knee pain

Are Knee Pain and Running Related?

Knee pain is a common complaint that at some stage in adulthood can affect around 30 per cent of the general population. Because running has a reputation for “wear and tear” causing knee pain, the issue also arises as to whether or not running speeds up knee problems. What does the current research body say, then?

Dr. Christopher Bramah and colleagues reported in a 2018 study published in The American Journal of Sports Medicine that the most frequent injuries in runners include the knee (50 percent), the foot (39 percent) and the lower leg (32 percent). Sounds like running is detrimental, doesn’t it?

Researchers analysed blood and knee joint synovial fluid samples before a 30-minute run, immediately after their run, and after a 30-minute rest, in a small pilot study which included six runners aged 18-35. To the research team’s surprise, the inflammatory factors associated with conditions such as osteoarthritis (OA) are higher before running, and lower after sprint in the two timescales. That would mean running can be OA-protective.

Because of the limited number of subjects studied, the authors are quick to point out that they intend to perform a larger-scale analysis and after running, test the inflammatory marker levels for a week or longer to see how long this “defence” lasts. Some also claimed that a 30-minute run is relatively short, citing a study of marathon runners (26.2 miles or 42.2 km) who found cartilage changes that could indicate injury risk that continued three months after the marathon.

The study compared data from several previous studies on recreational runners, competitive runners and non-runners (a “meta-analysis”) and found that recreational runners had a LOWER frequency of OA than participants in the other categories.

A study comparing 1,207 UK male football players to 4,085 general population men (all around 60 years of age) found that football players were twice as likely to have knee pain (52% vs. 27%, respectively). In addition, about 28 percent of football players vs. 12 percent of non-football players were diagnosed with radiographic knee OA, and the athletes were three times more likely to receive complete knee replacement.

To sum up, short distance running on healthy knees appears to be safe and maybe even preventive against OA. In comparison, engaging in more high-intensity exercise will increase the risk of knee problems. If an individual has OA, walking may be the safer option but it must be determined individually.

Evidence has shown that issues elsewhere in the body, such as the ankle and hips, can put additional pressure on the knees, which can raise the risk of problems in that area. That is why it is necessary to assess the entire patient when presenting for treatment for a condition such as knee pain, as if contributing factors are not discussed, a satisfactory outcome may not be obtained.