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So Does Running cause Arthritis?

Added: 01 January 1970

So Does Running cause Arthritis?

One of the things I’ve noticed working with people is that a lot of us have very similar assumptions about our bodies. I’m not saying any of these are right or wrong but I would like to share some with you.

I find it amazing how many of us believe that no pain no gain is true. Conversely most people feel that all aches and pains are cured by rest. Many people think that the only way to improve fitness is to exercise for longer. A lot of people think stretching is a good idea. Everyone, well, everyone’s Mum believes that clicking your knuckles is bad.

Most of us think the way our body looks and feels is purely down to what we eat and how often we exercise. Most people think that eating too much makes you fat and the only way to lose weight is to not eat. Most people think ‘5-a-day’ is a scientific fact.

However of all the assumptions and questions that I come across, the most interesting and common to running is the belief that running causes arthritis.

At this point I’m fairly sure that most of you have already agreed with or refuted this statement. Personally, I find it a very interesting concept. The body, particularly the skeletal system, is designed as a vehicle so that the brain can explore and interact with its environment. In order to do this over time the skeletal system has developed the means to repair and remodel itself. So why would running, our most dynamic and fastest method of exploring our surroundings cause it to break down?

The answer in short is that it doesn’t but kind of does in the same context. Given the right environment a large proportion of the things that go wrong with the musculoskeletal system are fixable and correctable. Bone is a living tissue that remodels to demand and strain. There is a constant balance between laying down new bone and bone resorption.

For those of you who like stats, the rate of bone activity, repair and resorption increases for 36hours after exercise. With the most strenuous levels of stimulus this process can take as long as 6weeks to match. The problems start when this cycle is regularly disturbed, and the consequence is arthritis.

To make sure we’re all on the same page, there are obviously many different types of arthritis. Some forms of arthritis are autoimmune and inflammatory in nature and are primarily due to what genes your parents passed on, the toxins you encounter and the influence of your environment. These forms of arthritis are not your fault and are definitely not related to how many miles you run per week.

Osteoarthritis is a bit different to this. It is the type of arthritis that your Grandmother had in her knobbly knees and fingers from years of gardening and knitting. It causes stiff swollen joints particularly if you’ve over done it the day before. It is also often worse when its damp and cold outside, first thing in the morning and when the weather changes.

Osteoarthritis is caused by a chronic imbalance between joint damage and joint repair. In simplistic terms this means a joint is overworked beyond what it is comfortable doing and consistently doesn’t get enough time to recover afterwards. If the natural repair cycle becomes unbalanced over time the joint surface will begin to break down. In response to chronic overload extra calcium deposits will be put down and little blighters called Osteophytes form. These cause sharper pain and further swelling and damage to the opposing tissues and so round and round we go in a progressive loop.

A real life example would be a runner who increases her running distance from 10miles to 15miles. She may notice an aching in her knee or ankle towards the end of the run and it may feel stiff and achey for a few days afterwards. It may even swell slightly. She decides the way to help this is to get things moving and do another run. This would be a definite case of overload and does not allow the joint enough time to restore its natural cycle.

The most at risk joints for runners are predictably the knees, hips, lower back and ankles. There are plenty of factors which increase your chances of developing Osteoarthritis. As with most things, unfortunately women are more susceptible than men. Unsurprisingly those with a greater body mass and who have a more sedentary lifestyle are also more at risk. Ethnic background seems to make a difference as the incidence rate is higher in Caucasians. Bone density impairments such as osteoporosis and osteopenia also increase your chances. 

Biomechanically those with higher foot arches aka supinated feet,  “knock knees” and those with significant leg length discrepancy’s are more at risk. Muscle weakness particular of the quadriceps and gluteal muscles contributes to increasing joint load.

However the biggest risk factor for developing osteoarthritis is a previous joint injury particularly a cartilage or significant ligament injury or a dislocation. The terms meniscus and ACL will be familiar to some people, and chances are that if you’ve heard of it then you’ve experienced it. In this case the news isn’t very good as the damage to the weight bearing surfaces, the loss of shock absorbency and the altered joint mechanics cause early wear.

Additionally a large proportion of these injuries require surgery. Surgery is sometimes unavoidable but one of the down sides is that joints are oxygen free for a reason. Oxygen is corrosive to hyaline cartilage and if it enters the joint during the procedure then it can enhance the degenerative process.

But that’s all the scare mongering out of the way, lets talk about prevention. It would seem that to give your joints the best chance of avoiding osteoarthritis, it is vital to not increase the joint load again for at least 36hours after exercise. However if you could draw this out to 48hours other structures such as tendons can also settle down.

But, I hear you shout, “What about my Recovery Run”. Active recovery sessions within 24hours of heavy exercise have been proven as the most effective method of recovering after exercise. However, to recover from overloading your body by further loading it in the same way you overloaded it in the first place is questionable considering what we have discussed. Substituting the road for a bike, a pool, a yoga session would be much more sensible and kinder to any temperamental joints you may have. 

The theme of controlling the things you can control is important, so other important points in preventing osteoarthritis are to keep your legs strong. Don’t just run, change up your sessions with body weight leg strengthening exercises, cycling or cross trainer drills. Keep your weight down and diet loaded with plenty of fish oils, alkaline or pH neutral foods. Wearing cushioned footwear or insoles isn’t a bad idea either.

But most importantly avoid significant joint injury, or if you’ve had one already then increase your rest periods and precautionary measures. If you are concerned about your joints there are certain signs and symptoms to look out for. Swelling, stiffness, pain, heat, and loss of movement are strong indicators that a joint is struggling to cope. If this is the case then I would strongly advise you get it checked out.

And finally…if you’re really worried about osteoarthritis don’t become a professional sports person. The incidence rates of osteoarthritis are infinitely higher in professional sports people. One of the most worrying stats I’ve ever read is that 90% of rugby players have at least one arthritic joint that leads to replacement by the age of 40.

But the message still remains a positive one. Running with restraint and common sense does not cause osteoarthritis. In fact an American study at Stanhope University looked at the relationship between activity and joint pain. They found that 1/3 of people who jogged regularly went on to develop arthritis after they turned 60. However, in the non-jogging group, 50% of the people had developed arthritis by the same age. 

So with all that said and done….Lets Go Running. Just not everyday.

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