Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative
Three pages on PainSci cite Lo 2018: 1. Guide to Repetitive Strain Injuries 2. How do you slow down the progression of arthritis? 3. Exercise is anti-inflammatory medicine for injuries (Member Post)
PainSci notes on Lo 2018:
This study looked at the relationship between running and arthritis in 1200 aging runners with at least some arthritis, selected from the Osteoarthritis Initiative (a 10-year study of about 5000 arthritis patients). No data is ever perfect or complete, and Lo et al. had to fill in the blanks (imputation) for 8% of the runners. The runners-with-arthritis were divided into groups who got worse or better signs or symptoms over two years, adjusting for factors like age, weight, and sex.
They did not get worse. In fact, the runners — normal people, mostly just a bunch of aging amateur athletes who consider themselves runners — actually had less pain than the non-runners, and the state of their joints (on x-ray) were stable. Conclusion:
self-selected running is associated with improved knee pain and not with worsening knee pain or radiographically defined structural progression.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
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.
related content
- “High-Field Magnetic Resonance Imaging Assessment of Articular Cartilage Before and After Marathon Running: Does Long-Distance Running Lead to Cartilage Damage?,” Luke et al, American Journal of Sports Medicine, 2010.
- “Effects of running and walking on osteoarthritis and hip replacement risk,” Williams, Medicine & Science in Sports & Exercise, 2013.
- “Is physical activity, practiced as recommended for health benefit, a risk factor for osteoarthritis?,” Lefèvre-Colau et al, Annals of Physical and Rehabilitation Medicine, 2016.
- “The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis,” Alentorn-Geli et al, Journal of Orthopaedic & Sports Physical Therapy, 2017.
- “Low Prevalence of Hip and Knee Arthritis in Active Marathon Runners,” Ponzio et al, Journal of Bone & Joint Surgery, 2018.
- “Walking, running, and recreational sports for knee osteoarthritis: An overview of the evidence,” Voinier et al, Eur J Rheumatol, 2022.
- “Comparative efficacy of exercise therapy and oral non-steroidal anti-inflammatory drugs and paracetamol for knee or hip osteoarthritis: a network meta-analysis of randomised controlled trials,” Weng et al, British Journal of Sports Medicine, 2023.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
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- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.