Running Myths and Facts for Knee Health
You’ve probably heard the saying, “Running is bad for your knees.” It’s a widespread belief, but it’s not true. In fact, running can be beneficial for your knees and overall health. To understand why, let’s start with a quick lesson about cartilage.
Cartilage is a firm, flexible type of connective tissue that cushions the bones of the knee and other joints. Cartilage doesn’t have any nerves or a blood supply. So, if you run a lot and repeatedly stress the cartilage, doctors believed it simply broke down.
But that’s not what clinical studies found. Researchers went through 43 MRI studies to determine how running affected cartilage. They discovered that running caused a “small and moderate decrease” in knee cartilage volume, but the effect was short-lived. “Repeated running exposure did not cause changes to foot and ankle cartilage thickness or composition.”
Walking and running are precisely the actions required for cartilage to heal. When you take a step, your joints compress and squeeze the cartilage like a sponge. That pushes the waste product out and draws in nutrient and oxygen-rich fluid. Take a step, squish out the bad and pull in the good.
When someone abruptly stops running or walking, they may be making things worse because the cartilage will no longer be squeezed. This prevents waste products from being pushed out, and it no longer draws in nutrients to heal.
So, running doesn’t destroy cartilage; what about arthritis?
Doctors used to advise people with arthritis to avoid exercise in the mistaken belief that exercise could further damage the joints and make the situation worse. That’s false.
At the Institute for Behavioral Research in The Netherlands, patients with arthritis admitted to the hospital because of a disease activity were randomly assigned to one of two groups. One group received three weeks of intensive exercise therapy when discharged, while the other was given “usual care” when they left the hospital.
They found that the group with intensive exercise therapy had a “better quality of life at lower costs after one year.” And that was with only three weeks of exercise. Hundreds of studies have come to the same conclusion. Exercise improves muscle function in people with arthritis and does not affect disease activity.
Arthritic individuals tend to avoid exercise because they’re afraid it will hurt. Unfortunately, they’re right for the first couple of weeks. Anyone who begins any exercise program will experience some muscle pains and discomfort when they start. However, after the first few weeks, a regular exercise program helps reduce long-term arthritic pain and suffering.
How much running is healthy?
Dr. James O’Keefe Jr. examined the running habits of over 50,000 adults to understand the effects of training on longevity. The doctor found that people who ran between 1 and 20 miles a week were nearly 20% less likely to die prematurely than non-exercisers. This finding was expected.
The surprise came with those running more than 20 miles a week. Their risk of premature death was similar to those who didn’t exercise at all, indicating that excessive running could negate the benefits of exercise.
Doctors found that the strain of a marathon can cause inflammation and damage to the right ventricle of the heart. Fortunately, this damage usually heals after 90 days of moderate activity.
The problem arises with runners who compete in multiple marathons a year and don’t allow their bodies enough time to heal fully.
Another potential issue is the high sugar intake of endurance athletes. Consuming large amounts of sugar to sustain energy may speed up aging, as seen in lab studies on worms and yeasts. This could potentially reduce lifespan by up to 20%.
Running a marathon is a remarkable achievement, but doing it too often might harm your health. Keep the total distance you run under 20 miles a week for best results.
So here’s what we know: Running builds up the muscles around your knees, providing better support and reducing the strain on your joints. It can also help you shed some extra pounds, easing the load on your joints. Running also improves the range of motion and function of your knees.
Running isn’t the knee-wrecker many people think it is. Studies have shown that running doesn’t increase the risk of knee osteoarthritis and can even strengthen your joints. So, if you want to try running, lace up those running shoes and hit the trail.
Reference Links:
The Influence of Running on Lower Limb Cartilage: A Systematic Review and Meta-analysis
Michaela C M Khan, James O'Donovan, Jesse M Charlton, Jean-Sébastien Roy, Michael A Hunt, Jean-Francois Esculier
Sports Medicine, 2022 Jan;52(1):55-74. doi: 10.1007/s40279-021-01533-7. Epub 2021 Sep 3.
Functional adaptation of knee cartilage in asymptomatic female novice runners compared to sedentary controls. A longitudinal analysis using delayed Gadolinium Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC)
A. Van Ginckel, N. Baelde, K.F. Almqvist, P. Roosen, P. McNair, E. Witvrouw
Osteoarthritis and Cartilage, VOLUME 18, ISSUE 12, P1564-1569, DECEMBER 01, 2010
Medial knee cartilage is unlikely to withstand a lifetime of running without positive adaptation: a theoretical biomechanical model of failure phenomena
Ross H. Miller, Rebecca L. Krupenevich
Peer J, Published August 5, 2020
Association Between Walking for Exercise and Symptomatic and Structural Progression in Individuals with Knee Osteoarthritis: Data from the Osteoarthritis Initiative Cohort
Grace H. Lo MD MSc, Surabhi Vinod MD, Michael J. Richard BS, Matthew S. Harkey PhD, Timothy E. McAlindon MD, Andrea M. Kriska PhD, Bonny Rockette-Wagner PhD, Charles B. Eaton MD, Marc C. Hochberg MD, Rebecca D. Jackson MD, C. Kent Kwoh MD, Michael C. Nevitt PhD, Jeffrey B. Driban PhD
Arthritis & Rheumatology, 08 June 2022 https://doi.org/10.1002/art.42241
Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline
Reed A C Siemieniuk, Ian A Harris, Thomas Agoritsas, Rudolf W Poolman, Romina Brignardello-Petersen, Stijn Van de Velde, Rachelle Buchbinder, Martin Englund, Lyubov Lytvyn, Casey Quinlan, Lise Helsingen, Gunnar Knutsen, Nina Rydland Olsen, Helen Macdonald, Louise Hailey, Hazel M Wilson, Anne Lydiatt, Annette Kristiansen
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Arthroscopic surgery for knee pain
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Arthritis and Rheumatology, 03 November 2021 https://doi.org/10.1002/art.42001
Cost-Effectiveness of Intensive Exercise Therapy Directly Following Hospital Discharge in Patients With Arthritis: Results of a Randomized Controlled Trial
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Run for your life … at a comfortable speed and not too far
James H O'Keefe1, Carl J Lavie
BMJ Journals Heart, Published Online First: 19 Mar 2013. doi: 10.1136/heartjnl-2012-303556
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