Is it a foregone conclusion, that if you run for years, you
will have arthritis? Many of my patients are concerned that
the aches and pains that are inevitable from distance
running are actually harbingers for the future aches and
pains of arthritis. This fear is even strong enough to get
older runners to quit and start a lower impact exercise
regimen like swimming and cycling. Is this a reasonable
fear? Yes and No! Running by itself does not cause
arthritis; improper biomechanics coupled with the rigors of
running can cause arthritis.
Consider the stress of running on the joints for a minute.
The foot hits the ground and the bones and joints
experience force up to six times the runner's body weight
at impact. The joints are being asked to move and glide
efficiently and smoothly while enduring this stress. In the
event of a misstep or stumble, the joints need to continue
to be stable to maintain their perfect alignment.
Osteoarthritis, a.k.a. "wear and tear arthritis", is what
runner's dread. This is degeneration of the articular
cartilage which absorbs shock, distributes stress and
allows the joints to glide smoothly. The ability to run
pain free depends on the health and integrity of this
cartilage as we age. In osteoarthritis, the surface of the
cartilage becomes roughened, fissured and even starts to
shred into small fragments. These fragments "float" around
the joint and cause more damage. The bone tries to protect
itself by producing small bony prominences called
osteophytes which actually in the end make the joint damage
and pain worse.
Any kind of sports participation can increase the incidence
of osteoarthritis due to increased twisting forces, high
impact, muscle weakness or over-development and joint
instability which causes abnormal peak pressures and
greater stress in certain areas of cartilage which can lead
to osteoarthritis. Nevertheless, for normal joints , there
is no scientific evidence that simply the action of
running, even over a long period of time, causes permanent
joint damage or even a predisposition for osteoarthritis.
What is the risk of osteoarthritis in runners? Many studies
of long-term runners show no increased incidence of
osteoarthritis in these competitive runners. Some studies
did show more evidence of osteophytes, but no correlation
with joint pain or instability. Confusing the issue for
many runners are the numerous incidents of misdiagnosis of
repetitive stress injuries like patella-femoral syndrome as
arthritis. This is reversible and caused by abnormal
tracking of the kneecap, which is treated with physical
therapy and orthotics.
Joints are in fact strengthened by activity and damaged by
inactivity. Studies have shown that the articular cartilage
actually thins and becomes more fragile with inactivity,
therefore increasing the risk of arthritis. Joints adapt to
the stress of exercise and become stronger and more able to
endure the long term stress of running. Remember the doctor
saying to increase slowly? This is why. Ligaments and
muscles, which support the joints, are strengthened and
reinforced by the stresses of the running activity,
improving joint mechanics, if the joints are properly
aligned.
Here is the truth about foot biomechanics. Proper
biomechanics during the strengthening process is essential
for joint health. Improper biomechanics can increase the
stress on the joints in an abnormal fashion and actually
increase the incidence of osteoarthritis and hasten joint
damage.
Bottom line? Running does not increase the incidence of
osteoarthritis unless the lower extremity biomechanics are
faulty. In fact, almost 75% of Americans over the age of 65
experience some symptoms of osteoarthritis. This is not
increased in runners. In fact, running may actually help
with the symptoms of osteoarthritis.
The benefits associated with long distance running
profoundly overshadow the risk of osteoarthritis. In
runners, orthotic devices to correct their biomechanics
early in their training may actually decrease the stress
associated with increased osteoarthritis. If you have joint
symptoms, see a sports medicine podiatrist today and have
your gait realigned. Your joints will thank you. Remember,
your feet are meant to carry you for a lifetime. Don't let
the fear of osteoarthritis rob you of the joy of a lifetime
of distance running!
----------------------------------------------------
Dr Marybeth Crane is a life-long runner and a sports
medicine podiatrist. For more information on running
injuries or for doctor-approved foot care products, visit
my website or read my blog at http://www.myrundoc.com
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