Study of marathoners dispels myth that long-distance running leads to hip and knee arthritis

CHICAGO — A new study by Northwestern Medicine found no connection between running and arthritis of the knees and hips.

Through surveying about 3,800 participants in the Bank of America Chicago Marathon, researchers found that runners have the same risk of developing arthritis as the general population, Dr. Vehniah Tjong, an orthopedic sports medicine surgeon at Northwestern Medicine and one of the paper’s authors, said.

She said many of her clinic’s patients have participated in the Chicago Marathon, and about six months before the race every year, runners pour in to ask about their training and whether it would be detrimental to their health.

Over time, Tjong said, the doctors began to wonder, “What are we actually telling these patients, and is the current dogma necessarily true? Is running really bad for an individual, especially if they’ve never picked up running before?”

The study answered these questions.

Survey results found arthritis to be caused by the same factors identified in previous literature, Tjong said. These risks include increasing age and body mass index, family history of arthritis and previous injuries and surgeries to the hip and knee areas.

In addition, a quarter of those surveyed said their physician had told them to stop running because of an increased risk of arthritis.

“(The results) really challenged that current approach, or what we’ve known historically about running,” Tjong said. “That running may be wearing down your joints, when in fact, from the study, that’s not necessarily true.”

Still, Tjong acknowledged that runners should avoid injuries by training properly and working with the advice of medical professionals. She said the study being self reported limited the researchers’ ability to identify true arthritis in the participants.

Tjong said she hopes that the study raises awareness among health care providers to not advise patients to stop running when it could be beneficial to them. She also said it’s a goal that the study highlights the positives of running — including its benefits to cardiovascular and mental health.

While previous studies looked at elite runners, Tjong said that the Northwestern Medicine study chose to survey marathon participants to hear from recreational runners of all levels of experience.

Ana Sarmousakis, a recreational runner and one of Lakeview Run Club’s leaders, said the myth that running leads to arthritis is often spread by non-runners.

People who don’t run will often tell her, “that’s not good for your knees,” she said, even though in her seven years of running, she’s not been injured or told by a doctor that running isn’t good for her health.

Sarmousakis called the study results “super exciting,” especially because she views running as a way to improve her health in the long run. She said the confirmation that running won’t be harmful to the joints over time is a strong reason to keep running.

“Obviously a big part of why people run and join running groups is to stay in shape and stay healthy,” she said. “You want to make sure it’s something that will benefit you in the short term — losing some weight before the summer or to improve your cardiovascular health — and also something that is going to set you up to be healthy long term.”

According to Sarmousakis, misconceptions related to running and arthritis can also be spread by people needing an excuse to stop themselves from trying something new.

“People like to talk ourselves out of doing things that are new to us or scare us or make us uncomfortable,” she said. ”People can use (the misconception) as an excuse to talk themselves out of running.”

She said the study results are encouraging for people who are thinking about getting into running but are concerned about the long-term health effects.

“Always listen to your doctor, and listen to other runners,” Sarmousakis said. “Don’t be afraid to try something new.”

Dr. George Chiampas, chief medical and safety officer for the Bank of America Chicago Marathon, is also on staff at Northwestern Medicine and part of the study.

He said that his conversations with Tjong often revolved around the safety of marathoning and the question of whether running long distances may lead to progressive arthritis.

Still, Tjong had seen in the clinic that running could possibly be more protective than harmful. She brought the question to Chiampas. He said there are very few opportunities to ask scientific questions in a population such as marathon runners, so it was a “natural fit” to work with the Chicago Marathon on the study.

He said the results can benefit runners by creating more awareness around marathon medicine. By surveying runners, researchers were able to answer a lot of questions, he said, and after finding results, there’s an opportunity to educate marathoners around the world to make their running as safe as possible.

Additionally, information in the study addresses the myths that running long distances causes runners to hurt themselves, Chiampas said.

He said the Chicago marathon has been a leader when it comes to marathon medicine and running studies. He said it’s a testament to the event to be able to work in a scientific way with an institutional review board and take the information learned back to the public.

“For a lot of people, running is their mental health benefit. Running is their ability to decompress. Running is their ability to stay healthy,” Chiampas said. “I think as we gather this information that is scientifically based, I think runners can then take this to their clinicians, we can obviously publish it and, and it obviously helps everyone in being able to bring this information to light. It’s really the largest study that’s ever been done to hopefully shift the narrative and start discussing the protective benefits of running.”