Is it a foregone conclusion, that if you run for years, you
will have arthritis? Many of my patients are concerned that the aches and pains
that are inevitable from distance running are actually harbingers for the
future aches and pains of arthritis. This fear is even strong enough to get
older runners to quit and start a lower impact exercise regimen like swimming
and cycling. Is this a reasonable fear? Yes and No! Running by itself does not
cause arthritis; improper biomechanics coupled with the rigors of running can cause
arthritis.
Consider the stress of running on the joints for a minute.
The foot hits the ground and the bones and joints experience force up to six
times the runner’s body weight at impact. The joints are being asked to move
and glide efficiently and smoothly while enduring this stress. In the event of
a misstep or stumble, the joints need to continue to be stable to maintain
their perfect alignment.
Osteoarthritis, a.k.a. “wear and tear arthritis”, is what
runner’s dread. This is degeneration of the articular cartilage which absorbs
shock, distributes stress and allows the joints to glide smoothly. The ability
to run pain free depends on the health and integrity of this cartilage as we
age. In osteoarthritis, the surface of the cartilage becomes roughened,
fissured and even starts to shred into small fragments. These fragments “float”
around the joint and cause more damage. The bone tries to protect itself by
producing small bony prominences called osteophytes which actually in the end
make the joint damage and pain worse.
Any kind of sports participation can increase the incidence
of osteoarthritis due to increased twisting forces, high impact, muscle
weakness or over-development and joint instability which causes abnormal peak
pressures and greater stress in certain areas of cartilage which can lead to
osteoarthritis. Nevertheless, for normal joints , there is no scientific
evidence that simply the action of running, even over a long period of time,
causes permanent joint damage or even a predisposition for osteoarthritis.
What is the risk of osteoarthritis in runners? Many studies
of long-term runners show no increased incidence of osteoarthritis in these
competitive runners. Some studies did show more evidence of osteophytes, but no
correlation with joint pain or instability. Confusing the issue for many
runners are the numerous incidents of misdiagnosis of repetitive stress
injuries like patella-femoral syndrome as arthritis. This is reversible and
caused by abnormal tracking of the kneecap, which is treated with physical
therapy and orthotics.
Joints are in fact strengthened by activity and damaged by
inactivity. Studies have shown that the articular cartilage actually thins and
becomes more fragile with inactivity, therefore increasing the risk of
arthritis. Joints adapt to the stress of exercise and become stronger and more
able to endure the long term stress of running. Remember the doctor saying to
increase slowly? This is why. Ligaments and muscles, which support the joints,
are strengthened and reinforced by the stresses of the running activity,
improving joint mechanics, if the joints are properly aligned.
Here is the truth about foot biomechanics. Proper
biomechanics during the strengthening process is essential for joint health.
Improper biomechanics can increase the stress on the joints in an abnormal
fashion and actually increase the incidence of osteoarthritis and hasten joint
damage.
Bottom line? Running does not increase the incidence of
osteoarthritis unless the lower extremity biomechanics are faulty. In fact,
almost 75% of Americans over the age of 65 experience some symptoms of
osteoarthritis. This is not increased in runners. In fact, running may actually
help with the symptoms of osteoarthritis.
The benefits associated with long distance running
profoundly overshadow the risk of osteoarthritis. In runners, orthotic devices
to correct their biomechanics early in their training may actually decrease the
stress associated with increased osteoarthritis. If you have joint symptoms,
see a sports medicine podiatrist today and have your gait realigned. Your
joints will thank you. Remember, your feet are meant to carry you for a
lifetime. Don’t let the fear of osteoarthritis rob you of the joy of a lifetime
of distance running!