Does long distance running cause osteoarthritis in your knees?

I think it’s worth tackling this question on the blog because 1) I do get asked it fairly often and 2) it can serve as an example of how there really are no simple answers when it comes to health.

So… does running cause joint damage in your knees?

Well yes and no.

On the yes side it seems pretty clear that people who have been elite athletes have a much higher frequency of joint surgery/replacement for arthritis in their old age. This study shows that older males who were elite athletes in their younger days had a 60% higher rate of knee replacement and a 150% higher rate of hip replacement than their more sedentary counterparts. So that seems pretty clear. However this study which followed a group of long-distance runners for 18 years and compared them to non-runners over the same time period found no difference in joint degeneration on x-ray. The study authors conclude that “Long-distance running among healthy older individuals was not associated with accelerated radiographic osteoarthritis. These data raise the possibility that severe osteoarthritis may not be more common among runners”. These are just two studies of course but they represent the whole body of this research pretty well. I guess the most logical conclusion is that moderate running is generally fine for your joints but at the very high volumes and intensities of an elite athlete the stress on the joints becomes damaging.

So in order to answer the very straight-forwards question “Does running cause joint damage?” we have to take into account numerous different factors such as training volume and intensity, the athletes weight and body type, running style, body alignment, running surface, previous joint or muscle injuries, genetic susceptibility etc.

I guess the take home message is that- there are no simple answers for lots of our questions. Welcome to the wonderful and complex world of health!

And while I’m at it…

Is a red wine good for you? Yes and no.

Is yoga good for you? Yes and no.

Does stress make you sick? Yes and no.

Doesn’t this all make life too complex? Yes and no.