Arthritis and Age in Runners
This is a shorter blog post, yay! We have done a few on running that are more detailed so you are now pretty smart folks! You know for instance that a fore-foot strike will load up the ankle whereas a rear-foot strike will load up the hip and knee. You know what type of stretching you should be doing. You know what I think about Kinesiotape and some of the concerns I have! You know that we have to be encouraging and cautious in the same breath when looking at children running. You know what level of pain should be acceptable when training and performing, and how not listening to the body can lead to significant injury and time away from what you love.
In this post, I want to cover a couple of papers that I think will interest you. Most runners I know and have treated want to continue running into old/older age, as they know a)they enjoy it, b)there are many health benefits. But they have heard stories of or have experienced doctors telling them they should stop running as they get older as they will have a higher risk of knee arthritis etc. I have never been convinced of this argument, or at least the strength of the advice (I am sure there are some cases where it is true, but should the advice be general?). When I read medical journals I have these and many other questions in the back of my mind, so am excited when I find a piece that addresses things. My recent readings did just that: they partly answered two of my questions, so I have to share!
Does running increase your risk of osteoarthritis?
- A recent editorial in the British Journal of Sports Medicine1 asked this question, but also asked the question if running in-fact protects against arthritis. The overall take home was that the majority of studies found no link between recreational running and knee arthritis.
- In a brief discussion of current evidence, it mentioned some interesting things:
- At the American College of Rheumatology annual meeting, an abstract was presented of data from the osteoarthritis initiative (OAI). The OAI is a multi-center trial of ~5000 people studied annually over a four-year period, and the abstract suggested that running may protect the knee joint from osteoarthritis!
- Another study found that long-distance running, but only at elite levels, increased risk of osteoarthritis.
What happens to our running mechanics as we age?
- Many studies have suggested that older runners use more variations in technique than younger runners, such as shorter stride length, lower ground reaction forces, and lower velocity.
- A recent study provided us with some new information. They studied 110 injury-free runners aged 23-59, who had an average running experience of 11.3±9.4 years and weekly milage of 33.8±22.0. They found:
- Changes were linear, meaning they occur evenly year-over-year
- They found that stride length reduction was due to changes in ankle range of motion, but not hip or knee function.
- They did not know if the limitation at the ankle was true physiological limitation, or a conscious selection that occurs as we age.
These two studies tell me that we should encourage people to run, and that concern about development of osteoarthritis is not at this time supported by the evidence. In fact, you may be protecting yourself from osteoarthritis by running. It also tells me that when I have a runner who has a had a long career, or is entering middle age, coming into my clinic with concerns of reduced pace, I should place a great deal of focus on the ankle. By placing focus on the ankle I can determine if a restriction is true or if there is some conscious or subconscious effort going on, which may be correctable with cueing strategies.
I hope you find this encouraging! good luck and have a long running career!
- Leech RD, Edwards KL, Batt ME. Does running protect against knee osteoarthritis? Or promote it? Assessing the current evidence. Br J Sports Med. 2015;
- Devita P, Fellin RE, Seay JF, Ip E, Stavro N, Messier SP. The Relationships between Age and Running Biomechanics. Med Sci Sports Exerc. 2015;