Sunday, August 26, 2007

Running and Arthritis

This is a great article that came across the ultralist about a question distance runners often get from those who, well, aren't distance runners. Originally from "Runner's World"

Enduring Questions - Does Running Cause Arthritis? by: Amby Burfoot

My 85-year-old Aunt Marian thinks it's pretty cool that I'm a
runner. Only problem: She wants me to give it up. The way she sees
things, I'm doing fine now, but trouble looms. A few years down the
road, I'll probably need a wheelchair. All that pounding and wear
and tear; it can't do a body any good. Marian's got her share of
aches and pains, and loving auntie that she is, she doesn't want me
to end up in even worse shape.
I bet you've got an Aunt Marian in your life, too--a family member,
or friend, or coworker who's always tsk-tsking the toll running is
taking on your knees, hips, and back. You might even be worried
yourself. We all know a few onetime runners forced to become
swimmers, cyclists, or mall walkers. We wonder: Does the same fate
await us?

The logic behind the wear-and-tear scenario can seem convincing.
After all, your car eventually breaks down, even if it's a Volvo.
Same for your toothbrush, and the foam in your running shoes.
You'll need to replace them at some point. You understand that, and
you've worked the expense into your budget. Chances are, however,
that you're not so keen on the idea of replacing body parts.
The Human Response
Fortunately, your body is different. It's a biomechanical system,
not a mechanical one, and those three little letters make all the
difference. Your body is composed of living tissues that are
constantly rebuilding themselves. Not only that, but living tissue
actually grows stronger when it is used. Use is better than abuse,
which includes both sedentary living and running when you're
injured, which is why you shouldn't do either.
The strongest evidence that running won't condemn you to a life of
pain and arthritis comes from an ongoing study of the Fifty Plus
Runners Association. The study was launched in 1984 when all the
runners were at least 50, and it has been updated every five years
or so. Many of the runners are now in their 60s, 70s, and beyond.
The newest update was published last September in Arthritis
Research & Therapy, under the title "Aerobic exercise and its
impact on musculoskeletal pain in older adults: a 14-year
prospective, longitudinal study." It compared the runners, who
averaged about 26 miles a week, to a matched set of controls, who
averaged about two miles a week. The authors noted that many
observers would predict a sad outcome for the aging runners. "If
running creates damage through accumulated trauma," they wrote,
"then runners with about ten-fold the exposure to such trauma
should have increased pain over time."

Yup, that's it all right: the Aunt Marian argument in a nutshell.
Only the argument appears to be unfounded, probably for some of the
biomechanical reasons I've already mentioned. The study's major
conclusion: The runners experienced "about 25 percent less
musculoskeletal pain" than the controls.
Dr. Bonnie Bruce, the principal investigator, is a doctor of public
health as well as a registered dietitian and a marathoner. I call
her to find out why she chose to measure a subjective feeling like
pain rather than a more objective, physical one like joint-space
narrowing. "Think about it," she says. "When you're in pain, you
can't move about the way you'd like, you can't work effectively,
and you can't enjoy a good social life. Pain is important, because
it affects every aspect of our lives."

Before long, we're discussing the widely held misperception that
vigorous exercise, especially running, will inevitably lead to
joint problems. Bruce thinks it comes from the way that running has
so often been used as punishment. "It was what your gym teacher
made you do when you weren't behaving," she says.
It would help immensely if medical investigators could explain why
running and other vigorous exercise don't lead to joint pain.
Unfortunately, few docs are willing to make this leap, and Bruce
certainly isn't one of them. She makes it clear that her research
only uncovered pain trends--and not the pathways behind them. She
does, however, list some possible explanations: endorphins, fewer
muscular injuries, and the high pain threshold that runners might
develop. An Arthritis Foundation paper called "Exercise and Your
Arthritis" offers a more direct answer. "The stronger the muscles
and tissues around your joints, the better they will be able to
support and protect those joints," it says. "If you don't exercise,
your muscles become smaller and weaker."

Joint Resolution
It's exciting to find a long-term study that supports the
connection between running and good joint health, but I wonder how
many other docs and medical organizations are ready to take up the
cause. To check up, I call Patience White, M.D., the chief public
health officer of the Arthritis Foundation. I tell her about the
Fifty Plus runners, and ask if she's surprised by the results.
"That study makes complete sense to me," Dr. White says. "People
with pain in their joints imagine that runners must have even more
pain, but we have lots of good data to show that running doesn't
cause arthritis."

She goes on to say that obesity is a major culprit in the onset of
arthritis, and that runners do themselves a lot of good simply by
keeping the pounds off. Also, "Runners keep their muscles strong
and well-balanced, which helps the joints."
Music to my ears. Of course, it will be a long time before we
runners convince skeptical friends that we aren't headed for a
hellish destiny with pain and arthritis. But keep the faith; the
tide is turning. The medical community is slowly coming to accept
that running is good for your joints, as well as your heart. And
the evidence is growing. This doesn't give you license to pound out
long runs while swallowing a handful of ibuprofen. But regular,
moderate, pain-free running? Get out there and enjoy it, no matter
what your auntie says.

Run Away Pain
As we age, we naturally experience more aches and pains. However, a
long-term study of runners over 50 showed that the runners had a
smaller pain increase than a nonrunning control group. The women
runners benefited the most.
Percent Pain Increase Age 60-80
Female Runners 11.8%
Female Control 70.6%
Male Runners 17.6%
Male Control 41.4%

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