Low Prevalence of Hip and Knee Arthritis in Active Marathon Runners
PainSci summary of Ponzio 2018?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★★☆?4-star ratings are for bigger/better studies and reviews published in more prestigious journals, with only quibbles. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
In this survey of 675 marathoners, there was no link between current arthritis symptoms and their running history, and they had a lower rate of arthritis than the general population. That is, no matter how much they ran, they had the same low rate of arthritis: about 9%, compared to 18% in non-runners. Obviously this is nice news that challenges the assumption that relentless “pounding” on the road is hard on joints, but for better evidence based on longer-term data, see Lo.
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.
BACKGROUND: Existing evidence on whether marathon running contributes to hip and knee arthritis is inconclusive. Our aim was to describe hip and knee health in active marathon runners, including the prevalence of pain, arthritis, and arthroplasty, and associated risk factors.
METHODS: A hip and knee health survey was distributed internationally to marathon runners. Active marathoners who completed ≥5 marathons and were currently running a minimum of 10 miles per week were included (n = 675). Questions assessed pain, personal and family history of arthritis, surgical history, running volume, personal record time, and current running status. Multivariable analyses identified risk factors for pain and arthritis. Arthritis prevalence in U.S. marathoners was compared with National Center for Health Statistics prevalence estimates for a matched group of the U.S. population.
RESULTS: Marathoners (n = 675) with a mean age of 48 years (range, 18 to 79 years) ran a mean distance of 36 miles weekly (range, 10 to 150 miles weekly) over a mean time of 19 years (range, 3 to 60 years) and completed a mean of 76 marathons (range, 5 to 1,016 marathons). Hip or knee pain was reported by 47%, and arthritis was reported by 8.9% of marathoners. Arthritis prevalence was 8.8% for the subgroup of U.S. marathoners, significantly lower (p < 0.001) than the prevalence in the matched U.S. population (17.9%) and in subgroups stratified by age, sex, body mass index (BMI), and physical activity level (p < 0.001). Seven marathoners continued to run following hip or knee arthroplasty. Age and family and surgical history were independent risk factors for arthritis. There was no significant risk associated with running duration, intensity, mileage, or the number of marathons completed (p> 0.05).
CONCLUSIONS: Age, family history, and surgical history independently predicted an increased risk for hip and knee arthritis in active marathoners, although there was no correlation with running history. In our cohort, the arthritis rate of active marathoners was below that of the general U.S.
POPULATION: Longitudinal follow-up is needed to determine the effects of marathon running on developing future hip and knee arthritis.
LEVEL OF EVIDENCE: Prognostic Level III.
related content
- “High-Field Magnetic Resonance Imaging Assessment of Articular Cartilage Before and After Marathon Running: Does Long-Distance Running Lead to Cartilage Damage?,” an article in American Journal of Sports Medicine, 2010.
- “Effects of running and walking on osteoarthritis and hip replacement risk,” an article in Medicine & Science in Sports & Exercise, 2013.
- “The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis,” an article in Journal of Orthopaedic & Sports Physical Therapy, 2017.
- “Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative,” an article in Clin Rheumatol, 2018.
These two articles on PainScience.com cite Ponzio 2018 as a source:
- PS Is Running on Pavement Risky? — Hard-surface running may be risk factor for running injuries like patellofemoral pain, IT band syndrome, shin splints, and plantar fasciitis
- PS Save Yourself from Patellofemoral Pain Syndrome! — Patellofemoral pain syndrome (aka runner’s knee) explained and discussed in great detail, including every imaginable self-treatment option and all the available scientific evidence
