When I was first diagnosed with hip Osteoarthritis in 2006 it was still thought that running *caused* osteoarthritis in healthy joints. I was warned to give up running (as well as other sports) in favour of cycling and swimming.

Research findings have since started to swing towards running actually having a protective effect on our joints. Here’s what Arthritis Research UK had to say in November 2014.

More studies supporting this finding can be found here and here.

The jury is still out on whether it’s safe to run on joints that already have degenerative changes. Most older adults have degenerative changes in their hips (regardless of whether they have symptoms or an OA diagnosis). It seems logical to me that if running was bad for hips that have existing degeneration, studies would show older runners (a group among whom asymptomatic degenerative changes in joints is high) would develop more symptomatic OA than non runners. In fact the studies found the opposite.

This research article concludes that it’s probably safe for people with mild osteoarthritis.

If you know of any other studies that I’ve missed please do let me know!

People want something more concrete than ‘probably safe’

Over the years I’ve written quite a bit about my battle with OA and my struggle to keep running. Consequently, I get a lot of email messages from runners that have been newly diagnosed with OA and told they can’t run. They all want reassurances that running is safe for them. Some have been told they have mild osteoarthritis and others more severe. They desperately want to keep running but are terrified their joints will disintegrate if they do.

Unfortunately, no one can give those reassurances. Research hasn’t provided us with enough evidence to know either way. However, that means the doctors don’t know either. When they tell you it’s bad for you they’re guessing. How much thought has gone into that guess? Have they read the latest research? How much knowledge do they have of your particular dysfunctions? Are they aware of all the positive benefits that you get out of running? How do they know that it’s not running that’s keeping your symptoms from being 10 times worse? To what extent is running keeping your weight down and reducing symptoms and excessive joint wear? If you’re a woman approaching menopause have they factored in the protection that running gives you from loss of bone and muscle mass? The effects of running on hormonal regulation, mood stability and sense of well-being? Are swimming and cycling really better for your hip and better for your mind and body as a whole?

I’ve been following quite a few osteoarthritis support groups online and some people are in an extremely bad way. I have to say that those in worse shape – both mentally and physically – are the ones that go into retreat. The people that sit back and wait for their problems to be solved by drugs and surgery. They seem to have more pain, more dysfunction and more depression. Now whether that’s because their symptoms are worse and they ‘can’t’ do anything it’s impossible to say. But to me it makes no sense to go into retreat if you can avoid it. Swimming and cycling might be great exercise for a couch potato but for someone in great shape through running it’s likely to result in a big downturn in fitness if they don’t have the skills to do either well enough to maintain current fitness levels. My personal approach is to do all I can to make sure I’m pushing forwards and fighting for health and fitness. You can’t separate mind and body – if one is ailing both will suffer.

Over the years I’ve heard / read doctors, physiotherapists and fitness experts express a view on this topic. Some say ‘it’s fine – just get out and enjoy yourself’; others warn of dire consequences. I maintain that both are equally wrong and equally right.

Yesterday I posted an article explaining that when you delve deeply into things you learn that osteoarthritis isn’t really a diagnosis – in actual fact it was simply a label to describe someone with un-diagnosed joint pain. Osteoarthritis is an umbrella diagnosis to describe a variety of different joint pain syndromes. You need to read the article to fully appreciate this.

No one that’s really thought through the implications of this can make broad statements about what is good for someone with osteoarthritis simply because we’re each likely to have pain and other symptoms for a variety of different reasons. Some might be helped by running, some made worse and some might not be affected either way.

So how do you know if running is right for YOU?

I think this always has to be a judgement call. A question of weighing up the pros and cons then just trying it to see how it feels. In an ideal world we’d know WHY we have painful joints. Unfortunately, in the real world current understanding and available resources mean the best we get is a label that means “sore joints”.

• Some people will have sore joints for congenital reasons – birth deformities that make them more prone to joint wear.
• Some will have actual injury or damage to cartilage, ligaments or bone.
• Some will have muscle imbalances causing their pain – and out of that group there is a variety of different types of imbalance

For some people it’s easy to see that running might help alleviate their symptoms. Joints rely on osmosis for nutrients and there’s nothing like a rhythmic running action to pump fluid through the cartilage. Running will help keep weight down, mood elevated, bone and muscle mass maintained, heart healthy and joints mobile.

But what if your joint pain is due to a muscle imbalance? Damage to soft tissue? Congenital defects? Loading up faulty movement patterns could well make your problem worse. The research simply doesn’t differentiate between different types of joint pain. It just lumps them all together as ‘osteoarthritis’. It would be foolish to continue to run if there’s a very high risk that doing so will cripple you and stop you from doing ANY exercise in the future. At the end of the day I think we each have to weigh up the pros and cons, use a bit of trial and error and come up with a plan that we feel comfortable with.

I know a few people that have run for a number of years with osteoarthritis – including myself. Also some that made the decision to change to another sport and are thriving. They have agreed to share their story and their reasoning behind their decisions. Hopefully this will help other people make their own informed decisions. I’ll be posting their stories on the blog over the next few days.

Starting with ‘Ultra-Bob’ tomorrow.