A survey of marathon runners found no association between a history of running and an increased risk of arthritis.

Results from the largest marathon runners survey showed no association between cumulative running history and the risk for arthritis.

Chicago Marathon participants helped orthopedic researchers further understand the impact of long-distance running on bone and joint health, specifically knee and hip arthritis in recreational runners.

“Despite growing knowledge that running and being active can be healthy for your joints, there is a continued dogma among the healthcare community that patients should stop running to avoid wearing out their cartilage,” said lead author Matthew J. Hartwell, MD, an orthopedic surgery sports medicine fellow at the University of California San Francisco. “Our survey showed that one in four people have received a recommendation by their physician to reduce their running volume, and for those with arthritis, nearly 50% of runners were told by their physicians to stop running altogether.”

Hartwell and his colleagues conducted the prospective cohort study, “Does Running Increase the Risk for Hip and Knee Arthritis? A Survey of 3,804 Chicago Marathon Runners,” during his residency at Northwestern University Feinberg School of Medicine in Chicago.

It was presented at the 2023 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

The electronic survey was completed by 3,804 participants registered for the 2019 and 2021 Chicago Marathons. The mean age of respondents was 43.9. Participants had run an average of five or fewer marathons, and they had been running for an average of 14.7 years.

The data showed that the prevalence of hip and knee arthritis was 7.3%. Prior hip/knee injuries or surgery, advancing age, family history, and BMI were risk factors for arthritis.

The cumulative number of years running, the number of marathons completed, weekly mileage, and mean running pace proved not to be significant risk factors for arthritis.

“Our multivariate analysis showed that the factors that increase a person’s risk for arthritis are the same for anyone with joint degeneration — whether or not they’re a runner,” said Hartwell. “Those factors include an increase in age, BMI, a family history of hip or knee arthritis, and whether they’ve had injuries or knee surgery.”

The participants were also asked if a doctor had ever advised them to stop or reduce their running, if they were still running at the time of questionnaire completion, and if they planned to run another marathon. The majority (94.2%) of runners planned to run another marathon despite 24.2% of all participants being told by a physician to do otherwise.

“Recreational runners are a dedicated group of people who use the sport for exercise, mental clarity, or to challenge themselves,” said Vehniah K. Tjong, MD, FAAOS, associate professor of orthopedic surgery at Northwestern University. “Our hope is these findings educate physicians, so they don’t instinctively advise against running and work to meet patients on their level — because, as these data show, runners are likely to continue running despite medical advice.”

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