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recreational runners - corellation of running and osteoarthritis

Running and osteoarthritis of the hip/knee

  |   Health   |   8 Comments

Patients often ask if there is a relationship between running and osteoarthritis of the hip and knee due to the high impact involved; yet, running is an activity that benefits cardiovascular fitness, mood, blood pressure, blood sugar, weight loss, bone density, etc.

Prior studies have linked running to the development of hip and knee arthritis and yet, many others have shown running to have a protective effect on the knees and hips. Research now shows that your risk of developing arthritis as a runner depends on how frequently you run, and with what intensity. It appears that running in moderation is best.

A systematic review and meta-analysis this year looked at 125,810 people in 25 studies and concluded that 3.5% of recreational runners had hip or knee osteoarthritis; individuals who didn’t run at all had a rate of osteoarthritis of 10.2%; professional runners or those that competed at an international level had a rate of 13.3%.1

So there is a relationship between running and osteoarthritis. These findings suggest that high intensity or competitive running increases one’s risk of hip and knee arthritis when compared to recreational running, but then so does a sedentary lifestyle. The authors who found a link between high intensity/volume running and arthritis defined high intensity running as more than 92 km/week. Those that had been running less than 15 years were also less likely to have osteoarthritis. The sedentary individuals were defined as nonrunners but did not control for involvement in other sports, previous injury, BMI, or occupation.

sedentary individual

Sedentary people had a rate of hip/knee osteoarthritis 10.2 percent

recreational runners

Recreational runners had a rate of hip/knee arthritis of 3.5 percent

marathon runners

High volume/intensity runners had a rate of osteoarthritis of 13.3 percent










1. Alentorn-Geli, E., Samuelsson, K., Musahl, V., Green, C. L., Bhandari, M., & Karlsson, J. (2017). The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis. JOSPT, (0), 1-36.

  • ursula ghaleb | Jun 26, 2018 at 10:27 am

    I am diagnosed with mild osteoarthritis in left hip with some cysts
    I used to do half/full marathons and mountain running. I am 65 and really miss the running. would like to know if running up to 10k would make it worse. many thanks

    • Janice | Jun 29, 2018 at 8:29 am

      Hi Ursula, you’re not alone. Evidence of osteoarthritis on xray is present in over 50 % of the population over the age of 65. This jumps to 80% of those over 75 (1).
      Osteoarthritis in the hip results in a mild incongruity of the joint surfaces – usually due to labral wear and tear and other intraarticular changes. Once this happens there is a change in mobility, the shape of the joint surfaces, and changes in the distribution of forces across the joint. All of these changes can cause excessive loading during running which can cause further damage. These mechanical forces as well as others such as weight gain, can accelerate the progression of OA.(1)
      Having said that though, if your case is mild, perhaps you should consult a specialist in your area who could examine the relevant imaging to determine if your anatomy is capable of withstanding the impact of running. Someone needs to assess your running mechanics and identify any technical faults or neuromuscular deficits that could possibly increase loading of the joint. In some individuals, if it is determined that their bony structure can withstand the impact associated with running, stability and neuromuscular timing can be addressed and technique can be modified to reduce hip loading during running.
      1. Arden N, Nevitt CM. Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol. 2006;20:3–25

  • Richard Hoover | Apr 16, 2020 at 2:50 pm

    How much running is safe?

    • Janice | May 4, 2020 at 12:07 pm

      How much running is safe?
      Running appears to have a U-shaped dose-response relationship in terms of hip and knee risk of osteoarthritis. Runners with a long history of high intensity training may have as much risk of OA as non runners; whereas, moderate volume runners have the lowest risk of OA.1
      In terms of managing risk of injury it’s most important to evaluate your ability to manage load. Most running injuries occur when there are training errors, increases in running volume or intensity, inadequate periods of rest, or biomechanical issues. Injury may not manifest until years later, as the body’s ability to compensate for its misgivings starts to fail.
      It’s hard to generalize for all populations In terms of how much is enough. Runners over 50 have different concerns that younger runners. For instance, runners over 50 tend to have issues related to increased stiffness and their ability to absorb load changes.2,3
      As a new runner it may be helpful to identify mechanical problems early. While there are many different styles of running, there are a few biomechanical errors that can be identified that research has shown may increase your risk of injury.

      1. Alentorn-Geli E, Samuelsson K, Musahl V, et al. The association of recreational and competitive running with hip and knee steoarthritis: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2017;47:373–390.
      2. Butler RJ, Crowell HP, Davis IM. Lower extremity stiffness: implications for performance and injury. Clin Biomech. 2003;18: 511–517.
      3. Knobloch K, Yoon U, Vogt PM. Acute and overuse injuries correlated to hours of training in master running athletes. Foot Ankle Int. 2008;29:671–676.

  • Thomas Scott | Jun 29, 2020 at 12:31 pm

    I had some doubts about running with my arthritis knee, but I started jogging and it turned out to be very good for me.

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