Does Running Cause Arthritis?

Even ardent runners wonder if all that pounding won't eventually harm our knees, hips, or back
by Amby Burfoot

 
My 85-year-old Aunt Marian thinks it's pretty cool that I'm a runner. Only problem: She wants me to give it up. The way she sees things, I'm doing fine now, but trouble looms. A few years down the road, I'll probably need a wheelchair. All that pounding and wear and tear; it can't do a body any good. Marian's got her share of aches and pains, and loving auntie that she is, she doesn't want me to end up in even worse shape.

I bet you've got an Aunt Marian in your life, too—a family member, or friend, or coworker who's always tsk-tsking the toll running is taking on your knees, hips and back. You might even be worried yourself. We all know a few onetime runners forced to become swimmers, cyclists, or mall walkers. We wonder: Does the same fate await us?

The logic behind the wear-and-tear scenario can seem convincing. After all, your car eventually breaks down, even if it's a Volvo. Same for your toothbrush, and the foam in your running shoes. You'll need to replace them at some point. You understand that, and you've worked the expense into your budget. Chances are, however, that you're not so keen on the idea of replacing body parts.

The human response

Fortunately, your body is different. It's a biomechanical system, not a mechanical one, and those three little letters make all the difference. Your body is composed of living tissues that are constantly rebuilding themselves. Not only that, but living tissue actually grows stronger when it is used. Use is better than abuse, which includes both sedentary living and running when you're injured, which is why you shouldn't do either.

The strongest evidence that running won't condemn you to a life of pain and arthritis comes from an ongoing study of the Fifty Plus Runners Association. The study was launched in 1984 when all the runners were at least 50, and it has been updated every five years or so. Many of the runners are now in their 60s, 70s and beyond.

The newest update was published last September in Arthritis Research & Therapy, under the title "Aerobic exercise and its impact on musculoskeletal pain in older adults: a 14-year prospective, longitudinal study." It compared the runners, who averaged about 26 miles a week, to a matched set of controls, who averaged about two miles a week. The authors noted that many observers would predict a sad outcome for the aging runners. "If running creates damage through accumulated trauma," they wrote, "then runners with about ten-fold the exposure to such trauma should have increased pain over time."

Yup, that's it all right: the Aunt Marian argument in a nutshell. Only the argument appears to be unfounded, probably for some of the biomechanical reasons I've already mentioned. The study's major conclusion: The runners experienced "about 25 percent less musculoskeletal pain" than the controls.

Dr. Bonnie Bruce, the principal investigator, is a doctor of public health as well as a registered dietitian and a marathoner. I call her to find out why she chose to measure a subjective feeling like pain rather than a more objective, physical one like joint-space narrowing. "Think about it," she says. "When you're in pain, you can't move about the way you'd like, you can't work effectively, and you can't enjoy a good social life. Pain is important, because it affects every aspect of our lives."

Before long, we're discussing the widely held misperception that vigorous exercise, especially running, will inevitably lead to joint problems. Bruce thinks it comes from the way that running has so often been used as punishment. "It was what your gym teacher made you do when you weren't behaving," she says.

It would help immensely if medical investigators could explain why running and other vigorous exercise don't lead to joint pain. Unfortunately, few docs are willing to make this leap, and Bruce certainly isn't one of them. She makes it clear that her research only uncovered pain trends—and not the pathways behind them. She does, however, list some possible explanations: endorphins, fewer muscular injuries and the high pain threshold that runners might develop. An Arthritis Foundation paper called "Exercise and Your Arthritis" offers a more direct answer. "The stronger the muscles and tissues around your joints, the better they will be able to support and protect those joints," it says. "If you don't exercise, your muscles become smaller and weaker."

Joint resolution

It's exciting to find a long-term study that supports the connection between running and good joint health, but I wonder how many other docs and medical organizations are ready to take up the cause. To check up, I call Patience White, M.D., the chief public health officer of the Arthritis Foundation. I tell her about the Fifty Plus runners, and ask if she's surprised by the results. "That study makes complete sense to me," Dr. White says. "People with pain in their joints imagine that runners must have even more pain, but we have lots of good data to show that running doesn't cause arthritis."

She goes on to say that obesity is a major culprit in the onset of arthritis, and that runners do themselves a lot of good simply by keeping the pounds off. Also, "Runners keep their muscles strong and well-balanced, which helps the joints."

Music to my ears. Of course, it will be a long time before we runners convince skeptical friends that we aren't headed for a hellish destiny with pain and arthritis. But keep the faith; the tide is turning. The medical community is slowly coming to accept that running is good for your joints, as well as your heart. And the evidence is growing. This doesn't give you license to pound out long runs while swallowing a handful of ibuprofen. But regular, moderate, pain-free running? Get out there and enjoy it, no matter what your auntie says.

Run away pain

As we age, we naturally experience more aches and pains. However, a long-term study of runners over 50 showed that the runners had a smaller pain increase than a nonrunning control group. The women runners benefited the most.

Percent Pain Increase Age 60-80

Female Runners 11.8%	Female Control 70.6%
Male Runners 17.6%	Male Control 41.4%

http://health.msn.com/centers/arthritis/articlepage.aspx?cp-documentid=100124262

Well, I will not be doing any running any time really soon, however I find a good brisk walk several times a week makes a huge difference overall in levels of pain & discomfort.  There also seems to be a correlation between oxygen levels in the body & symptoms, so the findings make sense to me plus the increased endorphin levels.   RM