Running and its Relationship with Osteoarthritis

We often believe that the more activity we do, the more osteoarthritis (OA) we will develop. So I had to find out if this is what researchers have published. What I found was very interesting, It turns out to be the exact opposite of what we believe. Many studies have found that there is no direct relationship of activities such as running and the development of osteoarthritis!!!

For my patients, please don’t forget to look here, I have listed many studies that show that OA, discs, and etc may not be related to your pain. So even if activity was related to OA, there is questionable relationship of OA and pain. So if you had surgery to correct a biomechanical issue and are still painful, there is hope. Researchers have found that understanding pain, promoting positive movement, and manual therapy can decrease protective mechanisms related to the nervous system. That is what this website is about.

If you are new to this site, please check out the section discussing the definition of pain by the International Association for the Study of Pain and the section on stories and metaphors  to understand pain. It is a great way to begin on your journey to understand pain. If you are a clinician, there is a shift in orthopedics, which involves the blending of orthopedics and neurophysiology. I think that the best website to discuss and learn about these topics is You can also check out the list of blogs and clinicians here to learn more.

Back to the topic on hand; I have found a handful of publications regarding running and OA and here is what researchers have to say:

“Running significantly reduced OA and hip replacement risk due to, in part, running’s association with lower BMI, whereas other exercise increased OA and hip replacement risk.”  Published by Williams PT in 2013

“Running is possible with mild forms of OA if proper joint mechanics, neuromuscular control, and technique are present” Published by Siverling S in 2012

“Limited evidence was found linking biomechanical measures of knee joint loading and observed short-term deformation of knee articular cartilage volume following running. Further enhancement of knee muscle modelling and analysis of stress distribution across cartilage are needed if we are to fully understand the contribution of biomechanical factors to knee joint loading and the pathogenesis of knee osteoarthritis (OA).” Published by Boocock M in 2012

“Previous research did not show a significant association between intense physical activity and knee OA in the general population” Published by Zeller L. in 2008

“Long-distance running among healthy older individuals was not associated with accelerated radiographic OA. These data raise the possibility that severe OA may not be more common among runners” Published by Charkravarty EF in 2008

“Osteoarthritis of the knee joint is rare in former elite marathon runners. The risk of osteoarthritis of the hip joint seems to be higher than in control subjects who do not engage in much sport.” Published by Schmitt H in 2006

“The presence of radiographic hip OA and the progression of radiographic knee OA was similar for older runners and nonrunners. Lumbar spine BMD remained higher in runners, but changes in lumbar BMD were similar for runners and nonrunners over a 9 year period.” Published by Lane NE in 1998

“We did not find an increased prevalence of OA among our runners, now in their seventh decade. These observations support the suggestion that running need not be associated with predisposition to OA of the lower extremities.” Published by Panush RS in 1995

In summary, running did not accelerate the development of radiographic or clinical OA of the knees, but with aging, 13% of all subjects developed OA of the hands and 12% of all subjects developed OA of the knees. Published by Lane NE in 1993


Boocock M, McNair P, Cicuttini F, Stuart A, Sinclair T. The short-term effects of running on the deformation of knee articular cartilage and its relationship to biomechanical loads at the knee. Osteoarthritis Cartilage. 2009 Jul;17(7):883-90. doi: 10.1016/j.joca.2008.12.010. Epub 2009 Jan 18. PubMed PMID: 19246217.

Chakravarty EF, Hubert HB, Lingala VB, Zatarain E, Fries JF. Long distance running and knee osteoarthritis. A prospective study. Am J Prev Med. 2008 Aug;35(2):133-8. doi: 10.1016/j.amepre.2008.03.032. Epub 2008 Jun 12. PubMed PMID: 18550323; PubMed Central PMCID: PMC2556152. Free full text

Lane NE, Oehlert JW, Bloch DA, Fries JF. The relationship of running to osteoarthritis of the knee and hip and bone mineral density of the lumbar spine: a 9 year longitudinal study. J Rheumatol. 1998 Feb;25(2):334-41. PubMed PMID: 9489830.

Lane NE, Michel B, Bjorkengren A, Oehlert J, Shi H, Bloch DA, Fries JF. The risk of osteoarthritis with running and aging: a 5-year longitudinal study. J Rheumatol. 1993 Mar;20(3):461-8. PubMed PMID: 8478853.

Panush RS, Hanson CS, Caldwell JR, Longley S, Stork J, Thoburn R. Is Running Associated with Osteoarthritis? An Eight-Year Follow-up Study. J Clin Rheumatol. 1995 Feb;1(1):35-9. PubMed PMID: 19077939.

Schmitt H, Rohs C, Schneider S, Clarius M. [Is competitive running associated with osteoarthritis of the hip or the knee?]. Orthopade. 2006 Oct;35(10):1087-92. German. PubMed PMID: 16932832.

Siverling S, O’Sullivan E, Garofalo M, Moley P. Hip osteoarthritis and the active patient: will I run again? Curr Rev Musculoskelet Med. 2012 Mar;5(1):24-31. doi: 10.1007/s12178-011-9102-y. PubMed PMID: 22231957; PubMed Central PMCID: PMC3535123. Free full text

Williams PT. Effects of running and walking on osteoarthritis and hip replacement risk. Med Sci Sports Exerc. 2013 Jul;45(7):1292-7. doi: 10.1249/MSS.0b013e3182885f26. PubMed PMID: 23377837; PubMed Central PMCID: PMC3756679.

Zeller L, Sukenik S. [The association between sports activity and knee osteoarthritis]. Harefuah. 2008 Apr;147(4):315-9, 374. Review. Hebrew. PubMed PMID: 18686813.


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