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Running & Osteoarthritis – Harmful or Helpful?

It is a long-held belief that high intensity activity, particularly running, is directly related with a worsening of osteoarthritis in the knees. As Physiotherapists, we often hear people mention that running ‘wrecked’ their knees and as a result, many people are very reluctant to take up any form of similar high intensity activity or participate in sports due to fear of incurring more ‘damage’. But current research has suggested that a graded, progressive running program may provide a protective effect on the knees, preventing the development and progression of osteoarthritis.

What is osteoarthritis?

Osteoarthritis is a condition that affects many of the large and small joints in our body. Most often, it affects the articular cartilage that covers the ends of the bones making it thin, fragile and prone to damage. It is a very common condition, impacting up to 30% of people between the ages of 50 and 70 years in one or more joints. Commonly affected joints include knees, hips, feet, lumbar spine, neck and hands.

Osteoarthritis is commonly described as ‘wear and tear’ within a joint, however this is incorrect. For a joint to remain healthy, it is important that it undergoes sufficient load bearing activity to keep cartilage healthy, as well as sufficient rest to help the cartilage recover. Where osteoarthritis becomes more likely, is when the load on the cartilage is significantly greater than the rest or deloading, and it is not able to recover sufficiently. This can cause thinning and cracking of the cartilage, which can result in pain. There needs to be a balance between loading and unloading of the cartilage for a joint to be healthy.

What are the risk factors for osteoarthritis?

There are two categories of risk factors related to the development of arthritis; modifiable, or those we can change, and non-modifiable, those we can’t.

Non-modifiable risk factors:

  • Female sex
  • Age
  • Family history of osteoarthritis

Modifiable risk factors:

  • Obesity
  • Muscle weakness
  • Physical inactivity

By focusing on reducing our modifiable risk factors and putting healthy load through a joint, we can work to reduce the development and progression of osteoarthritis.

So how can running be good for knee osteoarthritis?

In a 2017 study in the Journal of Orthopaedic & Sports Physical Therapy, it was found that recreational runners had less chance of developing knee and hip arthritis compared to non-runners or sedentary individuals. It was concluded that running at a recreational level for 15 or more years may be safely recommended and improves overall health as well as having a positive effect on hip and knee joint health. It was also noted that remaining sedentary and foregoing exercise increased the rate of hip and knee arthritis by up to 10% alone when compared with a graded, progressive running program.

It is important that when considering starting or resuming a running program that you increase your distance, pace and frequency of runs gradually to prevent injury and joint overload. Physiotherapists are highly trained in load management and load progression and can assist you in developing a running program to help you meet your running goals, while minimizing the impact to joints, muscles and tendons.


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