Does running increase the risk for osteoarthritis?

NewsBot · Jun 2, 2012

Members do not see these Ads. Sign Up.
Does running cause osteoarthritis in the hip or knee?
Hansen P, English M, Willick SE.
PM R. 2012 May;4(5 Suppl):S117-21.

Running is an excellent activity to promote general health and well-being. However, running injuries are common, and concern is sometimes raised that running might lead to osteoarthritis in weight-bearing joints. This article reviews the relevant in vitro and in vivo literature that looks at possible associations between running and the development of osteoarthritis. Also reviewed is the limited literature on running barefoot and with minimalist footwear. Low- and moderate-volume runners appear to have no more risk of developing osteoarthritis than nonrunners. The existing literature is inconclusive about a possible association between high-volume running and the development of osteoarthritis. The early literature on running barefoot and running with minimalist footwear has primarily focused on biomechanics but has not yet focused on any effect on cartilage health. Experienced and beginner runners should be encouraged to allow the body adequate time to adapt to changes in gait biomechanics caused by changing footwear, which can be done by slowly increasing running mileage in the new footwear. Clinicians can improve the health of runners by encouraging appropriate treatment of musculoskeletal injuries, encouraging maintenance of an optimal body mass index, and correcting gait abnormalities caused by deficits in flexibility, strength, or motor control along the kinetic chain.
Click to expand...

Craig Payne · Jun 2, 2012

Who remembers all the headlines, rhetoric and propaganda on the barefoot running sites that running shoes cause knee osteoarthritis based on a study that was not even on osteoarthritis? It was pointed out at the time if that was the case, then as most runners use running shoes you would expect to see more OA in runners compared to the general population, which every single study has shown that was not the case. Good to see that the research since then continues to confirm it.

Admin2 · Jun 2, 2012

Related threads:
Other threads tagged with osteoarthritis
Barefoot or shock absorbing insole for knee osteoarthritis?

NewsBot · Feb 6, 2013

Effects of Running and Walking on Osteoarthritis and Hip Replacement Risk.
Williams PT.
Med Sci Sports Exerc. 2013 Jan 30.

PURPOSE:
Running and other strenuous sports activities are purported to increase osteoarthritis (OA) risk, more so than walking and less-strenuous activities. Analyses were therefore performed to test whether running, walking, and other exercise affect OA and hip replacement risk, and to assess BMI's role in mediating these relationships.

METHODS:
Proportional hazards analyses of patients' report of having physician-diagnosed OA and hip replacement vs. exercise energy expenditure (metabolic equivalents, METs).

RESULTS:
74,752 runners reported 2004 OA and 259 hip replacements during 7.1-year follow-up, while the 14,625 walkers reported 696 OA and 114 hip replacements over 5.7 years. Compared to running <1.8 METhr/d, the risks for OA and hip replacement decreased: 1) 18.1% (P=0.01) and 35.1% (P=0.03), respectively, for 1.8 to 3.6 METhr/d run; 2) 16.1% (P=0.03) and 50.4% (P=0.002), respectively, for 3.6 to 5.4 METhr/d run; and 3) 15.6% (P=0.02) and 38.5% (P=0.01), respectively, for ≥5.4 METhr/d run, suggesting that the risk reduction mostly occurred by 1.8 METhr/d. Baseline BMI was strongly associated with both OA (5.0% increase per kg/m, P=2x10) and hip replacement risks (9.8% increase per kg/m, P=4.8x10), and adjustment for BMI substantially diminished the risk reduction from running ≥1.8 METhr/d for OA (from 16.5%, P=0.01 to 8.6%, P=0.21) and hip replacement (from 40.4%, P=0.005 to 28.5%, P=0.07). The reductions in OA and hip replacement risk by exceeding 1.8 METhr/d did not differ significantly between runners and walkers. Other (non-running) exercise increased the risk of OA by 2.4% (P=0.009) and hip replacement by 5.0% per METhr/d (P=0.02), independent of BMI.

CONCLUSIONS:
Whereas other exercise increased OA and hip replacement risk, running significantly reduced their risk due, in part, to running's association with lower BMI.
Click to expand...

NewsBot · Aug 29, 2013

Press Release:
Moderate physical activity does not increase risk of knee osteoarthritis

Adults age 45 and older who engaged in moderate physical activity up to two and a half hours a week did not increase their risk of developing knee osteoarthritis over a 6-year follow-up period, a new study finds.

Study participants who engaged in the highest levels of physical activity – up to 5 hours a week – did have a slightly higher risk of knee osteoarthritis, but the difference was not statistically significant.

Those findings taken together are good news, said Joanne Jordan, MD, MPH, senior study author and director of the Thurston Arthritis Research Center in the University of North Carolina School of Medicine.

"This study shows that engaging in physical activity at these levels is not going to put you at a greater risk of knee osteoarthritis," she said. "Furthermore, we found this held true no matter what a person's race, sex or body weight is. There was absolutely no association between these factors and a person's risk."

The corresponding author of the study, published online August 27 by the journal Arthritis Care & Research, is Kamil Barbour, PhD, of the Centers for Disease Control and Prevention (CDC) in Atlanta.

"Moderate physical activities are those that produce some increase in heart rate or breathing, like rapid walking," Barbour said. "Meeting physical activity recommendations through these simple activities are a great way to reduce your risk of heart disease, stroke, high blood pressure, diabetes, and other diseases."

The results are based on an analysis of data collected from 1999 to 2010 as part of UNC's long-running Johnston County Osteoarthritis Project, a prospective, population-based study of knee, hip, hand and spine osteoarthritis and disability in African Americans and Caucasians, aged 45 years and older. This project is funded by the CDC and the National Institute of Arthritis, Musculoskeletal, and Skin Diseases (NIAMS).

This new analysis included data from 1,522 study participants and tested whether or not there was an association between meeting Department of Health and Human Services (HHS) guidelines for 150 minutes of physical activity per week and the development of knee osteoarthritis, as confirmed both by X-rays and the presence of knee pain or other symptoms.

The study's findings support HHS recommendations and concludes that activities such as walking, conditioning exercises and household activities such as gardening or yard work that amount to moderate weekly levels of physical activity should continue to be encouraged.
Click to expand...

NewsBot · Sep 17, 2013

Why Don't Most Runners Get Knee Osteoarthritis? A Case for Per-Unit-Distance Loads
Miller, Ross H.; Edwards, W. Brent; Brandon, Scott C. E.; More
Medicine & Science in Sports & Exercise., POST ACCEPTANCE, 12 September 2013

Peak knee joint contact forces ("loads") in running are much higher than they are in walking, where the peak load has been associated with the initiation and progression of knee osteoarthritis. However, runners do not have an especially high risk of osteoarthritis compared to non-runners. This paradox suggests that running somehow blunts the effect of very high peak joint contact forces, perhaps to provide a load per unit distance traveled (PUD) that is relatively low.

Purpose: To compare peak and PUD knee joint loads between human walking and running.

Methods: Fourteen healthy adults walked and ran at self-selected speeds. Ground reaction force and motion capture data were measured and combined with inverse dynamics and musculoskeletal modeling to estimate the peak knee joint loads, PUD knee joint loads, and the impulse of the knee joint contact force for each gait with a matched-pair (within-subject) design.

Results: The peak load was three times higher in running (8.02 vs. 2.72 bodyweights, p < 0.001) but the PUD load did not differ between running and walking (0.80 vs. 0.75 bodyweights[middle dot]m-1, p = 0.098). The impulse of the joint contact force was greater for running than for walking (1.30 vs. 1.04 bodyweights[middle dot]s, p < 0.001). The peak load increased with increasing running speed, while the PUD load decreased with increasing speed.

Conclusions: Compared to walking, the relatively short duration of ground contact and relatively long length of strides in running seem to blunt the effect of high peak joint loads, such that the PUD loads are no higher than in walking. Waveform features other than or in addition to the peak value should be considered when studying joint loading and injuries.
Click to expand...

NewsBot · Oct 5, 2013

The effect of a six-month training program followed by a marathon run on knee joint cartilage volume and thickness in marathon beginners.
Hinterwimmer S, Feucht MJ, Steinbrech C, Graichen H, von Eisenhart-Rothe R.
Knee Surg Sports Traumatol Arthrosc. 2013 Sep 18.

PURPOSE:
The purpose of this study was to investigate the effect of a 6-month period of intensive running followed by the participation at a marathon run on cartilage volume and thickness in knees of marathon beginners.
METHODS:
Ten asymptomatic marathon beginners underwent a supervised 6-month training program, which was finalized by the participation at a marathon run. Three-dimensional quantitative magnetic resonance imaging was performed before the training program (baseline measurements) and 1 day after the marathon (follow-up measurements). Cartilage volume and thickness of the medial and lateral femur, medial and lateral tibia, and patella were measured using semiautomated cartilage segmentation and three dimensional data postprocessing.
RESULTS:
Significant differences between baseline and follow-up measurements were observed at the lateral femur, where cartilage volume and thickness decreased by a mean of 3.2 ± 3.0 % (p = 0.012) and 1.7 ± 1.6 % (p = 0.010), respectively. No significant changes in cartilage volume and thickness were observed at the medial and lateral tibia, the medial femur, and the patella.
CONCLUSION:
Significant cartilage loss was observed at the lateral femur; however, the measured values are comparable to previously reported precision errors for quantitative cartilage measurement and thus most likely not of clinical relevance. High-impact forces during long-distance running are well tolerated even in marathon beginners and do not lead to clinical relevant cartilage loss
Click to expand...

NewsBot · Nov 16, 2014

Habitual Running Any Time in Life Is Not Detrimental and May be Protective of Symptomatic Knee Osteoarthritis: Data from the Osteoarthritis Initiative.
Grace H. Lo, Jeffrey B. Driban, Andrea Kriska, Kristi Storti, Timothy E. McAlindon, Richard Souza, Charles B. Eaton, Nancy J. Petersen and Maria E. Suarez-Almazor
American College of Rheumatology Conference; Boston 14-19 November 2014

Background/Purpose: Controversy exists regarding whether habitual running is beneﬁcial versus harmful to the knee. Chronic mechanical overloading could potentially physically damage structures within the knee. Alternatively, runners have a lower body mass index (BMI), protective of knee osteoarthritis (OA). Most existing studies evaluating running and knee osteoarthritis (OA) have focused on elite male athletes, not generalizable to most of the population. Therefore, we aimed to evaluate the relationship of habitual running with symptomatic knee OA in the Osteoarthritis Initiative (OAI), a cohort recruited from the community not based on elite running status. Methods: This is a cross-sectional study of OAI participants with knee x-ray readings, symptom assessments, and completed surveys on lifetime physical activity. At the 96-month visit, a modiﬁed version of the Lifetime Physical Activity Questionnaire(LPAQ) asked participants to identify the top 3 most frequently performed physical activities(20 times in life) from ages 12 – 18, 19 – 34, 35 – 49 and 50 years old. Those indicating running as an activity were deﬁned as a runner in that time period. Running at any time in life included runners from all time periods. Posterior-Anterior semi-ﬂexed knee radiographs were obtained at OAI 48-month visit and scored for Kellgren-Lawrence (KL) grade (0–4). Radiographic OA (ROA) was deﬁned as KL 2. Frequent knee pain within a person required at least one knee have frequent knee pain at the OAI 48-month visit. Symptomatic radiographic OA (SOA) required that at least one knee had both ROA and frequent knee pain. Anyone with a total knee replacement was classiﬁed as having SOA. We performed logistic regression analyses where the predictor was running any time in life and running in the speciﬁc age ranges. The outcomes were ROA, frequent knee pain, and SOA; adjusted analyses included covariates age, sex and BMI.
Results: 2439 participants were included, 55% were female, mean age was 64.7(9.0)years and BMI was 28.5(4.9)kg/m2.28% ran at sometime in their lives; of those,49%,31%,15% and 5% identiﬁed running in 1,2,3,and 4 of the time periods respectively. From lowest to highest BMI tertile, 35%, 28%, and 24% were runners at any time in life. For outcomes of frequent knee pain and ROA, the results were similar to that of SOA.
Conclusion: Our ﬁndings suggest an exposure to non-elite running at any time in life is not associated with a higher odds of prevalent ROA, knee pain, and SOA. Those with the lowest BMI were most likely to identify running as a habitual activity. These ﬁndings were observed in a cohort recruited from the community not based on elite running status making these ﬁndings potentially more applicable to a broader population. Non-elite running at any time in life does not appear detrimental, and may be protective of SOA.
Click to expand...

Craig Payne · Nov 17, 2014

NewsBot said: ↑

Habitual Running Any Time in Life Is Not Detrimental and May be Protective of Symptomatic Knee Osteoarthritis: Data from the Osteoarthritis Initiative.
Grace H. Lo, Jeffrey B. Driban, Andrea Kriska, Kristi Storti, Timothy E. McAlindon, Richard Souza, Charles B. Eaton, Nancy J. Petersen and Maria E. Suarez-Almazor
American College of Rheumatology Conference; Boston 14-19 November 2014
Click to expand...

Here is my spin on this study:
http://www.runresearchjunkie.com/running-may-protect-the-knee-from-osteoarthritis/

NewsBot · Jun 16, 2015

Radiographic Abnormalities Common in Senior Athletes With Well-functioning Hips but Not Associated With Osteoarthritis.
Anderson LA, Anderson MB, Kapron A, Aoki SK, Erickson JA, Chrastil J, Grijalva R, Peters C.
Clin Orthop Relat Res. 2015 Jun 9

BACKGROUND:
It is not known whether morphological abnormalities of the hip are compatible with lifelong hip function and avoidance of osteoarthritis (OA). Our purpose was to investigate the prevalence of radiographic findings consistent with femoroacetabular impingement (FAI) and dysplasia (DDH) in senior athletes with well-functioning hips.
QUESTIONS/PURPOSES:
(1) What is the prevalence of FAI and DDH in senior athletes with well-functioning hips? (2) Are radiographic findings of FAI and DDH associated with OA? (3) Is a history of longer duration or more intense activity associated with hip pathomorphology? (4) Were the modified Harris hip scores and the Hip Outcome Scores lower (legacy scales) in patients with evidence of hip pathomorphology than those without?
METHODS:
Five hundred forty-seven individuals (55% men, 45% women; 1081 hips, 534 bilateral and 13 unilateral), mean age 67 years (SD 8 years), gave consent and qualified for this institutional review board-approved cross-sectional study of senior athletes. Hips were independently evaluated for radiographic signs of FAI, DDH, and OA. Additionally, a lifetime activities questionnaire and outcome instruments were used to assess pain and function. Hips that had previously undergone arthroplasty or fracture surgery were excluded.
RESULTS:
Eighty-three percent (898 of 1081) of hips had radiographic abnormalities consistent with FAI, of which 67% (599 of 898) were cam-type FAI. Ten percent (103 of 1081) of hips had radiographic evidence for dysplasia. Radiographic findings of FAI were not predictive of OA after controlling for age and sex (odds ratio [OR], 1.79; 95% confidence interval [CI], 0.48-6.62; p = 0.390). Similarly, radiographic findings of DDH were not predictive of OA (OR, 1.48; 95% CI, 0.31-7.21; p = 0.62). Our data suggest an increased risk of FAI-type morphologies in athletes who participated in competitive sporting events during early adult years (OR, 1.49; 95% CI, 1.04-2.11; p = 0.020). Additionally, participants who reported lifetime participation in competitive sports were at an increased risk of OA compared with those who did not (OR, 1.75; 95% CI, 1.14-2.69; p = 0.007). There were no differences in outcome scores between athletes with and without morphologic abnormalities.
CONCLUSIONS:
Radiographic findings consistent with FAI in these senior athletes were common and were not associated with the presence of OA. These data suggest that the need to screen for asymptomatic young athletes for radiographic evidence of FAI and DDH may not be necessary.
Click to expand...

NewsBot · Jul 29, 2015

Does running protect against knee osteoarthritis? Or promote it? Assessing the current evidence
Richard D Leech, Kim L Edwards, Mark E Batt
Br J Sports Med doi:10.1136/bjsports-2015-094749

NewsBot · Nov 4, 2015

Not running, but:

PUBLIC RELEASE: 4-NOV-2015
Why is osteoarthritis more common among athletes?
UNIVERSITY OF GOTHENBURG

Osteoarthritis and reduced range of motion in the hip and groin are more common among athletes and other people who engage in strenuous physical activity. The cause may be microscopic injuries due to high load on the hips and subsequent joint changes. A PhD thesis at Sahlgrenska Academy studied elite soccer and hockey players.

Research has conclusively shown that back problems are common among athletes and that high loads during childhood and adolescence can lead to growth disorders and spinal injuries. These individuals are also particularly prone to hip and groin problems.

More frequent in athletes

Hip changes that progress to osteoporosis are more frequent in athletes and others who engage in strenuous physical activity.

"We compared 17 elite male soccer players and 15 elite male hockey players with 30 men who did not engage in strenuous physical activity in order to identify frequency of hip problems and radiological changes," says P?ll J?nasson, a researcher at Sahlgrenska Academy "The changes were just as common in both groups, but the athletes were more susceptible to reduced range of motion."

Biomechanical studies

Two biomechanical studies placed high loads on porcine hips under controlled circumstances. The growth zone in the hip turned out to be the weak link.

"Microscopic injuries or fractures developed in and around the growth zone after repeated loading," Mr. J?nasson says. "These kinds of injuries presumably give rise to growth disorders that lead to joint changes and ultimately to osteoarthritis."

New instruments

Although young and middle-aged adults who engage in strenuous physical activity are increasingly afflicted, previous measurement tools had been designed to diagnose indications for hip arthroscopy among the elderly only.

"We have devised two instruments for younger people," Mr. J?nasson says. "A questionnaire adapted to them is now available for use in both clinical practice and future research."

###

Link to thesis: https://gupea.ub.gu.se/handle/2077/39553
Click to expand...

NewsBot · Jul 30, 2016

Not running:

What Is the Association of Elite Sporting Activities With the Development of Hip Osteoarthritis?
Jonathan M. Vigdorchik et al
Am J Sports Med July 29, 2016

Background: Male athletes participating in certain elite sporting activities may be at an increased risk for development of hip osteoarthritis (OA) later in life. However, the strength of the association of participation in sporting activities with the increased risk of hip OA has not been well summarized.
Purpose: To investigate the association of certain high-impact sporting activities with the risk of development of hip OA in elite athletes by conducting a systematic review of the available literature.
Study Design: Systematic review; Level of evidence, 3.
Methods: PubMed, Cochrane, and EMBASE databases were searched to identify all potential studies. Eleven studies met the inclusion criteria, which included participation in elite-level sporting activities, greater than 50% male athletes in the study population, diagnosis of hip OA by radiograph, hospital admission or total hip arthroplasty (THA), and greater than 80% follow-up. Exclusion criteria were recreational sporting activities, primarily female cohorts as there was a dearth of available literature on the topic, and self-reported symptoms without radiographic confirmation of diagnosis. Most studies were with European athletes, where elite-level was defined as involvement in national- or professional-level competition.
Results: Participation across elite-level impact sports was associated with increased risk of development of hip OA when compared with matched controls (odds ratio, 1.8-8.7). Twelve of 15 studies reviewed demonstrated an odds ratio of 1.8 or greater of developing hip OA in elite-level athletes. Handball was associated with the highest rate of OA of any sport, nearly 5 times that of matched controls. Soccer players demonstrated between 2 and 9 times increased risk of hip OA as defined by radiography or THA. Hockey players demonstrated 2 to 3 times increased risk of hip OA (THA or hospital admission). Five studies investigating the association of competitive long-distance running with hip OA demonstrated inconsistent results.
Conclusion: Currently available literature suggests that male athletes participating in elite impact sports (soccer, handball, track and field, or hockey) are at an increased risk of developing hip OA, while those participating in high-level long-distance running do not have a clearly elevated risk. Further research is warranted to elucidate the pathomechanics of development of hip OA in these patients.
Click to expand...

NewsBot · Aug 13, 2016

Running and Knee Osteoarthritis
A Systematic Review and Meta-analysis
Kate A. Timmins et al
Am J Sports Med August 12, 2016

Background: Osteoarthritis (OA) is a chronic condition characterized by pain, impaired function, and reduced quality of life. A number of risk factors for knee OA have been identified, such as obesity, occupation, and injury. The association between knee OA and physical activity or particular sports such as running is less clear. Previous reviews, and the evidence that informs them, present contradictory or inconclusive findings.
Purpose: This systematic review aimed to determine the association between running and the development of knee OA.
Study Design: Systematic review and meta-analysis.
Methods: Four electronic databases were searched, along with citations in eligible articles and reviews and the contents of recent journal issues. Two reviewers independently screened the titles and abstracts using prespecified eligibility criteria. Full-text articles were also independently assessed for eligibility. Eligible studies were those in which running or running-related sports (eg, triathlon or orienteering) were assessed as a risk factor for the onset or progression of knee OA in adults. Relevant outcomes included (1) diagnosis of knee OA, (2) radiographic markers of knee OA, (3) knee joint surgery for OA, (4) knee pain, and (5) knee-associated disability. Risk of bias was judged by use of the Newcastle-Ottawa scale. A random-effects meta-analysis was performed with case-control studies investigating arthroplasty.
Results: After de-duplication, the search returned 1322 records. Of these, 153 full-text articles were assessed; 25 were eligible, describing 15 studies: 11 cohort (6 retrospective) and 4 case-control studies. Findings of studies with a diagnostic OA outcome were mixed. Some radiographic differences were observed in runners, but only at baseline within some subgroups. Meta-analysis suggested a protective effect of running against surgery due to OA: pooled odds ratio 0.46 (95% CI, 0.30-0.71). The I2 was 0% (95% CI, 0%-73%). Evidence relating to symptomatic outcomes was sparse and inconclusive.
Conclusion: With this evidence, it is not possible to determine the role of running in knee OA. Moderate- to low-quality evidence suggests no association with OA diagnosis, a positive association with OA diagnosis, and a negative association with knee OA surgery. Conflicting results may reflect methodological heterogeneity. More evidence from well-designed, prospective studies is needed to clarify the contradictions.
Click to expand...

NewsBot · Oct 24, 2016

Running decreases knee intra-articular cytokine and cartilage oligomeric matrix concentrations: a pilot study
Hyldahl, R.D., Evans, A., Kwon, S. et al.
Eur J Appl Physiol (2016). doi:10.1007/s00421-016-3474-z

Introduction
Regular exercise protects against degenerative joint disorders, yet the mechanisms that underlie these benefits are poorly understood. Chronic, low-grade inflammation is widely implicated in the onset and progression of degenerative joint disease.

Purpose
To examine the effect of running on knee intra-articular and circulating markers of inflammation and cartilage turnover in healthy men and women.

Methods
Six recreational runners completed a running (30 min) and control (unloaded for 30 min) session in a counterbalanced order. Synovial fluid (SF) and serum samples were taken before and after each session. Cytokine concentration was measured in SF and serum using a multiplexed cytokine magnetic bead array. Ground reaction forces were measured during the run.

Results
There were no changes in serum or SF cytokine concentration in the control condition. The cytokine GM-CSF decreased from 10.7 ± 9.8 to 6.2 ± 5.9 pg/ml pre- to post-run (p = 0.03). IL-15 showed a trend for decreasing concentration pre- (6.7 ± 7.5 pg/ml) to post-run (4.3 ± 2.7 pg/ml) (p = 0.06). Changes in IL-15 concentration negatively correlated with the mean number of foot strikes during the run (r2 = 0.67; p = 0.047). The control condition induced a decrease in serum COMP and an increase in SF COMP, while conversely the run induced an increase in serum COMP and a decrease in SF COMP. Changes in serum and SF COMP pre- to post-intervention were inversely correlated (r2 = 0.47; p = 0.01).

Conclusions
Running appears to decrease knee intra-articular pro-inflammatory cytokine concentration and facilitates the movement of COMP from the joint space to the serum.
Click to expand...

NewsBot · Nov 17, 2016

Distance running did not increase risk for arthritis in marathon runners

NewsBot · Dec 9, 2016

NewsBot said: ↑

Running decreases knee intra-articular cytokine and cartilage oligomeric matrix concentrations: a pilot study
Hyldahl, R.D., Evans, A., Kwon, S. et al.
Eur J Appl Physiol (2016). doi:10.1007/s00421-016-3474-z
Click to expand...

Press Release re above study:
Study: Running actually lowers inflammation in knee joints
Running may also slow the process that leads to osteoarthritis

We all know that running causes a bit of inflammation and soreness, and that’s just the price you pay for cardiovascular health. You know; no pain, no gain.
Well, maybe not. New research from BYU exercise science professors finds that pro-inflammatory molecules actually go down in the knee joint after running.
In other words, it appears running can reduce joint inflammation.
“It flies in the face of intuition,” said study coauthor Matt Seeley, associate professor of exercise science at BYU. “This idea that long-distance running is bad for your knees might be a myth.”
In a study recently published in the European Journal of Applied Physiology, Seeley and a group of BYU colleagues, as well as Dr. Eric Robinson from Intermountain Healthcare, measured inflammation markers in the knee joint fluid of several healthy men and women aged 18–35, both before and after running.
The researchers found that the specific markers they were looking for in the extracted synovial fluid—two cytokines named GM-CSF and IL-15—decreased in concentration in the subjects after 30 minutes of running. When the same fluids were extracted before and after a non-running condition, the inflammation markers stayed at similar levels.
“What we now know is that for young, healthy individuals, exercise creates an anti-inflammatory environment that may be beneficial in terms of long-term joint health,” said study lead author Robert Hyldahl, BYU assistant professor of exercise science.
Hyldahl said the study results indicate running is chondroprotective, which means exercise may help delay the onset of joint degenerative diseases such as osteoarthritis.
This is potentially great news, since osteoarthritis—the painful disease where cartilage at the end of bones wears down and gradually worsens over time—affects about 27 million people in the United States.
“This study does not indicate that distance runners are any more likely to get osteoarthritis than any other person,” Seeley said. “Instead, this study suggests exercise can be a type of medicine.”
Researchers, which included then undergraduate (and now grad student) Alyssa Evans and PhD student Sunku Kwon, now plan to turn their attention to study subjects with previous knee injuries. Specifically, they’re looking to do similar tests on people who have suffered ACL injuries.
BYU professors Sarah Ridge and Ty Hopkins were also coauthors on the study.
Click to expand...

NewsBot · Feb 2, 2017

Joint Loading in Runners Does Not Initiate Knee Osteoarthritis.
Miller, Ross H.
Exercise & Sport Sciences Reviews: January 31, 2017

Runners do not have a greater prevalence of knee osteoarthritis (OA) than non-runners. The hypothesis that joint loads in running do not cause OA is forwarded. Two mechanisms are proposed: 1) cumulative load, which is surprisingly low in running, is more important for OA risk than peak load, and 2) running conditions cartilage to withstand the mechanical stresses of running
Click to expand...

.

NewsBot · Mar 18, 2017

Joint Loading in Runners Does Not Initiate Knee Osteoarthritis
Miller, Ross H.
Exercise & Sport Sciences Reviews: April 2017 - Volume 45 - Issue 2 - p 87–95

Key Points
* Runners do not have a high risk of developing knee osteoarthritis despite placing high loads on their knees on a frequent basis.
* One potential mechanism for this phenomenon is that whereas the peak load per stride in running is quite high, the average load accumulated per stride is surprisingly low (similar to walking).
* Due to the viscoelastic nature of cartilage, the internal strains induced by high peak loads in running also are relatively low because of the high loading rates involved.
* Another potential mechanism is that living cartilage in a healthy state adapts (i.e., becomes conditioned) to withstand the greatest stress it frequently sustains.
Click to expand...

NewsBot · May 14, 2017

The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-Analysis
Eduard Alentorn-Geli et al
J Orthop Sports Phys Ther, Epub 13 May 2017.

Study Design
Systematic review and meta-analysis.

Background
Running is a healthy and popular activity worldwide, but data regarding its association with osteoarthritis (OA) are conflicting.

Objectives
To evaluate the association of hip and knee OA with running and to explore the influence of running intensity on this association.

Methods
PubMed, EMBASE and Cochrane Library databases were used to identify studies investigating the occurrence of OA of the hip and/or knee among runners. Studies comparing this occurrence between runners and controls (sedentary, non-running individuals) were meta-analyzed. Runners were regarded as ‘competitive’ if they were reported as professionals/elite athletes, or participated in International competitions. Recreational runners were individuals running in a non-professional (amateur) manner. The prevalence and odds ratio (95% CI) for OA between runners (at competitive and recreational level) and controls were calculated. Subgroup analyses were conducted for OA location (hip or knee), gender and years of exposure to running (less or more than 15 years).

Results
Twenty-four studies (n=123,173 individuals) were included and 16 (n=112,192 individuals) were meta-analyzed. The overall prevalence (95% CI) of hip and knee OA was 13.3% (11.62-15.2) in competitive runners, 3.5% (3.38-3.63) in recreational runners and 10.23% (9.89-10.58) in controls. The odds ratio (95% CI) for hip and/or knee OA between recreational runners and controls was 0.66 (0.57-0.76). The odds ratio (95% CI) for hip and/or knee OA in competitive runners was higher than that in recreational runners (OR (95% CI) 1.34 (0.97-1.86) and 0.66 (0.57-0.76) respectively (controls as reference group); p=0.0001).

Conclusions
Recreational runners had a lower occurrence of OA compared with competitive runners and controls. These results indicated that a more sedentary lifestyle or long exposure to high-volume and/or high-intensity running are both associated with hip and/or knee OA. However, it was not possible to determine whether these associations are causative or confounded by other risk factors, such as previous injury.
Click to expand...

NewsBot · Jun 2, 2017

PUBLIC RELEASE: 2-JUN-2017
Recreational running benefits hip and knee joint health
Recreational runners are less likely to experience knee and hip osteoarthritis compared to sedentary individuals and competitive runners, according to a new study published in the June issue of the Journal of Orthopaedic & Sports Physical Therapy® (JOSPT®).

The study concludes that running at a recreational level for up to 15 years--and possibly more--may be safely recommended as a general health exercise. Further, the evidence suggests recreational running may have benefits for hip and knee joint health.

An international team of researchers in Spain, Sweden, the United States, and Canada aimed to evaluate the association of hip and knee osteoarthritis with running and to explore the influence of running intensity and years of exposure on that association. They found in their systematic review of several studies investigating the relationship between running and arthritis of these weight-bearing joints that only 3.5% of recreational runners developed hip or knee arthritis. This was true for both male and female runners.

Their findings further indicate that remaining sedentary and forgoing running for exercise was associated with a rate of knee and hip arthritis of 10.2%, while training and running competitively increases the incidence of arthritis in these joints to 13.3%. The study's authors note that other researchers who have also found a link between high-volume and high-intensity runners and knee and hip arthritis define exercise at this level as running more than 57 miles (92 km) per week.

"The principal finding in this study is that, in general, running is not associated with osteoarthritis," says lead author Eduard Alentorn-Geli, MD, MSc, PhD, with Fundación García-Cugat; Artroscopia GC, Hospital Quirón; and Mutualidad Catalana de Futbolistas-Delegación Cataluña, Federación Española de Fútbol in Barcelona, Spain, as well as the Department of Orthopedic Surgery, Mayo Clinic in Rochester, MN. He adds that "the novel finding in our investigation is the increased association between running and arthritis in competitive, but not in recreational, runners."

Dr. Alentorn-Geli and his fellow researchers used PubMed, Embase, and Cochrane Library databases to identify studies investigating the occurrence of osteoarthritis of the hip and/or knee among runners. They reviewed 25 studies that included 125,810 people, and ultimately selected 17 studies involving a total of 114,829 people.

The study's authors then conducted a meta-analysis of studies, comparing this occurrence between runners and sedentary individuals who did not run. Runners were considered "competitive" if they were identified themselves as professional/elite athletes or participated in international competitions. Recreational runners were those individuals who ran in a nonprofessional, or amateur, context.

The researchers calculated the prevalence rate and odds ratio (with 95% confidence interval [CI]) for osteoarthritis between runners at both competitive and recreational levels and sedentary individuals. They also performed subgroup analyses for arthritis location (hip or knee), gender, and years of exposure to running (less or more than 15 years).

Dr. Alentorn-Geli and his colleagues were not able to determine the amount of running that is safe for these joints. The study's authors also caution that they did not assess the impact of obesity, occupational workload, or prior injury on the future risk of hip and knee arthritis in runners.

###

The study is titled "The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis." Co-authors on the paper are Kristian Samuelsson, MD, MSc, PhD and Jón Karlsson, MD, PhD, Department of Orthopaedic Surgery, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden; Volker Musahl, MD, PhD, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA; Cynthia L. Green, PhD, Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC; and Mohit Bhandari, MD, PhD, Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada. The research report's full citation is: J Orthop Sports Phys Ther 2017;47(6): 373-390. Epub May 13, 2017. doi:10.2519/jospt.2017.7137.

No institutional review board approval was needed for this study, and no funding was received. The authors certified that they have no affiliations with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the article.

For more information, please contact Dr Alentorn-Geli at ealentorngeli@gmail.com, or JOSPT Editor-in-Chief J. Haxby Abbott, DPT, PhD, FNZCP, at haxby.abbott@otago.ac.nz.

NewsBot · Jun 28, 2017

Is Participation in Certain Sports Associated With Knee Osteoarthritis? A Systematic Review.
Jeffrey B. Driban, Jennifer M. Hootman, Michael R. Sitler, Kyle P. Harris, and Nicole M. Cattano
Journal of Athletic Training: June 2017, Vol. 52, No. 6, pp. 497-506.

Objective: Information regarding the relative risks of developing knee osteoarthritis (OA) as a result of sport participation is critical for shaping public health messages and for informing knee-OA prevention strategies. The purpose of this systematic review was to investigate the association between participation in specific sports and knee OA.

Data Sources: We completed a systematic literature search in September 2012 using 6 bibliographic databases (PubMed; Ovid MEDLINE; Journals@Ovid; American College of Physicians Journal Club; Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Review, Database of Abstracts of Reviews of Effects; and Ovid HealthStar), manual searches (4 journals), and reference lists (56 articles).

Study Selection: Studies were included if they met the following 4 criteria: (1) an aim was to investigate an association between sport participation and knee OA; (2) the outcome measure was radiographic knee OA, clinical knee OA, total knee replacement, self-reported diagnosis of knee OA, or placement on a waiting list for a total knee replacement; (3) the study design was case control or cohort; and (4) the study was written in English. Articles were excluded if the study population had an underlying condition other than knee OA.

Data Extraction: One investigator extracted data (eg, group descriptions, knee OA prevalence, source of nonexposed controls).

Data Synthesis: The overall knee-OA prevalence in sport participants (n = 3759) was 7.7%, compared with 7.3% among nonexposed controls (referent group n = 4730, odds ratio [OR] = 1.1). Specific sports with a significantly higher prevalence of knee OA were soccer (OR = 3.5), elite-level long-distance running (OR = 3.3), competitive weight lifting (OR = 6.9), and wrestling (OR = 3.8). Elite-sport (soccer or orienteering) and nonelite-sport (soccer or American football) participants without a history of knee injury had a greater prevalence of knee OA than nonexposed participants.

Conclusions: Participants in soccer (elite and nonelite), elite-level long-distance running, competitive weight lifting, and wrestling had an increased prevalence of knee OA and should be targeted for risk-reduction strategies.
Click to expand...

NewsBot · Oct 24, 2017

Editorial:
Running causes knee osteoarthritis: myth or misunderstanding
Br J Sports Med Published Online First: 24 October 2017. doi: 10.1136/bjsports-2017-098227

NewsBot · Jan 24, 2018

Low Prevalence of Hip and Knee Arthritis in Active Marathon Runners.
Ponzio DY et al
J Bone Joint Surg Am. 2018 Jan 17;100(2):131-137. doi: 10.2106/JBJS.16.01071.

BACKGROUND:
Existing evidence on whether marathon running contributes to hip and knee arthritis is inconclusive. Our aim was to describe hip and knee health in active marathon runners, including the prevalence of pain, arthritis, and arthroplasty, and associated risk factors.

METHODS:
A hip and knee health survey was distributed internationally to marathon runners. Active marathoners who completed ≥5 marathons and were currently running a minimum of 10 miles per week were included (n = 675). Questions assessed pain, personal and family history of arthritis, surgical history, running volume, personal record time, and current running status. Multivariable analyses identified risk factors for pain and arthritis. Arthritis prevalence in U.S. marathoners was compared with National Center for Health Statistics prevalence estimates for a matched group of the U.S.

POPULATION:

RESULTS:
Marathoners (n = 675) with a mean age of 48 years (range, 18 to 79 years) ran a mean distance of 36 miles weekly (range, 10 to 150 miles weekly) over a mean time of 19 years (range, 3 to 60 years) and completed a mean of 76 marathons (range, 5 to 1,016 marathons). Hip or knee pain was reported by 47%, and arthritis was reported by 8.9% of marathoners. Arthritis prevalence was 8.8% for the subgroup of U.S. marathoners, significantly lower (p < 0.001) than the prevalence in the matched U.S. population (17.9%) and in subgroups stratified by age, sex, body mass index (BMI), and physical activity level (p < 0.001). Seven marathoners continued to run following hip or knee arthroplasty. Age and family and surgical history were independent risk factors for arthritis. There was no significant risk associated with running duration, intensity, mileage, or the number of marathons completed (p > 0.05).

CONCLUSIONS:
Age, family history, and surgical history independently predicted an increased risk for hip and knee arthritis in active marathoners, although there was no correlation with running history. In our cohort, the arthritis rate of active marathoners was below that of the general U.S.

POPULATION:
Longitudinal follow-up is needed to determine the effects of marathon running on developing future hip and knee arthritis.

LEVEL OF EVIDENCE:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Click to expand...

NewsBot · May 8, 2018

Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative
Grace H. Lo et al
Clinical Rheumatology: 04 May 2018

Higher levels of moderate to vigorous physical activity improve all-cause mortality and cardiovascular events. However, the effect of running, a moderate to vigorous activity, in those with knee osteoarthritis (OA), a common arthritis that occurs with aging, a high-risk group for mortality and cardiovascular events, is unclear. Therefore, we aimed to evaluate the association of self-selected running on OA symptom and structure progression in people with knee OA. This nested cohort study within the Osteoarthritis Initiative (OAI) (2004–2014) included those at least 50 years old with OA in at least one knee. Runners were defined using a self-administered questionnaire at the 96-month visit. At baseline and 48-months, symptoms were assessed and radiographs were scored for Kellgren-Lawrence (KL) grade (2–4) and medial Joint Space Narrowing (JSN) score (0–3). We evaluated the association of self-selected running with outcomes: KL worsening, medial JSN worsening, new knee pain, and improved knee pain over 48 months, adjusting for baseline age, sex, body mass index (BMI), KL score, contralateral KL score, contralateral knee pain, and injury. If data were not available at the 48-month visit, then they were imputed from the 36-month visit. One thousand two hundred three participants had a mean age of 63.2 (7.9) years, BMI of 29.5 (4.6) kg/m2, 45.3% male, and 11.5% runners. Data from 8% of participants required imputation. Adjusted odds ratios for KL grade worsening and new frequent knee pain were 0.9 (0.6–1.3) and 0.9 (0.6–1.6) respectively. Adjusted odds ratio for frequent knee pain resolution was 1.7 (1.0–2.8). Among individuals 50 years old and older with knee OA, self-selected running is associated with improved knee pain and not with worsening knee pain or radiographically defined structural progression. Therefore, self-selected running, which is likely influenced by knee symptoms and may result in lower intensity and shorter duration sessions of exercise, need not be discouraged in people with knee OA.
Click to expand...

NewsBot · Jun 4, 2018

Perception about Running and Knee Joint Health
among the Public and Healthcare Practitioners
Jean-Francois Esculier, Natasha M. Krowchuk, Linda L. Li, Jack
E. Taunton, FACSM, Michael A. Hunt.
Presented at ACSM Mtg, 2018

PURPOSE: There is conflicting evidence surrounding the effect of running on knee
joint health, particularly as it relates to knee osteoarthritis (KOA). The perception
about running and knee joint health could affect choices of activities, but remains
undocumented in the population. Given the uncertainty in the literature, the objective
of this study was to evaluate the perception of the public and healthcare practitioners
(HCP) with respect to running and KOA.
METHODS: A total of 397 public respondents (mean age=53.1 years, 163 females;
79 non-runners [NRUN]; 318 runners [RUN]) and 176 HCP (mean age=39.2 years, 68
females) completed an online cross-sectional survey. The survey included multiplechoice
questions about perceptions of running as it relates to knee joint health, and
about the appropriateness of maintaining running by individuals with KOA. The
HCP subgroup was also asked about clinical recommendations to runners with KOA.
Proportions (agree, uncertain, disagree) were compared between subgroups using
chi-squared tests.
RESULTS: In general, 11% of respondents perceived running as detrimental for
knee joint health (NRUN=43.0%, RUN=5.0%, HCP=6.3%; p<0.001) while 21.1%
were uncertain. Frequent running was perceived as a risk factor for KOA by 6.3%
of respondents (NRUN=24.1%, RUN=2.2%, HCP=5.7%; p<0.001) and 26.5% were
uncertain. Running long distances (marathons, ultra-marathons) was perceived by
15.5% as a risk factor (NRUN=32.9%, RUN=9.1%, HCP=19.3%; p<0.001), but
38.7% were uncertain. As for continuation of running in the presence of KOA, 14.7%
of respondents agreed that it would lead to greater cartilage damage (NRUN=40.5%,
RUN=10.2%, HCP=11.1%; p<0.001). However, 31.3% were uncertain about the
appropriateness of running in the absence of symptoms (NRUN=34.2%, RUN=38.7%,
HCP=16.4%; p<0.001). The subgroup of HCP reported having recommended to 76.1%
and 30.7% of runners with KOA to modify training parameters and to quit running,
respectively.
CONCLUSION: These results suggest that many non-runners perceive running
as detrimental to knee joint health. High rates of uncertainty warrant further
studies to guide the population and HCP about the appropriateness of running for
individuals with KOA, as it may influence choices of physical activity and clinical
recommendations.
Click to expand...

NewsBot · Jun 8, 2019

Running Dose and Risk of Developing Lower-Extremity Osteoarthritis
Gessel, Trevor, MD; Harrast, Mark A., MD
Current Sports Medicine Reports: June 2019 - Volume 18 - Issue 6 - p 201–209

Whether or not running leads to the development of knee and hip osteoarthritis has been a much-debated topic and is often a question patients pose to their physicians. Recent literature adds to a growing body of evidence suggesting that lower-dose running may be protective against the development of osteoarthritis, whereas higher-dose running may increase one's risk of developing lower-extremity osteoarthritis. However, running dose remains challenging to define, leading to difficulty in providing firm recommendations to patients regarding the degree of running which may be safe. Furthermore, when counseling patients regarding their risk of developing lower-extremity osteoarthritis secondary to running, clinicians must consider many additional factors, such as the numerous health benefits from running and individual risk factors for developing osteoarthritis.
Click to expand...

NewsBot · Aug 24, 2019

Cartilage recovery in runners with and without knee osteoarthritis: A pilot study
Jean-FrancoisEsculieraMichaelJarrettbNatasha M.KrowchukaAlexanderRauschercdeVanessaWiggermanncdeJack E.TauntonfDavid R.WilsonghAnthony A.GattiijMichael A.Hunta
The Knee; 18 August 2019

Objective
Running is an easy way of meeting physical activity recommendations for individuals with knee osteoarthritis (KOA); however, it remains unknown how their cartilage reacts to running. The objective of this pilot study was to compare the effects of 30 min of running on T2 and T1ρ relaxation times of tibiofemoral cartilage in female runners with and without KOA.

Methods
Ten female runners with symptomatic KOA (mean age 52.6 ± 7.6 years) and 10 without KOA (mean age 52.5 ± 7.8 years) ran for 30 min on a treadmill. Tibiofemoral cartilage T2 and T1ρ relaxation times were measured using magnetic resonance imaging prior to and immediately after the bout of running. Repeated-measures analyses of covariance (ANCOVA) were conducted to examine between-group differences across scanning times.

Results
No Group × Time interactions were found for T2 (P ≥ 0.076) or T1ρ (P ≥ 0.288) relaxation times. However, runners with KOA showed increased T2 values compared with pre-running in the medial and lateral femur 55 min post-running (5.4 to 5.5%, P < 0.022) and in all four tibiofemoral compartments 90 min post-running (6.9 to 11.1%, P < 0.01). A significant group effect was found for T1ρ in the medial femur, with greater values in those with KOA compared with controls.

Conclusion
While Group × Time interactions in T2 and T1ρ relaxation times remained statistically insignificant, the observed significant increases in T2 in runners with tibiofemoral osteoarthritis TFOA may suggest slower and continuing changes in the cartilage and thus a need for longer recovery after running. Future research should investigate the effects of repeated exposure to running.
Click to expand...

NewsBot · Nov 26, 2019

Can marathon running improve knee damage of middle-aged adults? A prospective cohort study
Laura Maria Horga et al
BMJ Open Sport & Exercise Medicine 2019;5:e000586

Objectives To evaluate the short-term impact of long-distance running on knee joints using MRI.

Methods 82 healthy adults participating in their first marathon underwent 3T (Tesla) MRI of both knees 6 months before and half a month after the marathon: 71 completed both the 4 month-long standardised training programme and the marathon; and 11 dropped-out during training and did not run the marathon. Two senior musculoskeletal radiologists graded the internal knee structures using validated scoring systems. Participants completed Knee Injury and Osteoarthritis Outcome Score questionnaires at each visit for self-reporting knee function.

Results Premarathon and pretraining MRI showed signs of damage, without symptoms, to several knee structures in the majority of the 82 middle-aged volunteers. However, after the marathon, MRI showed a reduction in the radiological score of damage in: subchondral bone marrow oedema in the condyles of the tibia (p=0.011) and femur (p=0.082). MRI did also show an increase in radiological scores to the following structures: cartilage of the lateral patella (p=0.0005); semimembranosus tendon (p=0.016); iliotibial band (p<0.0001) and the prepatellar bursa (p=0.016).

Conclusion Improvement to damaged subchondral bone of the tibial and femoral condyles was found following the marathon in novice runners, as well as worsening of the patella cartilage although asymptomatic. This is the most robust evidence to link marathon running with knee joint health and provides important information for those seeking to understand the link between long distance running and osteoarthritis of the main weight-bearing areas of the knee.
Click to expand...

NewsBot · Dec 25, 2019

Magnetic Resonance Imaging Findings of Knees and Spines in Recreational Runners who Completed 1000 Marathons
Hyechang Rhim, Young Ha Kim, Myung Gyu Kim, Ki-Mo Jang, Seung Woo Suh
Cureus 11(12): e6382. doi:10.7759/cureus.6382

Introduction
Marathon running is a popular recreational activity, but the effects of chronic running on the knee or other joints remain unclear. The purpose of this article was to evaluate any degenerative changes in the knees and spines of recreational runners who completed at least 1000 marathons.

Methods
Recreational runners who completed at least 1000 marathons were recruited. Magnetic resonance imaging (MRI) of both knees and spines of six such runners was performed with a 1.5 T MR scanner. The anatomical structures of the knee joint including meniscus, bone marrow, cartilage, ligaments, and joint effusion were examined along with other abnormalities. Spinal alignment, degenerative change in intervertebral disc, intervertebral disc herniation, osteoarthritis in facet joint, degenerative anterior/lateral spur, and other abnormalities were evaluated.

Results
In terms of knee joints, one runner showed degeneration at the meniscus, while three runners had cartilage lesions. However, none of the six runners showed radiologic evidence of knee osteoarthritis. All six runners demonstrated degenerative changes in intervertebral spinal discs.

Conclusions
Running 1000 marathons may not have a harmful effect on the knee joints and may not result in osteoarthritis. However, it is unclear whether degenerative changes in the spine are derived from running or aging.
Click to expand...

Dr Rich Blake · Dec 26, 2019

NewsBot said: ↑

Does running cause osteoarthritis in the hip or knee?
Hansen P, English M, Willick SE.
PM R. 2012 May;4(5 Suppl):S117-21.
Click to expand...

Some patients have bad joints (apples) Some patients are runners (oranges). Rich
PS Runners should not run through injuries!

NewsBot · May 7, 2020

IMPACT LOADS DURING WALKING AND RISK OF KNEE PAIN: THE
MOST STUDY
K. Gross et al
Osteoarthritis and Cartilage 28 (2020) S86eS527

Purpose: Studies of runners indicate that an increased rate of vertical
loading during the initial contact phase of gait is associated with an
increased risk of running-related knee pain, a finding that has prompted
testing of specialized shoes and gait retraining interventions to reduce
injury risk. Comparable studies are lacking in non-running populations
that are at-risk for OA-related knee pain. Studies comparing loading
rates across different individuals are challenged by the need to control
for confounding by between-person differences in age, sex, body mass,
race, and in particular, footwear and walking velocity. By comparing
loading rates across the left and right legs within an individual, a
within-subject case-control study remains unconfounded by these
factors.
Methods: The Multicenter Osteoarthritis Study (MOST) includes middle-aged and older adults living in or around Iowa City, Iowa or Birmingham, Alabama that have or are at risk of knee OA. Measurements of
impact loading were acquired at the 144-month clinic exam, which
served as baseline for these analyses. Participants walked at a selfselected velocity over an embedded force plate (1000 Hz) during 2-4
trials each for the left and right legs. For each knee, a mean was
recorded for 3 parameters related to impact loading. Peak Impact Force
(PIF) is the peak vertical load (N) during the first half of stance following
initial ground contact. Average Loading Rate (ALR) is the average rate of
loading (N/sec) during the period between initial contact and PIF.
Maximum Instantaneous Loading Rate (MILR) is the maximum slope of
the loading curve during the period between initial contact and PIF. For
each variable (PIF, ALR, MILR), we carried out an analysis comparing the
distribution among case knees to the distribution among control knees.
A case of incident frequent knee pain was a knee with no frequent pain
at baseline but reported to have “pain, aching, or stiffness on most days”
during at least 2 of 3 follow-up interviews (8, 16, and 24 mos. after
baseline). A case of worsening pain severity was a knee that had a nonzero WOMAC pain score (> 1 / 20) at baseline followed by an increase of
> 2 points (corresponding to the MCID) during at least 2 of the subsequent follow-up interviews. To carry out our within-subject casecontrol study, we selected participants who had left and right knees
that were discordant for the targeted knee pain outcome. Paired t-tests
made crude comparisons of mean PIF, ALR, and MILR at baseline across
the case and control knees contributed by each participant. Using a
standardized beta coefficient and adjusting for baseline differences in
WOMAC pain score, separate conditional logistic regression models
estimated the relative odds of frequent or worsening knee pain for each
standard deviation increase in baseline PIF, ALR, or MILR exposure.
Results: 98 subjects had knees that were discordant for incident frequent knee pain by 24 months (mean þ/- sd age 64.9 þ/- 10.2 yrs, BMI
29.0 þ/- 5.2 kg/m2; 57.1% female, 85.7% white, 51.7% in Iowa). 118
subjects had knees that were discordant for worsening pain severity
(mean þ/- sd age 64.0 þ/- 10.0 yrs, BMI 30.6 þ/- 5.8 kg/m2; 58.5%
female, 83.9% white, 62.7% in Iowa). Although mean PIF and ALR did not
differ significantly (p> 0.05) in crude comparisons of cases with
incident frequent knee pain to controls (851.9 þ/- 179.8 vs. 857.8 þ/-
176.8 N and 4305.9 þ/- 1138.2 vs. 4372.5 þ/- 1075.5 N/sec, respectively),
mean MILR at baseline was significantly reduced (p¼ 0.03) in the case
knees (13080.6 þ/- 3796.7 vs. 13614.1 þ/- 3878.0 N/sec). This association did not persist after adjustments were made for baseline differences in WOMAC pain severity score (standardized OR¼ 0.56; 95% CI:
0.25, 1.24). WOMAC pain severity at baseline was significantly greater
(p< 0.001) among the case knees (3.09 þ/- 2.81 vs. 1.61 þ/- 2.06 points).
When comparing cases of worsening knee pain severity to controls,
there were no significant differences (p> 0.05) in mean PIF, ALR, or MILR
at baseline, and no associations between any of these loading parameters and the relative odds of worsening knee pain severity by 24
months (standardized OR¼ 0.50; 95% CI: 0.14, 1.80; OR¼ 1.04; 95% CI:
0.61, 1.80; and OR¼ 1.40; 95% CI: 0.87, 2.26).
Conclusions: These findings fail to confirm the hypothesized longitudinal association between increased impact loading rates during
walking and increased 2-year risk of incident frequent knee pain or
worsening knee pain severity. The data do suggest, however, that persons with infrequent knee pain at baseline may alter their gait in such a
way as to reduce the maximal impact loading rate for their more painful
knee.
Click to expand...

NewsBot · Aug 12, 2020

Medial knee cartilage is unlikely to withstand a lifetime of running without positive adaptation: a theoretical biomechanical model of failure phenomena.
Miller RH, Krupenevich RL. 2020.
Source

Runners on average do not have a high risk of developing knee osteoarthritis, even though running places very high loads on the knee joint. Here we used gait analysis, musculoskeletal modeling, and a discrete-element model of knee contact mechanics to estimate strains of the medial knee cartilage in walking and running in 22 young adults (age 23 ± 3 years). A phenomenological model of cartilage damage, repair, and adaptation in response to these strains then estimated the failure probability of the medial knee cartilage over an adult lifespan (age 23–83 years) for 6 km/day of walking vs. walking and running 3 km/day each. With no running, by age 55 the cumulative probability of medial knee cartilage failure averaged 36% without repair and 13% with repair, similar to reports on incidence of knee osteoarthritis in non-obese adults with no knee injuries, but the probability for running was very high without repair or adaptation (98%) and remained high after including repair (95%). Adaptation of the cartilage compressive modulus, cartilage thickness, and the tibiofemoral bone congruence in response to running (+1.15 standard deviations of their baseline values) was necessary for the failure probability of walking and running 3 km/day each to equal the failure probability of walking 6 km/day. The model results suggest two conclusions for further testing: (i) unlike previous findings on the load per unit distance, damage per unit distance on the medial knee cartilage is greater in running vs. walking, refuting the “cumulative load” hypothesis for long-term joint health; (ii) medial knee cartilage is unlikely to withstand a lifetime of mechanical loading from running without a natural adaptation process, supporting the “cartilage conditioning” hypothesis for long-term joint health.
Click to expand...

NewsBot · Oct 14, 2020

Why Don't Runners' Knees Fail More Often?

NewsBot · Jun 9, 2021

Daily cumulative load and body mass index alter knee cartilage response to running in women
Elora C.Brenneman WilsonaAnthony A.GattibcPeter J.KeiraMonica R.Malyacd
Gait & Posture Volume 88, July 2021, Pages 192-197

Highlights
•Low joint loading with high daily steps explained less tibial volume change after running.
•Low BMI with high daily steps explained less tibial volume change after running.
•Our findings suggest a role of cumulative load in tibial cartilage conditioning.
Click to expand...

Background
It is unknown whether a greater accumulation of knee load over a typical day is related to how cartilage responds to an acute bout of loading. This information may clarify the role of habitual activity on cartilage function.

Research Question
Is there a relationship between change in tibial and femoral cartilage thickness, volume, and T2 relaxation time following running with daily cumulative knee load in women? Secondarily, is there a relationship between cartilage change following running and the statistical interaction of body mass index (BMI) and daily steps?

Methods
Participants (n = 15) completed gait analyses and wore an accelerometer over a week. Daily cumulative knee load was the statistical interaction between tibial compressive joint reaction force (JRF) impulse with the average number of daily steps measured using accelerometry. Magnetic resonance imaging scans were acquired before and immediately after 15-min of treadmill running. Changes in tibial and femoral cartilage thickness, volume, and T2 relaxation time were calculated. Multiple linear regressions tested the associations of cartilage change outcomes with: baseline (thickness, volume, T2), JRF impulse, steps, and the interaction JRF impulse*steps. Secondarily, BMI was substituted for JRF impulse.

Results and Significance
Tibial volume change was explained by baseline volume, JRF impulse, steps, and JRF impulse*steps (R2 = 0.50, p = 0.013). Additionally, tibial volume change was explained by baseline volume, BMI, steps, and BMI*steps (R2 = 0.43, p = 0.002). Those who were more physically active with lower JRF impulse (or lower BMI) showed less change in tibial cartilage after a running exposure. This may suggest cartilage conditioning.
Click to expand...

NewsBot · Jun 21, 2021

Association of Sports Participation With Osteoarthritis: A Systematic Review and Meta-Analysis
Thomas Bestwick-Stevenson, MRes, Onosi S. Ifesemen, MPH, Richard G. Pearson, PhD, ...
Orthopaedic Journal of Sports Medicine June 14, 2021

Background:
The association between participating in sport and osteoarthritis is not fully understood.

Purpose:
To investigate the association between osteoarthritis and participating in sports not listed in previous reviews: American football, archery, baseball, bobsleigh, curling, handball, ice hockey, shooting, skeleton, speed skating, and wrestling.

Study Design:
Systematic review; Level of evidence, 3.

Methods:
We searched 4 electronic databases and hand searched recent/in-press editions of relevant journals. The criteria for study selection were case-control studies, cohort studies, nested case-control studies, and randomized trials with a control group that included adults to examine the effect of exposure to any of the included sports on the development of osteoarthritis.

Results:
The search returned 6197 articles after deduplication. Nine studies were included in the final review, covering hip, knee, and ankle osteoarthritis. There were no studies covering archery, baseball, skeleton, speed skating, or curling. The 6 sports included in the review were analyzed as a collective; the results of the meta-analysis indicated that participation in the sports analyzed was associated with an increased risk of developing osteoarthritis of the hip (relative risk [RR] = 1.67 [95% confidence interval (CI), 1.15-2.41]; P = .04), knee (RR = 1.60 [95% CI, 1.23-2.08]; P < .001), and ankle (RR = 7.08 [95% CI, 1.24-40.51]; P = .03) as compared with controls. Meta-analysis suggested a significantly increased likelihood of developing hip osteoarthritis through participating in wrestling (RR = 1.78 [95% CI, 1.20-2.64]; P = .004) and ice hockey (RR = 1.70 [95% CI, 1.27-2.29]; P < .001), while there was no significant difference through participating in handball (RR = 2.50 [95% CI, 0.85-7.36]; P = .10). Likelihood of developing knee osteoarthritis was significantly increased in wrestling (RR = 2.22 [95% CI, 1.59-3.11]) and ice hockey (RR = 1.52 [95% CI, 1.18-1.96]; both P < .002). According to the meta-analysis, shooting did not have a significant effect on the RR of knee osteoarthritis as compared with other sports (RR = 0.43 [95% CI, 0.06-2.99]; P = .39).

Conclusion:
The likelihood of developing hip and knee osteoarthritis was increased for ice hockey and wrestling athletes, and the risk of developing hip osteoarthritis was increased for handball athletes. The study also found that participation in the sports examined, as a collective, resulted in an increased risk of developing hip, knee, and ankle osteoarthritis.
Click to expand...

NewsBot · Sep 5, 2021

The Influence of Running on Lower Limb Cartilage: A Systematic Review and Meta-analysis
Michaela C. M. Khan, James O’Donovan, Jesse M. Charlton, Jean-Sébastien Roy, Michael A. Hunt & Jean-Francois Esculier
Sports Medicine (2021)

Background
Running is a popular activity practiced worldwide. It is important to understand how running affects joint health to provide recommendations to sports medicine practitioners and runners.

Objective
Our aim was to summarize the influence of running on lower limb cartilage morphology and composition using quantitative magnetic resonance imaging (MRI).

Methods
Prospective repeated-measures studies evaluating cartilage using MRI before and after running were included. Data sources included Pubmed, Embase, CINAHL, SportDiscus, Web of Science, and Cochrane Central Registry of Controlled Trials. Qualitative analyses considered the number and methodological quality ratings of studies based on the QualSyst tool, and recommendations were based on the strength of evidence (strong, moderate, limited, or very limited). Quantitative analysis involved meta-analyses, for which effect sizes were calculated as Hedge’s g standardized mean differences.

Results
We included 43 articles, assessing seven outcomes (lesions, volume, thickness, glycosaminoglycan content, and T1ρ, T2, and T2* relaxation times). Nineteen articles were rated as high quality, 24 were rated as moderate quality, and none were rated as low quality. Qualitative analyses suggest that running may cause an immediate reduction in knee cartilage volume, thickness, as well as T1ρ and T2 relaxation times immediately; however, these changes did not persist. Meta-analyses revealed a small and moderate decrease immediately following a single running bout in T2 relaxation time in the medial femur and tibia, respectively. Qualitative analyses indicated that the influence of repeated exposure to running on cartilage morphology and composition was limited. Despite conflicting evidence regarding pre-existing knee cartilage lesions, moderate evidence suggests that running does not lead to the formation of new lesions. Repeated running exposure did not cause changes to foot and ankle cartilage thickness or composition.

Conclusions
Changes to lower limb cartilage following running are transient. Immediate changes to cartilage morphology and composition, which likely reflect natural fluid dynamics, do not persist and were generally not significant when pooled statistically. Results suggest that cartilage recovers well from a single running bout and adapts to repeated exposure. Given that moderate evidence indicates that running does not lead to new lesions, future trials should focus on clinical populations, such as those with osteoarthritis.
Click to expand...

NewsBot · Sep 22, 2021

Running kinetics and femoral trochlea cartilage characteristics in recreational and collegiate distance runners
Peter K. Mitchell,Tyler J. Moffit,Melissa M. Montgomery &Derek N. Pamukoff
Journal of Sports Sciences: 08 Sep 2021

Recreational running can benefit knee cartilage, but the relationship between competitive running and knee cartilage is unclear. We compared femoral cartilage between collegiate runners, recreational runners, and controls; and evaluated the association between running amount, running kinetics and femoral cartilage characteristics. Thirty collegiate runners, 30 recreational runners, and 30 controls completed ultrasound imaging of the femoral cartilage and running gait analysis. Outcomes included cartilage thickness, and echo-intensity from the medial and lateral femoral condyles; and the peak external knee flexion (KFM) and knee adduction moments. Cartilage outcomes were compared via one-way MANOVA. The associations between running kinetics, running amount, and femoral cartilage characteristics were assessed via linear regression models adjusted for sex. No differences were found in cartilage outcomes between groups (p = 0.067). Among recreational runners, a larger peak KFM was associated with lower medial femoral cartilage echo-intensity (ΔR2 = 0.176, Δp = 0.014). In collegiate runners, a greater self-reported running amount was associated with higher medial femoral cartilage (ΔR2 = 0.117, Δp = 0.046) and lateral cartilage (ΔR2 = 0.121, Δp = 0.042) echo-intensity. Cartilage did not differ between groups, but the association between running kinetics, running amount, and knee cartilage may vary between collegiate and recreational runners.
Click to expand...

NewsBot · Feb 2, 2022

Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative
Grace H. Lo, Sarra M. Musa, Jeffrey B. Driban, Andrea M. Kriska, Timothy E. McAlindon, Richard B. Souza, Nancy J. Petersen, Kristi L. Storti, Charles B. Eaton, Marc C. Hochberg, Rebecca D. Jackson, C. Kent Kwoh, Michael C. Nevitt & Maria E. Suarez-Almazor
Clinical Rheumatology volume 37, pages2497–2504 (2018)

Higher levels of moderate to vigorous physical activity improve all-cause mortality and cardiovascular events. However, the effect of running, a moderate to vigorous activity, in those with knee osteoarthritis (OA), a common arthritis that occurs with aging, a high-risk group for mortality and cardiovascular events, is unclear. Therefore, we aimed to evaluate the association of self-selected running on OA symptom and structure progression in people with knee OA. This nested cohort study within the Osteoarthritis Initiative (OAI) (2004–2014) included those at least 50 years old with OA in at least one knee. Runners were defined using a self-administered questionnaire at the 96-month visit. At baseline and 48-months, symptoms were assessed and radiographs were scored for Kellgren-Lawrence (KL) grade (2–4) and medial Joint Space Narrowing (JSN) score (0–3). We evaluated the association of self-selected running with outcomes: KL worsening, medial JSN worsening, new knee pain, and improved knee pain over 48 months, adjusting for baseline age, sex, body mass index (BMI), KL score, contralateral KL score, contralateral knee pain, and injury. If data were not available at the 48-month visit, then they were imputed from the 36-month visit. One thousand two hundred three participants had a mean age of 63.2 (7.9) years, BMI of 29.5 (4.6) kg/m2, 45.3% male, and 11.5% runners. Data from 8% of participants required imputation. Adjusted odds ratios for KL grade worsening and new frequent knee pain were 0.9 (0.6–1.3) and 0.9 (0.6–1.6) respectively. Adjusted odds ratio for frequent knee pain resolution was 1.7 (1.0–2.8). Among individuals 50 years old and older with knee OA, self-selected running is associated with improved knee pain and not with worsening knee pain or radiographically defined structural progression. Therefore, self-selected running, which is likely influenced by knee symptoms and may result in lower intensity and shorter duration sessions of exercise, need not be discouraged in people with knee OA.
Click to expand...

NewsBot · Feb 6, 2022

Running with Bad Knees Might Be OK After All

Does running increase the risk for osteoarthritis?

NewsBot The Admin that posts the news.

Craig Payne Moderator

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Craig Payne Moderator

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Dr Rich Blake Active Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Minimalist Running Does NOT Increase Arch Strength

Years of running does not influence kinematics and kinetics

Superficial plantar cutaneous sensation does not trigger barefoot running adaptations

Tibial rotation in running: does rearfoot adduction matter?

How does the foot leave the ground during running ?

The world's first woolen running shoe that doesn't require socks

Running shoe cushioning does not affect injury rate

Share This Page

Useful Searches