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Osteoarthritis

As a long-time runner, I have been concerned about the effects of running on my joints. Does running contribute to the development of osteoarthritis? For years, I have done frequent literature searches to see if there are any new studies that might help provide an answer to this question. Osteoarthritis refers to a degeneration of the cartilage that cushions the joints. Over a period of time, the cartilage can be worn down to the point that the bones are actually rubbing against each other. This results in pain with movement of the joints.
There is an abundance of data to suggest that exercise helps prevent cardiovascular disease, assists in weight reduction, improves blood pressure, and improves mood and emotional well being. The cartilage that forms the joints is a living tissue that undergoes replacement and degradation throughout life. The joints must be able to withstand up to six times the body weight on a repetitive basis, for up to one million cycles per year. Osteoarthritis is a very common disease with about 75% of individuals over the age of 70 having some radiographic evidence of the disease. Only about 50-60% of these individuals actually complain of symptoms. The most common joints that are affected are the hips, knees, finger joints, cervical spine and lower spine. The most common factors that are implicated as the cause of osteoarthritis are a genetic predisposition, obesity and trauma. Cartilage doesn't have a nerve supply so considerable deterioration may have occurred before any pain is produced. If you have a torn cartilage or a damaged ligament, it has been shown that early surgical repair will help prevent the early development of osteoarthritis that is associated with an unstable joint.
Dr. Walther reviewed 10 retrospective studies and three prospective studies. The conclusion was that "there is no evidence that running is associated with an increase risk for degenerative arthritis of the hip."

In Dr. Canaghan's article the conclusion was that "there seems to be little risk associated with recreational running." "There was an increased risk of lower limb osteoarthritis in participants of repetitive high impact sports."

Most of the literature seems to suggest that osteoarthritis is more related to age and heredity than it is to exercise. This was a welcome relief, but there are a few catches. The chance of getting osteoarthritis is significantly increased in people who have a pre-existing injury to the knee, hip or ankle joint and run or jog on a regular basis. This does not refer to a running injury, but more to a serious injury that causes damage to the cartilage or produces a torn ligament. Another factor that predisposes one to osteoarthritis is an anatomical abnormality of the weight-bearing joints. Examples of anatomical abnormalities would be knock-knees, bowlegs or leg-length discrepancy. This evidently puts much stress on the joints while running and can cause joint damage.
The main conclusion of the article was that normal joints in individuals of all ages appear to tolerate prolonged and vigorous exercise without adverse consequences or accelerated development of osteoarthritis. They also concluded that exercise may actually help prevent the development of osteoarthritis. A regular exercise program is also helpful in individuals that have developed osteoarthritis.
Well, it looks as if I can continue running for a while longer although I will continue to monitor the literature for any new studies on exercise and osteoarthritis. I believe it is important to use moderation in your exercise program. Cross-training refers to using other forms of exercise to improve cardiovascular endurance. It is an excellent way to improve cardiovascular fitness without the persistent stress on the legs that is produced by running. If you have pain in a joint that seems to get worse as you exercise, it is important to have it evaluated.

References

Walther M: Is running associated with premature degeneration of the hip? A systemic review. Z Orthop Ihre Grenzgeb-March 1, 2004; 142(2):213-20.
Conaghan PG: Update on osteoarthritis part 1: current concepts and the relationship to exercise. British J Sports Med, October 1, 2002; 36(5):330-3.

Lane NE, Buckwalter JA: Exercise: A Cause of Osteoarthritis? Rheumatic Disease Clinics of North America, Vol. 19 Aug. 1993 PP 617-633.

The information provided above is offered as a community service about health-care issues and is not a substitute for individual consultation. Advice on individual problems should be obtained from your personal physician. This information is based on research by the author and represents his interpretation of the literature.

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