Osteoarthritis and Running - Can They Co-exist

On any given day, the Colorado landscape is spotted with running enthusiasts of all ages and intensities. Running for health-related purposes is one of the best documented exercises to increase cardiovascular and general health as well as weight loss. Despite its health benefits, concern has been raised about whether impact exercise such as running can cause osteoarthritis, primarily in the hip and knee.

What is OA: Commonly referred to as the "wear and tear" arthritis, OA is a degenerative joint disease where the cartilage or cushion between the joint surfaces begins to break down and wear away. Cartilage covers the end of the bones and provides a smooth surface for the joint to glide and provides impact control. In OA, the cartilage breaks down, wears away, and can lead to pain, swelling, and difficulty with joint motion.  In some cases, motion can be restricted, and in other situations, may be increased… initially. For example, think of mortar between two bricks: if the mortar wears away and becomes uneven, motion may feel stiff or limited—conversely, if it wears and becomes too thin, motion my increase as the surfaces are not as congruent. In both instances, you may experience popping, crunching, clicking, with or without pain.

As OA worsens, the bones may develop growths called bone spurs, or parts of the bone or cartilage may chip off, float around in the joint, creating more inflammation, imitation, loss of function. Unfortunately, inflammation can facilitate more degeneration and damage to the cartilage. In the final stages, the cartilage is worn away such that the bone rubs on bone, leading to more dysfunction.

INSIGHT: So, the big question remains: Is running safe and healthy for weight bearing joints?

Let's be clear, in general, studies have demonstrated that previous injury, heavy occupational workload, obesity, and the level of sport participation may play a factor in developing or progressing OA. Contradictory data exists with respect to running, wherein, running was protective in nature to bone health, and others have observed a higher risk of OA. Why? most likely due to the presence of mentioned variables in those studied.

In a more recent study (JOSPT, 2017), along with others, the researchers found that in general, running was not associated with OA in a certain population, however led to an increased association compared with runners of other populations, and variables, and in non-runners.

QUESTION: To Run, or not to Run.

Running is still considered a favorable option for bone, joint, CV and mental health! However, recreational runners have a lower incidence of OA vs competitive/elite runners as well as sedentary people, whom have demonstrated an increased association with OA. The Good news is recreational running shows protective potential on the hip and knee, whereas increased mileage, intensity and years running are shown to aide in progression of OA, and is more present in long distance/elite runners. Of course, controlling all of the other risks involved in these studies related to running are limited.  Alas, recreational running appears to be safe and healthy and somewhat protective.
In summary, running is found to have a beneficial association with runners with less than 15 years of exposure and running at recreational levels. Sedentary people are more subject to OA due to lack of bone and cartilages stimulation.

Like most activity... MODERATION is Key!

PRACTICAL INTERVENTIONS: So, you want to continue running or take it up as a sport for all the health benefits described? Perhaps you are experiencing limitation or want to minimized progression? Wish to continue running long distances?
There are a number of interventions that can keep you in stride: From a functional PHYSICAL THERAPY perspective, our team at Revolution
identify muscular and functional imbalances in strength, flexibility, stabilization, and movement patterns. In addition, a discussion regarding shoe wear, supports, and running techniques is beneficial. Creating balance across the joints acts to unload and disperse forces.

ALTERNATIVE TECHNOLOGIES: Have wear and tear, but not quite ready to consider surgery or cease activity? Cortisone and Hylagan injections are an option to discuss with an Orthopedist. The combination of a good home program and running schedule with injections has proven to be very beneficial.

Of more recent interest and review is Regenerative Medicine, i.e.: Stem Cell implantation. While the research and results are still out there, Stem cell therapy in the appropriate population is gaining favorable outcomes and longevity of function. Dr. Michael Shell, a Regenerative Medicine Specialist quotes: "Stem cell therapy in its various iterations is cutting edge medicine that is transforming patients’ lives by improving quality of life, physical function and reducing pain. There is no question that stem cell therapy will be the standard of care for musculoskeletal pain and other medical conditions in the future.”

Visit Revolution Rehab to Repair, Restore, and Renew to keep you in stride!

Keep it Moving!
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Dr. Allie