It's certainly an interesting finding, but I wonder if there are any long term implications of it? Especially as swimming should be easier on the knees than running is.
Like all repetitive activities, runners are prone to overuse injuries and the most common is to the knee. However, runners are still much better off than non-runners. Also, knee pain is almost always due to a biomechanical or strength issue. If you’re smart about your running (most runners, self included, are idiots about their running), you need not get injured and you’re way better off than sitting on the couch.
That said, I don’t know what happens to the knees of swimmers, weightlifters, cyclists, etc, but inactivity is the worst thing you can do.
Sorry, I just hate this very common misconception that runners are out there destroying their knees.
Runners don't get arthritis in their knees more often than nonrunners.
Those are the facts. Period. If anything, long-term studies have found that runners have less incidence of knee osteoarthritis. One study[1] that followed runners and nonrunners for 18 years found that, while 20% of the runners developed arthritis during that time, 32% of the nonrunners did. A large study that looked at runners and walkers[2] found that regular runners had roughly half the rate of arthritis as regular walkers. In that second study, the runners with the highest regular mileage had the lowest rate of arthritis.
Do these studies control for people who quit running due to an injury? It doesn't appear that they do. They look only at "healthy long distance runners." Sorry, but that is not very compelling. It's like studying 90-year old chess grandmasters and concluding that chess prevents Alzheimer's.
You have to control for all the people who don't do an activity because they're too unhealthy to continue. And there is no obvious way to do that.
It says they followed runners and non-runners for 18 years. Presumably, that means they monitored the same bunch of people over the 18 years and the effect you mention would have been noticed, if it existed.
The question is: did they only count someone as a runner if they were still a runner at the end of 18 years? Or if someone was running for 1 year, got injured and then quit running, did they get dropped from the study or even grouped with the non-runners?
Well, I don't have the time to go through the whole thing but on a first glance:
1. Seems like they identify someone as runner or walker based on a questionnaire filled. After X years those people fill another questionnaire to indicate whether they had OA or hip replacement. I would think that at the time of the second questionnaire a runner will still be assumed a runner, even if he doesn't run anymore.
2. Exercise other than running increased rates of OA and hip replacement.
That's not a very good study then. They should be taking a group of people, none of whom are runners, and randomly assign them to runner or non-runner groups, and then follow them for 18 years. The activity levels of all participants should be tracked at all times by GPS devices with heart rate monitors. Their health should be monitored by professionals, though they should not be given any instruction in proper running techniques. At the end of the study they should give everyone a full examination to determine the outcomes for each group.
Of course, I'm being facetious. Such a study would never be done because it's completely unethical. But the point is that you can't determine an intervention (running) is safe and effective without a proper trial like that. A survey that asks people whether they're a runner or not, before even beginning, has a problem with selection bias.
Thanks for mentioning that, this is something I often wonder about, as this is at least often left out of the press. I don't know how/if the underlying research accounts for it, but I'd be very happy if such statistical complications were mentioned more often to show hard it is to get the science right.
Right now I weigh a little more than 100kg and am currently trying to better my life to live healthier and be more active.
I can run pretty well, currently about 10km with a heart rate monitor to not exceed my limits. I've tried swimming as well but for some reason I get knee pain during swimming, it's probably just bad technique but it feels so stupid to have to get out of the water because of knee pain.
At my max I weighed 115-120kg and I'm pretty sad that I didn't start doing all this stuff earlier.
Also, the article briefly mentioned rowing. I didn't enjoy it as much when I was competing when younger, but it's a brilliant exercise if you have access to even (or can afford) an ergometer (indoor rowing machine).
As long as you study form and adhere to that principally before exerting yourself, it's a great aerobic exercise that also helps build and maintain muscle mass (arms, back, and legs mainly). It's easier on the joints as well—again, and I must stress, as long as you maintain proper form. I see so many "cross-fitters" yanking and janking their arms and back and shooting their butts around it makes me cringe knowing what kind of hell it's going to render to their bodies. With proper form, it's one of the best compound exercises. I wish I had access to an erg these days, but I'm trying to keep my own costs down by using the limited gym in my building.
Also if you're in a town with a rowing club, they often host "learn to row" sessions that will guide you through a lot of it—and get you out on the water as well, if you're not averse.
> (...) it's probably just bad technique but it feels so stupid to have to get out of the water because of knee pain.
Get one-on-one classes! A teacher can correct most of your errors in a couple of hours, and will make a decent swimmer out of anyone in ten hours[¹]. It's a very small investment for a very large gain.
[¹] Assuming there's no fear of water involved, you can go from "I can't do one lap without stopping for air at the wall" to "I can swim 1km continuous" with 10h of classes.
As a lifelong soccer player, my knees are in terrible shape. I have multiple meniscus tears in each, and I've also had catastrophic injuries in both ankles. Despite that, I keep playing. The most useful teammates I have are those players who are also running fanatics. They put a lot of effort into gear, technique, and ritual that helps prevent and repair knee and foot damage. I've not encountered this much devotion to bodily integrity in any other sort of athlete.
Soccer is a totally different game than running - it's basically a game of "how to best apply extreme forces to your lower body in unstable positions". You're twisting and turning and applying force in ways the body wasn't meant to handle in any sort of repeated manner. I can definitely see how running would help - it'll help build up the muscles and surrounding tissue, but really, when it comes to longevity of the joints, soccer is just bad news.
> Also, knee pain is almost always due to a biomechanical or strength issue.
If you have a recurring running issue it’s one of those. I got shin splints every month. Then I stopped running for six months and started weightlifting. No one who squats is going to get shin splints.
Shin splints is the classic injury for enthusiastic people who see aerobic improvements that outpace the strengthening of muscle, tendon and bone. Shin splints is almost unheard of amongst experienced runners.
It's fantastic that squats helped you, but if you are primarily looking to improve your running then months of training at a lower intensity, to avoid the shin splints, is much more productive than stop-start training resulting from the need to let your injury heal.
This is why I bike rather than run. Crashing is your primary risk there but otherwise, it's stupendously hard+ to hurt yourself unknowingly.
I'm not fully aware of all of the possible long term risks to cycling but I know pollution from cars comes up a lot. I believe the prevailing consensus is that the benefits still outweigh the harm done.
+: May be overstating it. You can hurt your wrists through a bad fit and your knees through using too high a gear. In both cases, your body will probably let you know about it soon though.
I bike and run, and like you appreciate how gentle cycling is on one's body. With that said, I don't worry about getting killed while running the way I do while cycling (i.e. by cars).
That is a very general statement. It really depends on the type of swimming and intensity.
I have a bad shoulder (pain) from having it dislocated several times over the years.
When I first started swimming (only breaststroke), I felt tingles of pain pretty quickly. Outside of swimming, I would feel it if I raised my arm over my head in certain angles.
After about 6 months of regular swimming, literally all the pain went away. Clearly my body developed strength around the injury. My shoulders feel better because of swimming.
In a similar vein... I used to have terrible RSI from typing. I randomly started rock climbing. After a while, my hands strengthened and the RSI pain went away. I climbed actively for about 8 years. I stopped climbing years ago (kept typing) and the pain never returned to the same degree as before. When I started swimming more recently, the current hand pain went away again as well.
Is running hard on the knees? I see a large number of older people running here in Portland, OR. As a runner myself, the study I’ve chosen to believe shows that running may actually be good for the knees.
As best I can tell, running and knee problems, like most sports injuries, are generally self-induced and avoidable (at least for over-use injuries).
Also, my opinion... running is one of the first sports sedentary people will attempt. It's cheap (just need shoes), accessible (no special field, no special skill), and high calorie burn for time spent.
Running does pound your leg joints. Especially if you heel strike badly. And do so in inadequate shoes (cheap cross-trainers). And this is exacerbated by being over-weight. All correctable and avoidable (good form, good shoes, slow ramp-up and diet control). But, people don't know what they don't know, and if they get shin splint or knee pain, they're likely to quit and blame it on "running is bad for you".
This is why I hate the "just go minimal" cargo cult. Yes, some people will notice how it highlights their heel-striking ways and will make the necessary adjustments. Others will not, and they'll end up smashing their feet even more than before. For them - and I think they're more numerous - minimal shoes are the exactly wrong answer. Not all runners are lithe twenty-somethings. Some are built differently, and react differently, and need different shoes.
ETA: Yes, it's a shame that heavily padded shoes are the default. They shouldn't be. And minimal shoes are great for some people. All I'm saying is that "go minimal" has become the "do you even lift" of running, and I find it just as unhelpful. It's not a universal prescription.
I have a pair of NB Minimus Trail. They're great for what I use them for... short runs on vacation, usually on mixed terrain. And walking around casually (weekend errands, etc). I don't think I'd ever run in them as my primary trainer. Even if I didn't fear injury, I'm just not convinced they'd be any faster than a good trainer, plus a road race shoe for race day.
Shortening my stride length was the best fitness change I made recently. Dramatically less stress on the knees, but now I have some pain on top of my ankles, which, I hope, is not-joint related. Not sure what to do about that one.
As far as the study - I don't see any actionable info there.
I had this very issue and changing my shoes resolved it. I had transitioned from off-road running over hilly trails, to very aggressive ascents followed by steep an often technical descents. The Brooks Cascadias that were awesome for the hilly trails weren't working for the steep techy stuff. Moving into Saucony Peregrino Isos that have a stiffer upper and much burlier tread solved the issue almost immediately.
No idea what kind of mileage you're covering or terrain you're running, but footwear can be a real maker/breaker as the mileage gets longer and the terrain gets gnarlier.
I never have any issue with my knees. I’ve been running 12 miles a week for over 4 years now. I’m not a fast runner either, average about 9.5 minute mile. I find that pace keep me going and can relax when I run. The pain on top of the ankle recently creeps up to me. I think it is related to how I tie my laces. If I loosen them a bit it feels a lot better. I will go to a runner store to have them pick my next shoes.
> I will go to a runner store to have them pick my next shoes.
Do this now if you can afford it. Try to find one of the smaller stores that really focuses on runners and is staffed by avid runners. A good store will have a treadmill and cameras to be able to look at your stride and make recommendations on both your stride pattern as well as your shoes. It was a running store that helped me find the Saucony shoes that have helped my ankle issues go away. :)
You could maybe also be dealing with an imbalance of strength between your hamstring and quadriceps. When runners have joint issues this can be the culprit or at least a key contributor. Adding in a couple sessions a week of weight training that include movements like deadlifts, good mornings, and back squats can strengthen the posterior chain (https://en.wikipedia.org/wiki/Posterior_chain) and address those imbalances.
Cool and thanks! I'll make a trip to the running store in downtown soon. Like you said, it's small shop and hopefully run by knowledgeable staff.
I used to wear ASIC for over 10 years. I notice that the quality has gone down a bit: cheaper material, shorter laces and mostly I cannot find a wider size. I switched to Brooks in 2017 and it seems to be OK (wide size).
I also heard a lot of recommendations for Saucony. Let's hear what the running store's staff suggest.
You're also very on point w.r.t weight training! I quit going to 24-hour fitness in 2015 because of commute change. So now I mostly exercise by running outdoor. I need to sign up for gym again to squat.
Thanks for the advice! I wear Brooks too, but it's been around a year since I changed them out. I only run about 12 miles a week, but I try to keep the pace up.
Oh wow, you're way overdue for new shoes. 300-500 miles is the usual rule of thumb[1].
My personal rule of thumb is 500 miles minus moving weight. So in my case I'm 225 lbs, I usually have 10 lbs of water/layers/kit, so 235lbs moving. 500 - 235 = 265 miles max per pair of shoes. I replace sooner because technical terrain trashes the lugs on the soles.
> Shortening my stride length [...] now I have some pain on top of my ankles
Same. I just took a month off, after three months of dealing with that pain. Seems to have gone away, but I just started back a couple of days ago and haven't gone all out just yet.
I also switched to super-cushioned shoes (Hoka Bondi). I figure I'm running for exercise, not performance, so now I'm prioritizing safety over speed. It's no fun if you can't run at all.
FWIW, I've found that the best way to shorten stride length is not to think about stride length. For many people, that will result in a very unnatural stride. Instead, focusing on increased cadence will cause stride length to decrease more naturally.
Running the wrong way is hard on the knees and everything else, and is surprisingly common even among those who run a lot. When I started running nearly five years ago, I quickly realized that I was doing it wrong. A little research on stride and foot landings, a few adjustments, and things were a lot better. If I'd kept running the "naive" way I'm sure I would have wrecked my knees in no time. As it is, I've had fewer injuries (and illnesses!) than before I started. As with most systems in the body, making your knees work a bit is likely to be beneficial.
BTW, one irony with running form is that it's often the young fast folks who are the worst. I often see some high-school or college kid zipping by with atrocious form, because at that age it's easy to get away with. I cringe when I think of what's going to happen when they get older, their bodies change, and they're still slamming their feet into the pavement. By contrast, older runners tend to be more careful about form. The ones who aren't tend to become non-runners very quickly.
Running with a minimalist shoe helps protect your knees. You learn to strike with your middle foot rather than flat-footed or heel first. The shock is absorbed by the muscles and tendons in your calf rather than by your knees.
Going back to when I was a teen I've never been able to keep up a running habit on pavement for more than a week before my knees hurt too much to keep going, but I've never had a problem running on trails and broken ground.
I did parkour for years, and at my peak I could jump from 12 feet up to pavement, everyone told me I was going to wreck my knees, it never happened. at 42 my knees are great but for the fact that I can't run regularly on pavement, and never could.
Yes, but...
Please don't jump into minimal shoes and expect to do your normal mileage. Or, use them as your first running shoe, if you aren't a runner. Transitioning to them too quickly can lead to different overuse injuries (due to your body being used to heel-striking, and now you'er doing it without cushion). Start with a short run, on the track if you can, with PERFECT form.
As a semi-serious runner (sub-20 5k at 42 years old, ~20 miles/week), I've found it best to rotate shoes, not just to minimize wear on a given pair (cushioning can take a day to fully rebound from a long run), but also "horses for courses". Cushioned trainers for long runs. Light-weight racers for speed work and races. Trail shoes for off-road. Etc.
There’s some evidence that suggests adipose tissue can be an inflammatory mediator - which potential could lead to arthritic changes in joints. This is used to explain why we get arthritis not only in weight bearing joints such as the knees and hips, but also in the digits of the hands, which don’t bear as much weight.
Presumably as a regular runner, you are not overweight (less adipose tissue than a more sedentary person)
Swimming has its own set of injuries. Shoulders in particular. Also your skin gets bad with all the chlorine unless you shower thoroughly +before+ and after, and apply moisturizer. None of the swimmers I know only shower afterwards, including women.
Second this on the repetitive stress injuries. Strong breaststroke swimmers can have knee issues due to the lateral force on a joint that doesn't move laterally. For shoulders - rotary cuff injuries are incredibly common, especially since the muscles developed by swimming are far larger and stronger than the muscles which hold the joints in place.
20+ years after finishing my swimming career, I still have to deal with both of those repetitive injuries.
That said, I don’t know what happens to the knees of swimmers, weightlifters, cyclists, etc, but inactivity is the worst thing you can do.
Sorry, I just hate this very common misconception that runners are out there destroying their knees.
From https://www.runnersworld.com/health-injuries/a20850408/5-thi...
Runners don't get arthritis in their knees more often than nonrunners.
Those are the facts. Period. If anything, long-term studies have found that runners have less incidence of knee osteoarthritis. One study[1] that followed runners and nonrunners for 18 years found that, while 20% of the runners developed arthritis during that time, 32% of the nonrunners did. A large study that looked at runners and walkers[2] found that regular runners had roughly half the rate of arthritis as regular walkers. In that second study, the runners with the highest regular mileage had the lowest rate of arthritis.
1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556152/
2. http://www.ncbi.nlm.nih.gov/pubmed/23377837