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Running Causes Knee Arthritis | Fact or Fiction?

The perception that running causes knee arthritis is a common one. If I had a pound for every time someone blamed their knee arthritis on running, or was critical of runners for the damage they’re doing to their knees through ‘pounding the pavements’, I would have already retired! In this blog we will explore whether this is fact or fiction.

What is Arthritis?

There are different types of arthritis, but this article will focus on the most common type, osteoarthritis (OA). OA typically affects older individuals and is characterised by joint pain and stiffness. It occurs as the result of deterioration in the cartilage that covers the ends of bones. Think of it as the internal equivalent of grey hair and wrinkles. You can read more detail about the process of OA here.

Running and Knee OA

It is commonly believed by both lay people and many healthcare professionals that running accelerates the process of deterioration. But is this really the case?

It won’t surprise you to read that the answer to this is not straightforward. However, put simply, if it were true there would be a much higher prevalence of OA in runners than non-runners, and this hasn’t been found to be the case.

Does Running Cause Knee OA?

This is a very difficult question for researchers to study due to the vast number of variables such as: running mileage, terrain, previous injury history, biomechanical changes, age, gender, weight, etc, etc, which need to be taken into account. However, this recent systematic review from 2023 identified multiple studies that found no significant difference in cartilage thickness or OA on x-ray between groups of runners and non-runners. They also found a ‘significantly higher prevalence of knee pain in runners compared to non-runners’.

Known Risk Factors For OA

According to present research, there isn’t one specific cause of OA, however there are several known risk factors (i.e. something that makes is more likely that a person will develop OA). These include age, previous injury and being overweight. You can read more detail on these and other known risk factors here. To date, there is no evidence that has identified running (or similar impactful activity) as a risk factor for OA.

Weight and Osteoarthritis

Weight and OA

What we do know, is that being over weight is a significant risk factor for developing hip and knee arthritis. Running is a fantastic form of exercise for both physical and mental health. Therefore if running is utilised as part of a long term weight management strategy, it is probably the lesser of two evils.

I’ve got Knee OA, should I stop running?

You may be delighted to learn that the simple answer to this is NO!

…unless high pain levels mean you have to. It all depends on how symptomatic your knees are. If your pain is mild, and settles when you stop running or soon after, then it is ok to continue. If pain levels are high and/or linger for a long time after you finish running, particularly into the next day or even longer, then you need to either cut back or stop for a period.

There is good evidence that ‘self-selected running’ according to knee pain does not result in worsening knee pain or advanced changes on x-ray. In other words, adapt your running distance, intensity and frequency according to your current pain levels.

If high pain levels are preventing you from running, the good news is that there’s a lot that can be done to help reduce pain and enable you to keep running. You can learn about treatment options for knee OA here.

Running for stronger bones

As a side note, it is also well documented that impact exercises increases bone density which reduces osteoporosis risk. This is particularly important in peri and post menopausal women.

Our Conclusion

If we combine what we know about the positive benefits of running on both physical and mental health, with the fact that the prevalence of OA is no higher in runners than non-runners, there appears to be no firm evidence that it’s in our interest to stop running. Therefore, if running is something that you enjoy as part of a healthy lifestyle, we will do everything we can to keep you running for as long as possible!

If you’re a runner struggling with knee pain, or want to know what you can do to reduced your risk of osteoarthritis, book an appointment with one of our experienced physiotherapists today. Book online or call our friendly reception team on 0114 267 8181.