This week’s blog post is from Dr. Annie Neurohr. Annie is a physical therapist in Baltimore, MD. She also does a lot of GREAT work with “Back On My Feet.” Back On My Feet is a national organization that combats homelessness through the power of running, community support and essential employment and housing resources. How many times have you been told to stop running because it “damages” joints or causes arthritis? Pull up a chair, Annie is about to debunk some old myths.
I am a runner. I BELIEVE in running.
But honestly, this really doesn’t make me anything special. Lots of people run. Lots of people are runners. Whether it be to lose weight, to get faster, to make a team, to avoid paying for therapy, to avoid paying for parking, to make up for that bottle of wine you crushed while watching the Bachelor, to keep up with your kids, to keep up with your grandkids, to wear out your Jack Russell, to overcome your hangover, to overcome your addiction, or to just get off your ass and do something- whatever the reason, if you run, you are a runner.
But despite the endless reasons to start running or to keep running, we often question our rationale when someone (sometimes a medical professional) tells us to “just stop running”. There are endless misconceptions around America’s most loved and most hated sport so I’m here to help you wade through just some of the bullsh*t that surrounds the sport of running and to disarm what I refer to as The Running Myth.
Running Doesn’t Give you Arthritis. Life Does.
The truth is, arthritis is a process of aging and if you’re lucky enough to live into older age, you’re lucky enough to get some! With that being said, too often I have patients coming to me telling me they were “diagnosed” with osteoarthritis as if it is a death sentence. They fear pain. They fear movement. And they absolutely fear running. But what if I were to tell them that running could be their solution? What if I were to tell you that lacing up those shoes may be one of the best ways to combat the development or progression of osteoarthritis?
The Journal of Orthopedic and Sports Physical Therapy published a somewhat groundbreaking article this year, in which 25 studies were reviewed and 17 analyzed to determine the so-called “link” between hip and knee osteoarthritis (OA) and running. The groundbreaking part…. THERE ISN’T ONE. At least not for most of your average joe runners.
Researchers determined that individuals that run “recreationally” for up to, and possibly more than 15 years actually have a lower prevalence of OA at 3.5% than individuals who are sedentary and don’t run at all at 10.2%. Now here’s a caveat- the same study did show that “competitive” runners did have a higher prevalence at 13.3%1. Let’s dive a little deeper…
So who can we call competitive vs. recreational? Well in this study, competitive runners were classified as professional, elite, or had represented their own countries in international competition. That rules most of us out.
To sum this up, here’s a visual:
There is still some debate about how much is too much running on the body. Distance, frequency, duration, speed- they all play a factor. One study by Konradsen et. al. showed that a median distance of about 13 to 26 miles a week (21-42 km/wk) showed no association with developing hip or knee OA. Elite runners getting up to about 57 weekly miles (92 km/wk), however, did show an increased prevalence for OA2.
Another study showed runners that had in fact developed OA had been running for a significantly longer time, nearly 20 years, compared to runners that had not developed OA who had been running for about 12 years3. Again, many factors to consider, definite room for more investigation, but it’s nice to have some numbers to guide the way we utilize our runs.
So now that we’ve disarmed The Running Myth, let’s talk briefly about how running can actually help decrease our risk of developing arthritis.
Being Overweight Hurts… Literally.
While there isn’t any evidence to prove recreational running causes arthritis there is a substantial amount of evidence that shows a higher Body Mass Index (BMI) does. On average, the risk of developing OA increases by 5% per kg/m2 increase in body mass4. Even scarier, the risk for getting a hip replacement goes up almost 10% with each kg/m2. If your bad with numbers like me, look at the pretty graph to your right.
Here it shows your hazard ratio for developing OA or having a hip replacement steadily climbing as that BMI continues to creep from overweight to obese. So again, pretty simple- if running can keep the pounds off, we lower our risk all the while maintaining the peace of mind that we’re not hurting ourselves!
Running is Good For ME!
Running not only helps decreases body fat, it can also build strength and endurance to help our muscles support our joints. It can lower your resting heart rate, decreasing the regular workload of the cardiovascular system, and it helps to lower cholesterol and triglyceride levels in the blood5. The health benefits are undeniable.
It’s time we stop believing that running is hurting us and start realizing the detrimental effects of what really happens when we “just stop running.”
-Dr. Annie Neurohr, PT, DPT
Rubin Institute of Advanced Orthopedics, Baltimore MD
- Alentorn-Gell, E., Samuelsson, K., Musahl, V., Gree, C., Bhandari, M., Karlsson, J. The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-Analysis. The Journal of Orthopedic and Sports Physical Therapy. 47. Number 6. Pg. 373-390. June 2017.
- Konradsen, L., Hansen, EM., Sondergaard, L. Long Distance Running and Osteothrosis. Am J Sports Med. 1990; 18: 379-38.
- McDermott M., Freyne, P. Osteoarthrosis in runners with knee pain. Br J Sports Med. 1983; 17:84-87.
- Williams, P. Effects of Running and Walking on Osteoarthritis and Hip Replacement Risk. Med Sci Sports Exerc. July 2013. 45 (7): 1292-1297.
- Junior, L., Pillay, J.D., can Mechelen, W., Verghagen, E. Meta-Analysis of the Effects of Habitual Running on Indices of Health in Physically Inactive Adults. Sports Med. 45:1455-1468. 16 July 2015.