Q&A

Q:

I have been an avid runner for years. Recently, I developed severe knee pain and have received a diagnosis of osteoarthritis (OA) in both knees. Can I keep running, or will I have to stop?

A:

The answer to this question depends on various factors, and we would need more information about you to determine whether continuing to run is appropriate for you. For example, we would need to know your “clinical history” — that is, your age, symptoms, and what criteria your doctor used to conclude you had OA of the knees (that is, whether the diagnosis was based on your symptoms or on x-rays or other imaging studies). Certainly we would want to know about your running (amount, frequency, distance, pace, surface, and shoes), any treatments you use, and any other medical conditions you have.

OA typically affects people over the age of 50 and is characterized by pain and stiffness in large joints such as the knees, although it can occur in any joint and commonly affects joints in the fingers and spine. It is often referred to as a “degenerative” disease because it involves the erosion of cartilage, the tough, slippery material that cushions the ends of the bones in the joint. Eventually, the bone may become exposed and erode as well. It was once thought that OA was simply the result of “wear and tear” on joints, but we now know that OA can also result from various genetic, biochemical, and inflammatory processes. It is no longer thought that OA is the inevitable consequence of accumulated stress on joints, and running does not necessarily lead to OA. Putting a healthy joint through a normal range of motion, with reasonable activities, need not be harmful. On the other hand, exercising with abnormal joints (such as those with OA), or doing unusual activities (such as using your head to hit a soccer ball) may be. When it comes to running on a knee with OA, the concern is that the stresses on the joint may lead to further cartilage loss or increased pain. You also risk injury if the joint isn’t stable.

We all maintain exercise regimens and one of us is also an avid runner, so we appreciate your passion for running. Depending on your situation, it may be possible to keep running, at least in some fashion. Consulting a physician knowledgeable not only about arthritis but also about running is essential. You want to be sure that you have an accurate diagnosis, and that any other problems that may be contributing to your knee pain are addressed.

You should then work with your doctor to come up with an effective treatment plan for your OA. For many people, pain and inflammation can be satisfactorily managed with physical measures such as heat and cold therapy or with pain-relieving or anti-inflammatory medicines or topical creams. (While once popular and thought effective, glucosamine supplements have been found in more recent studies to have no consistent value.) Moderating the frequency, pace, or distance of your runs may also help, as may wearing knee braces while you run. An informed physical therapist can help you determine what kinds of modifications are best for you.

Whatever your doctor or physical therapist recommends about running, remember that OA does not mean you have to stop exercising altogether. On the contrary, exercise is an important part of an OA self-management plan because it helps you maintain joint strength and flexibility and control your weight. The key is to find activities that don’t aggravate your arthritis symptoms — and that you enjoy.

Last Reviewed on March 30, 2012

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This question was answered by Adam J. Kreitenberg, MD, Resident, Roshan Kotha, MD, Postdoctoral Fellow, and Richard S. Panush, MD, MACP, MACR, Professor, Division of Rheumatology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles.

Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

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