Running and Joint Health - as featured in Women's Running Magazine
Joint health is the centre point of a musculoskeletal physiotherapists daily life! We are often asked what the ‘right amount of running’ is and what damage it might cause. Before answering these questions it’s important to remember a few key points about joints.
Starting with; joints are made up of a lot of structures! Muscles, ligaments, tendons, bones, and the most talked about, cartilage. Osteoarthritis is wear and tear of the articular cartilage over time and the inflammation and pain it can cause. The cartilage is there to absorb forces during activities, so high impact twisting and poor overall joint stability can increase the risk of this breakdown. To focus on the cartilage alone would be a grave disservice to the joint complex! The other structures are there to stabilise and protect. This enables the joint to move smoothly and efficiently, reducing the risk of damage.
As of 2016, a meta-analysis (read: big study) of running and risk to joint health found no evidence that moderate levels of running in itself was detrimental. In fact, a 2017 Study in Nature found that regular running actually good for the discs in our spine! We can also reduce the risk of osteoarthritis by maintaining a healthy weight, building muscle, flexibility and balance. Which can all be achieved through being active.
Running, osteoarthritis and genetics
Genetics are often to blame for ‘bad knees’. However, no studies have been able to conclude the exact genetics of osteoarthritis and research is ongoing. Most importantly modifiable environmental factors are the critical points in happy knees – such as obesity, occupation and diet all contribute to joint health and are easily changed for the better.
Family history of osteoarthritis and running
Running is part of a person’s identity and the current evidence isn’t strong enough for someone to abandon their lace ups because of family history. Running can be modified to suit almost anyone; style, specific exercise programmes, stretching, footwear… A moderate amount of running seems to be the best approach. Like the goldilocks and the three bears – not too much, not too little, but just enough.
Treadmills or green, green grass?
Both treadmill running and flat grass running have been shown in biomechanical analysis to reduce stress and load on the lower limb joints compared to the road. Whether this reduces the overall impact on joint health for runners isn’t clear. Numerous anecdotal sources however, advise running around parks in bright leggings boosts endorphins, vitamin D, the smile factor and potential interaction with pugs. Another reason to go green! Varying running routes Shaking up your run is excellent for many reasons. Biomechanically, keeping ourselves alert during a run will reduce the fatigue we translate into our running style. This is important as absent-minded running increases the risk of poor technique and not paying attention/falling over (see the author) which increases overall injury risk. Avoiding concrete and tarmac surfaces would be desirable but not to the detriment of not running at all! What’s great about running is that it is accessible to everyone – you just need some good trainers, a good sports bra and some space (paisley leggings are preferable but optional).
Knee pain when increasing running?
Some knee pain isn’t necessarily their body’s way of telling you that a limit has been reached, but more likely that training has increased far too quickly and the body needs some time to adapt. The golden rule is to increase a run by no more than 10% per week. Bigger distances can certainly be achieved with smart training and injury prevention. Talk to your physiotherapist or doctor about any sharp pain and get a balanced programme in place.
Overall, we are all special in our own way – just like we were told as kids! Running has a vast array of benefits (neon leggings notwithstanding) and can actually help maintain good joint health, not to mention the cardiovascular, healthy weight, stress busting and sleep assisting…need I go on…benefits! Like all activities, balance is the answer. We must run to suit our own needs and style, mix up running with flexibility and low impact activities such as yoga and swimming, invest in good footwear and if you are unsure – ask a physiotherapist, they are always willing to provide some interesting exercises to achieve that amazing run!