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ARTHRITIS MYTHS PART 2: Does Running CAUSE Arthritis?



In the previous post, we talked about how some folks with mild arthritis are able to manage their symptoms and still pursue their desired activity levels with running, walking, dancing, hiking, ect. However, you’ve probably heard, likely from a non runner, “running is terrible for your joints and is going to give you arthritis”. Is THIS true? Let’s explore.


Fortunately, there has been extensive research into this question, and the results are promising. A research study of over 600 marathon runners found that there was not an increased risk of osteoarthritis amongst runners vs non runners, and factors such as age, family history, and an individuals’ surgical history played a much greater role in risk of OA compared to running. In fact, in this study, the rate of arthritis amongst active marathoners was lower than that of the general population in the US. 


Proposed reasons why running is not a risk factor for arthritis include that the cumulative load is more of a factor than peak load. Essentially, compared to walking, runners are spending less time on the ground. Thus the load per unit of distance covered remains relatively low while running, while the amount of time you are in  contact with the ground is reduced.  Additionally, it is theorized that running may condition the cartilage (joint cushioning) to withstand mechanical stress better. Aka running teaches your body to adapt to accept the specific joint demands associated with running. 


A 2017 Systemic Review did indicate there may be a sweet spot with running, as sedentary


folks, and folks running very high mileage over many years may have an elevated risk of developing OA. The updated 2023 report indicated that it is unclear if running volume is correlated with increased risk, or if previous joint injury/trauma is more heavily contributing to these findings in high-volume long-duration runners. This preliminary research may indicate that avoiding extreme amounts of volume and intensity with running may be best for the body.



Rust out or Wear Out?


As we’ve outlined, x-rays and “bone on bone” findings are of limited utility in determining how to address your osteoarthritis. We’ve also broken down how running is unlikely to cause arthritis. However, as the research above indicates, it is better to “Wear out than to rust out”.


Whether your goal is to be proactive to avoid the onset, or if you want to manage the arthritis symptoms you are currently experiencing, this mantra holds true. 


If you are experiencing arthritis symptoms,  finding an appropriate and helpful level of exercise will serve you well. This is where I, as a physical therapist, can work with you to assess your joint, your body and how you move overall, then work with you to find that “sweet spot” level of exercise that is best. 


The specific exercises I will prescribe for you will vary based on how severe your symptoms are, but some starter movements you can try to get your hips and knees moving throughout the day can include: (visit associated IG post for video demos)


  • Knee extension

  • Squat

  • Hip Circles

  • Hip Stretch (FABER, Extension) 


These are very basic exercises to start with, and after evaluating you a physical therapist will be able to give you a program that is tailored more specifically to you. 

In fact, physical therapy treatment including exercise is recommended as a first-line conservative (meaning non-surgical/non-invasive) treatment approach for osteoarthritis.  This exercise program could include strength training, stretching, balance work, aerobic work, and or manual therapy to help with managing pain.


In addition to joint-specific exercises, there is good research indicating that aerobic exercise can be very helpful in managing arthritis related pain. Although this may feel counterintuitive at first, moving those stiff, sore joints will leave you feeling much better in the long run.  In particular, walking, water jogging, yoga, and Tai Chi have been found to significantly reduce pain, joint tenderness, and functional ability in folks with arthritis. 


Although there are many treatments to help with arthritis, it is a progressive condition requiring long term maintenance of exercises and healthy habits. That’s where Zenith is well positioned to help you manage your pain with intermittent check-ins. Rather than seeing you for a 4-6 week course of care and then dismissing you to continue on your own, we are set up to provide you with a more consistent wellness approach. With us, you can check back in with your same physical therapist for pain management and exercise progressions and modifications on an ongoing basis. Treatment of arthritis should entail having a team of professionals working with you on an ongoing basis to help you optimize your active lifestyle.  


It’s time to change the conversation about arthritis. Arthritis is a progressive but manageable condition that should not limit you from moving your body in a healthful, productive way. Running now should not set you up for joint damage down the road. When it comes to managing arthritis, we, as physical therapists at Zenith, are here to be your “arthritis allies”, helping you to manage pain, symptoms, and navigate activity. You can learn more or schedule an appointment here.


1 Wang W, Niu Y, Jia Q. Physical therapy as a promising treatment for osteoarthritis: A narrative review. Front Physiol. 2022 Oct 14;13:1011407. doi: 10.3389/fphys.2022.1011407. PMID: 36311234; PMCID: PMC9614272.


2 Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskelet Disord. 2008 Sep 2;9:116. doi: 10.1186/1471-2474-9-116. PMID: 18764949; PMCID: PMC2542996.


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5 Miller RH, Edwards WB, Brandon SC, Morton AM, Deluzio KJ. Why don't most runners get knee osteoarthritis? A case for per-unit-distance loads. Med Sci Sports Exerc. 2014 Mar;46(3):572-9. doi: 10.1249/MSS.0000000000000135. PMID: 24042311.


6 Alentorn-Geli E, Samuelsson K, Musahl V, Green CL, Bhandari M, Karlsson J. The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2017 Jun;47(6):373-390. doi: 10.2519/jospt.2017.7137. Epub 2017 May 13. PMID: 28504066.


7 Burfield M, Sayers M, Buhmann R. The association between running volume and knee osteoarthritis prevalence: A systematic review and meta-analysis. Phys Ther Sport. 2023 May;61:1-10. doi: 10.1016/j.ptsp.2023.02.003. Epub 2023 Feb 13. PMID: 36809693.


8 Ponzio DY, Syed UAM, Purcell K, Cooper AM, Maltenfort M, Shaner J, Chen AF. Low Prevalence of Hip and Knee Arthritis in Active Marathon Runners. J Bone Joint Surg Am. 2018 Jan 17;100(2):131-137. doi: 10.2106/JBJS.16.01071. PMID: 29342063.


9 Vincent KR, Vasilopoulos T, Montero C, Vincent HK. Eccentric and Concentric Resistance Exercise Comparison for Knee Osteoarthritis. Med Sci Sports Exerc. 2019 Oct;51(10):1977-1986. doi: 10.1249/MSS.0000000000002010. PMID: 31033900; PMCID: PMC6746593.


10Bartels EM, Juhl CB, Christensen R, Hagen KB, Danneskiold-Samsøe B, Dagfinrud H, Lund H. Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database Syst Rev. 2016 Mar 23;3(3):CD005523. doi: 10.1002/14651858.CD005523.pub3. PMID: 27007113; PMCID: PMC9942938.


11Yvonne M. Golightly , Kelli D. Allen & Dennis J. Caine (2012) A Comprehensive Review of the Effectiveness of Different Exercise Programs for Patients with Osteoarthritis, The Physician and Sportsmedicine, 40:4, 52-65, DOI: 10.3810/psm.2012.11.1988


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13Lucie Brosseau, Lucie Pelland, George Wells, Lynn Macleay, Catherine Lamothe, Guillaume Michaud, Judith Lambert, Vivian Robinson & Peter Tugwell (2004) Efficacy of Aerobic Exercises For Osteoarthritis (part II): A Meta-analysis, Physical Therapy Reviews, 9:3, 125-145, DOI: 10.1179/108331904225005061

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