both treating and preventing arthritis.
In a study published in the journal Medicine and Science in Sports and Exercise, researchers determined that those with higher levels of quad strength were less likely to suffer symptoms of knee arthritis, even when joint degeneration was present. Similarly, strengthening the gluteus medius and maximus muscles plays an important role in rehabilitating those with hip osteoarthritis.
Due to the many positive effects of exercise and running on blood pressure, bone density and body mass, many sports-medicine experts recommend modification of a running program rather than an outright stop. “Unless symptomatic, a diagnosis of osteoarthritis shouldn’t put a stop to a running program,” says Dr. Luke. “Instead, consider incorporating cross training, changing running surface and addressing possible biomechanical flaws.”
Modifying a running program can often allow those with mild to moderate osteoarthritis to continue running. The good news is that sports-medicine physicians like Dr. Luke feel that running on softer surfaces, like trails, lessens the impact of running and is easier on arthritic joints.