by Dr. Andy Rudins

I have been an active runner since high school, and now I’m turning 40. My friends tell me I should stop running, or I’ll develop arthritis in my knees. Should I stop? Is there anything I can do to protect my knees?
-Gia Floyd, Marshall, N.C.

I’ve been running for over 20 years, so I can definitely sympathize with you, Gia. The most common form of arthritis, and the one you are referring to, is osteoarthritis. In osteoarthritis, the cartilage that covers the ends of the bones and allows smooth, pain-free running, becomes thinner, and can eventually result in bone rubbing on bone, a very painful situation. Fortunately, there is no evidence that running causes or increases the likelihood of developing osteoarthritis in a healthy knee. However, once a person has arthritis, running can contribute to the progression of the condition.

So if your knees aren’t hurting, keep running. But I strongly recommend that you see a physician if you are having any knee pain, particularly if it limits your ability to run. A simple set of X-rays can reveal if you have any significant arthritis.

Genetics is a big factor in osteoarthritis, which unfortunately you can’t do much about. However, many other factors contribute to the development of knee pain, whether it’s caused by osteoarthritis or other conditions such as tendonitis or bursitis. Decreased flexibility, muscle imbalance, inappropriate shoes, poor training schedule, terrain, and suboptimal mechanics can play a role in knee pain. Don’t wait until you experience pain to address these issues. Talk with a running specialist to ensure your running gait isn’t doing long-term damage, and make sure you purchase running shoes that fit your running stride and build. Most running specialty stores can help you select the appropriate shoe for your needs. And whenever possible, run on soft surfaces that reduce the pounding on your knees. If you do develop osteoarthritic changes in your knee, there is no absolute cure for it. However, recent research has shown that certain medications, which are not steroids, and which are injected into the knee, can potentially prevent the progression of arthritis in mild to moderate cases. Many runners with even minimal osteoarthritis are now having these injections to make sure they are doing everything they can to continue running into their 70s and beyond.

Dr. Andy Rudins is a physician with Southeastern Sports Medicine in Asheville, N.C.