Running vs. Osteoarthritis: Is running a risk factor for knee and hip arthritis?

By Joshua Bruner, PT, DPT, CSCS – Physical Therapist at Southwest Health.

Knee and hip osteoarthritis (OA) continues to be a growing epidemic in the United States (US). It has been estimated that 12.2% and 7.4% of the US population have knee and hip OA, respectively. Osteoarthritis is a joint disease that causes a breakdown of cartilage and the underlying bone over time, which leads to decreased shock absorption and joint stiffness. While not initially painful, progression of knee and hip OA can lead to an increase in pain and decline in function. There are multiple risk factors that can lead to the development of OA such as obesity, previous surgeries/injuries, and repetitive workloads. It has recently been suggested that running may also be a risk factor for OA due to its repetitive nature. Close to 64 million individuals in the US use running as a form of recreational activity, but does it truly increase their risk of developing knee and hip OA in the future?

The answer to that question is No! Recent research has shown that individuals who run between 10-20 miles per week actually have a decreased risk of developing knee and hip OA. These same studies found that only 3.5% of recreational runners develop OA compared to 10.2% of sedentary individuals. This decreased risk of OA is thought to be due to the bone having to adapt to the repetitive loads experienced with running. A bone will typically remodel itself over time in order to resist a specific load. Therefore, a bone may actually become stronger and more adaptable to the stresses placed on it while running which could potentially decrease the development of OA over time. Consequently, a lack of bone remodeling may explain the higher risk of OA in sedentary individuals.

Evidence has shown recreational running to be beneficial at reducing the risk of OA, but what about elite runners or individuals training for a marathon?  The answer to that question is less clear, but still positive. Research has shown there is no increased risk of developing OA from running longer distances. Therefore, an individual running between 50-60 miles per week has no greater risk of developing OA when compared to an inactive person. Unlike recreational running however, long distance running does not decrease the risk of OA.

While developing OA from running is uncommon, an individual with an acute or chronic injury should consider resting before returning to running. Research has found that individuals who run with a lower body injury may increase their risk of developing OA. This is thought to be due to the possible change in running form and mechanics causing undue stress on the knees and hips. Before resuming a running routine, an individual should allow the injury to heal with time or seek a medical professional in order to accelerate the healing process.

In conclusion, recreational running is a safe form of activity that individuals can use to stay healthy and active. Low to moderate running may even decrease the risk of OA by improving bone strength and combating risk factors such as obesity and quadriceps weakness. If an individual has experienced an injury while running, it may be beneficial to allow that injury to heal prior to returning to running. Injuries that continue to linger should be treated with guidance from a medical professional. The physical therapists at Southwest Health are movement experts who are knowledgeable in assessing and treating lower body injuries in runners. We perform an in-depth analysis of your running form that includes video feedback. Please feel free to contact The Orthopedic Institute at Southwest Health if a lower body injury is preventing you from being able run consistently. In order to schedule a running assessment, please contact the clinic at (608) 342-4748.