A running battle

I spent the weekend at a reunion with some old friends. On the Saturday morning, I rose early to go for a short run. One of my friends expressed concern that, although I may look fit and healthy now, I could pay the price in future with joint problems from running, and that she knew several people who were highly active in their youth, but in later middle-age suffered from arthritis and required joint replacement. People often come to the conclusion that running causes bad knees, after meeting older runners who suffer from knee pain, but another thing that happens during decades of running is ageing - and this will happen whether you run or not! 

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Over a twenty year period, Professor James Fries of Stanford University studied a cohort of 538 runners (aged 50+ at the start of the study) and discovered that the runners developed fewer disabilities, enjoyed a longer span of active life and were half as likely as non-runners to have died during the study period. They had no more arthritis than non-runners. This may seem to defy common sense - surely joints wear out? - but cartilage needs motion and stress to stay healthy. Synovial fluid is stored in cartilage, and when the joint is used, the synovial fluid excretes from the cartilage and delivers nutrients and lubrication to the joint. Furthermore, impacts of 4.2 G or above have been found to strengthen hip bones - this can be achieved by running at a speed of a 10 minute mile (9.6 kph or 6:15 min/km), while slower speeds (more achievable for many people) can maintain existing bone strength.

The small nugget of truth, from which the larger myth has emerged, is that running when you are injured can lead to arthritis, and if you already have osteoarthritis and bone-to-bone contact, running could make it worse. 

Chris Troyanos, certified athletic trainer and the medical coordinator for the Boston Marathon offers some great advice: 

"Inherently, running is good and healthy for most people, but it's a matter of how you get started in it, and it's a matter of slow progression. However, there are body types out there that are not conducive to running. For example, people who are excessive pronators have the inside part of their feet drop inward more than it should when they're running. That causes stress on the feet and knees, so their bodies are naturally not great shock absorbers. People who have hyperextending knees ... are also going to have trouble running. Those who have some of these issues can run, but they may not be able to run more than a mile or two. When you're looking at starting a running program, one you might want to start with a walking program first, then make the leap to an easy running program. As you go through these steps of increasing your activities, it's important to listen to your body. If you are getting knee pain when you go from 5 to 7 miles a day, that could be your threshold for you. If you have any type of existing pain or discomfort in your legs, it's not smart to keep running."

Making sure that you can maintain good running form by taking a holistic approach to your health - maintaining a healthy weight, a strong core, good alignment and flexibility will also help to ensure that you are doing more good than harm when you pound the pavements. And on that note, running on softer surfaces can also help to reduce impact - though watch your footing on natural surfaces!

Listen to your body. If you run and it doesn't cause you joint pain, then you have no need for a nagging doubt that you will regret your choice decades down the line. If you used to run and now you have joint problems, there is no need to blame yourself. If anything, you may congratulate yourself for possibly having delayed their onset.
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