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For years, the idea that runners get knee arthritis has been widely accepted and spread, leading many to avoid the sport out of fear of developing osteoarthritis (OA) or exacerbating existing joint issues. However, recent research has challenged this belief, revealing that not only is running safe for your knees, but it may also promote knee health, particularly when compared to a sedentary lifestyle. This blog will delve into the evidence supporting the safety of running for knee health, explore how it may improve cartilage health, and discuss the broader health benefits of incorporating running into your routine.
The Origins of the Myth: Running and Knee Osteoarthritis
The notion that running is bad for the knees likely stems from the notion that osteoarthritis is a ‘wear & tear’ condition. However, correlation does not imply causation and we also now know that OA is a multi-system issue. Many early studies that linked running to knee OA were based on populations of elite athletes who engage in high-intensity training and competitive running, often leading to overuse injuries. These studies did not necessarily represent the experiences of recreational runners.
Recent Research: Running and Knee Health
Recent studies have provided compelling evidence that running does not increase the risk of knee osteoarthritis and may actually protect against it. A study published in the American Journal of Preventive Medicine (2017) examined over 2,500 participants and found that recreational runners had a significantly lower prevalence of knee OA compared to sedentary individuals. The study showed that 3.5% of recreational runners developed knee OA, compared to 10.2% of non-runners, suggesting that moderate running may be protective rather than harmful.
Another study published in Arthritis Care & Research (2014) analysed data from nearly 75,000 runners and walkers. The researchers found that runners had a lower risk of developing knee OA and required fewer total knee replacements compared to those who were more sedentary. This finding challenges the belief that the repetitive impact of running is harmful to the knee joints. Instead, it suggests that running might stimulate the maintenance of healthy cartilage, possibly by promoting nutrient flow, cartilage hydration which is important given cartilage is 70% water (Crolla et al, 2022), and reducing inflammation in the joint.
Running and Cartilage Health: The Science Behind the Benefits
Cartilage, the smooth tissue that cushions the ends of bones in joints, is often thought to degrade with repetitive impact. However, running may have the opposite effect. Research published in the European Journal of Applied Physiology (2010) found that moderate running improved cartilage thickness and health. The study concluded that the cyclical loading and unloading of the knee joint during running might stimulate the production of cartilage and increase its resilience.
Furthermore, a study in the Journal of Orthopaedic Research (2016) investigated the effects of long-term running on cartilage in older adults. The results indicated that those who ran consistently over many years had better cartilage health than sedentary individuals of the same age. These findings suggest that the mechanical stimuli provided by running can enhance cartilage repair and slow down the degenerative processes associated with osteoarthritis.
Comparing Sedentary Individuals to Recreational Runners
The evidence also points to a higher rate of osteoarthritis in sedentary populations compared to recreational runners. Sedentary lifestyles are associated with obesity, muscle weakness, metabolic syndrome (systemic low level inflammation), and poor joint health, all of which are risk factors for osteoarthritis. In contrast, running helps maintain a healthy weight, strengthens the muscles around the knee, and promotes overall joint health.
A study published in Medicine & Science in Sports & Exercise (2013) found that individuals who engaged in regular physical activity, including running, had a lower incidence of knee osteoarthritis compared to those who were inactive. The study highlighted the importance of maintaining an active lifestyle to preserve joint health and prevent the onset of degenerative conditions like OA.
The Broader Health Benefits of Running
Beyond its protective effects on knee health, running offers a host of other benefits that contribute to overall well-being.
1. Weight Loss and Maintenance
Running is one of the most effective forms of cardiovascular exercise for burning calories,
making it an excellent choice for weight loss and weight management. Maintaining a healthy weight is crucial for reducing the load on the knees, which in turn helps prevent joint issues, including osteoarthritis. The relationship between body weight and knee health is well-documented; each pound of weight loss can reduce the load on the knee joint by four pounds, according to a study published in Arthritis & Rheumatism (2005).
2. Stress Reduction and Mental Health
Running is also known for its mental health benefits. The release of endorphins during and after a run, often referred to as the "runner's high," can help alleviate stress and improve mood. A study in The Journal of Adolescent Health (2010) found that regular aerobic exercise, including running, was associated with lower levels of anxiety and depression. The rhythmic nature of running also provides a form of meditation, helping individuals manage stress and improve mental clarity.
3. Improved Sleep Quality
Regular physical activity, including running, has been shown to improve sleep quality. A study published in Sleep Medicine Reviews (2012) reviewed the effects of exercise on sleep and found that moderate-intensity aerobic exercise, such as running, can help reduce the time it takes to fall asleep and improve sleep duration and quality. This is particularly beneficial for those who struggle with insomnia or other sleep disorders, as better sleep contributes to overall health and well-being.
Addressing Concerns: Running Safely to Protect Your Knees
While the evidence supports the benefits of running for knee health, it is essential to approach the activity with proper form and precautions to minimise the risk of injury. Running does involve high levels of load through all joints in the lower limb and it is suggested that you have up to eight times body weight through your knee when running so it is important to build up slowly. Here are some tips for running safely:
Start Slowly: If you're new to running, begin with a walk-run program to gradually build up your endurance and strength. This approach reduces the risk of overuse injuries. Couch to 5k could be a nice place to start.
Invest in Good Footwear: Proper running shoes that provide adequate support and
cushioning can help reduce the impact on your knees. Replace shoes regularly to ensure they continue to provide the necessary support.
Strengthen Supporting Muscles: Incorporating strength training exercises that target the muscles around the knee, such as the quadriceps, hamstrings, and calves, can provide additional stability and reduce the risk of injury.
Listen to Your Body: Pay attention to any signs of pain or discomfort in your knees. If you experience persistent pain, consider consulting a healthcare professional or physiotherapist for advice. Load management is paramount when it comes to avoiding injury risk.
Avoid Comparison: We all love recording our runs on Strava and it’s a great community for those who love exercise. But avoid the temptation of comparing yourself to others, and feeling you should be running, further and faster too quickly.
Conclusion: Embrace Running for Better Knee Health
The myth that running is bad for your knees has been debunked by a growing body of research. Far from being harmful, running can actually promote knee health, improve cartilage resilience, and reduce the risk of osteoarthritis, particularly when compared to a sedentary lifestyle. The broader health benefits of running, including weight management, stress reduction, and improved sleep quality, further underscore its value as a form of exercise.
For those concerned about knee health, the key is to run smart. By starting slowly, using proper footwear, listening to your body and incorporating strength training, you can enjoy the many benefits of running while protecting your knees for the long term. So, lace up your running shoes and hit the road with confidence – your knees may thank you for it.
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