Running With Arthritis: You Can Keep Your Running Routine!

Have you ever felt pain or stiffness in your ankle, knee or hip joint and wondered if you should run through it or stop and have it looked at by a professional? 

Chances are that if you have pain in one or more of your joints that is continuous you may have developed a form of arthritis

The term Arthritis is from the Greek, arthron which means joint, and –itis, a suffix that means inflammation. Arthritis is a general term for joint inflammation.

There are several forms of arthritis, and contrary to popular opinion, people (and animals) of all ages and body types are susceptible to developing a form of arthritis. 

In fact, according to a longitudinal study in over 3,000 people, one in four people may experience a form of arthritis in their lifetimes!

In this article we will cover:

  • Different Types of Arthritis,
  • Causes of Arthritis,
  • Diagnosing Arthritis,
  • How Arthritis Affects You as a Runner,
  • How to Run With Arthritis and Not Make it Worse,
  • When to See a Professional,
  • Resources For Athletes With Arthritis.

If you think you may have arthritis, wonder how to manage it, and whether you can and should keep running, read on!

running with arthritis

Different Types of Arthritis

There are several different types of arthritis that affect both young and older people.  The most common types are:

  • Osteoarthritis (degenerative type),
  • Rheumatoid, psoriatic, ankylosing spondylitis (inflammatory types),
  • Infectious Arthritis,
  • Gouty Arthritis (Metabolic type)

The scope of this article will focus on Osteoarthritis (OA), the most common one, and the one we think of as “wear and tear” on the joint.

How Do I Know If I Have Arthritis?

There are four main symptoms of osteoarthritis, and you may experience one or all of them in one or more joints. 

The four main symptoms are:

  • Pain,
  • Swelling,
  • Stiffness,
  • Difficulty With Joint Mobility.

The main joints affected by arthritis in runners are hips and knees.  Basically, in OA the spongy, impact-absorbing tissue called cartilage breaks down over time and the bone underneath can become damaged. 

Risk factors for OA include:

  • Obesity (Body Mass Index >30.0),
  • Sedentary Lifestyle,
  • Age (OA risk increases with age),
  • Gender (women after age 50 more at risk than men),
  • Genetics,
  • Injury or Overuse.
running with arthritis

The first bit of good news is that runners and athletes overall are at lower risk of developing OA simply due to their reduced body weight, or increase in lean body mass.

Obesity is the largest risk factor for OA due to chronically increased stress placed on the joints. 

The second good bit of news is that an active lifestyle also puts people at lower risk for OA. As a runner you most likely already have an active lifestyle, so you are at low risk for developing OA.

Diagnosing Arthritis

Arthritis can be diagnosed by a general doctor or a specialist (think rheumatologist, pain specialist, sports medicine specialist) with a combination of a good history, physical exam, and a few x-rays.

Occasionally, some people will need more specialized tests such as ultrasounds, MRIs, or nerve testing, and sometimes blood tests to see if there are chemicals in the body causing damage to the joints.

The workup of osteoarthritis will also tell you about the severity of the joint inflammation, which helps guide your treatment.

running with arthritis

Arthritis: How Does It Affect You As An Athlete?

No matter what your level of fitness, if running and exercise are part of your life you are an athlete! 

And as an athlete, you are probably used to running with and dealing with occasional aches, pains, soreness, stiffness, even injury.

For some of us, it is more than occasional depending on your training plan.

Athletes with arthritis may have more frequent symptoms, and they may last longer than those without arthritis.

This does not mean that you have to stop training, it just means that you may have to adjust your training.

If you are starting out running, and have a history of osteoarthritis, you should start gradually, alternating between running and walking.  This allows the joints and supporting muscles to adjust to the new movement.

Running with arthritis means that you will need more recovery, and perhaps increase your strength training to increase muscle mass to support those affected joints.

Increasing muscle mass, by the way, also increases resting metabolism and therefore reduces your risk of developing obesity, which in turn reduces your future risk of arthritis.

As you know, regular running has numerous whole-body benefits, even in times of soreness and times of stress!

running with arthritis knee

Arthritis of the Knee- Is It the End of Your Running?

The points about slow progression, strength training, and recovery are especially important for athletes who have arthritis in their knees

The knee joints are especially prone to cartilage damage and need tender loving care in the form of rest and muscular support to help adjust to running.

Over time, running actually increases cartilage growth.

Don’t listen to those who may tell you to stop running if you have arthritis, just tell them that you’re growing with every run!

Other techniques to support your knee joints is to work them in different ways

If you are accustomed to running on concrete or asphalt, try running on different terrains to help cushion your runs.

Gravel, dirt, turf, cushioned track surfaces, these landing zones work different muscles in your feet and legs. 

Also, adding hill work into your routine will strengthen the muscles around the knee joints, and the bonus is the increased cardiovascular work it takes to crush those hills!

Changing up your terrain will help strengthen the smaller, stabilizing muscles that support your joints. 

So, go ahead and treat your soft tissue to new and possibly welcoming surfaces! 

Another way to support those tired knees is to run in supportive shoes with cushioned soles.  Supportive running shoes are designed to absorb more force will help take the load off your knees.

If you are a barefoot runner or are running in a neutral running shoe, one with more stability may help your arthritis symptoms.

Your knees will thank you!

There are also cutting-edge therapies in laboratories around the world, including injectables that help regenerate cartilage and others that may stop the breakdown.  These are not yet available for consumer use but stay tuned!

running with arthritis

Does Running Make Arthritis Worse?

There are several studies that have shown running actually improves arthritis

Routine activity, such as running has been shown to reduce total body inflammation, and thus reduce the risk of arthritis. 

The anti-inflammatory benefits of regular exercise has the potential to reduce arthritis symptoms.  

The key to these benefits is that exercise needs to be regular, part of your daily life.

Ten Tips to Keep Running With Arthritis and Not Get Injured

  • Start slowly and increase mileage gradually.
  • Check your shoes, consider adapting to new ones for adequate support.
  • Consider low-impact cross-training such as swimming, biking, or elliptical work.
  • Run according to how your joints are feeling, and temporarily reduce activity if needed.
  • Stay hydrated!  All joints and muscles work better and heal faster when nourished.
  • Try out different terrains to change the stress on your knee joints.
  • See a professional for accurate diagnosis and treatment.
  • Don’t stop exercising, keep your body moving!
Running With Arthritis: You Can Keep Your Running Routine! 1

Resources for Athletes with Arthritis

If you are interested and wonder where to look for more information, consider the following online links:

            Arthritis Foundation (arthritis.org)

            American College of Rheumatology (rheumatology.org)

Related article: Is Running Bad for Your Knees?

  1. Murphy L, Schwartz TA, Helmick CG, et al. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008; 59: 1207–13.
  2. Murphy LB, Helmick CG, Schwartz TA, et al. One in four people may develop symptomatic hip osteoarthritis in his or her lifetime. Osteoarthritis Cartilage. 2010; 18: 1372–9. 
  3. Amoako AO, Pujalte GG. Osteoarthritis in young, active, and athletic individuals. Clin Med Insights Arthritis Musculoskelet Disord. 2014 May 22; 7: 27-32. doi: 10.4137/CMAMD.S14386. PMID: 24899825; PMCID: PMC4039183.
  4. Lo, G.H., Musa, S.M., Driban, J.B. et al. Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative. Clin Rheumatol 37, 2497–2504 (2018). https://doi.org/10.1007/s10067-018-4121-3

Amy K. Whitson, MD

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