Running and the Risk for Osteoarthritis

You still see the claims being made in forums and blogs that heel striking and the cushioned supportive shoes increase stress on the joints and therefore those that heel strike and wear these shoes are going to get more osteoarthritis later in life. I have previously discussed the debacle that followed the release of one study that lead several barefoot running websites to claim that running shoes did cause osteoarthritis (they lied about the research).

If running shoes and heel striking did increase the risk of osteoarthritis and given the vast majority of runners heel strike and wear cushioning and supportive shows, then it stands to reason that runners would have more osteoarthritis than the general population if this was the case. Pretty much every study has shown that this is not the case! Yet the propaganda and rhetoric continues.

This study was first released in February and I been meaning to get to it for a while. Notably, this is a really big one:

Effects of running and walking on osteoarthritis and hip replacement risk.
Williams PT.
Med Sci Sports Exerc. 2013 Jul;45(7):1292-7.
Running and other strenuous sports activities are purported to increase osteoarthritis (OA) risk, more so than walking and less-strenuous activities. Analyses were therefore performed to test whether running, walking, and other exercise affect OA and hip replacement risk and to assess the role of body mass index (BMI) in mediating these relationships.
In this article, we studied the proportional hazards analyses of patients’ report of having physician-diagnosed OA and hip replacement versus exercise energy expenditure (METs).
Of the 74,752 runners, 2004 reported OA and 259 reported hip replacements during the 7.1-yr follow-up; whereas of the 14,625 walkers, 696 reported OA and 114 reported hip replacements during the 5.7-yr follow-up. Compared with running CONCLUSIONS:
Running significantly reduced OA and hip replacement risk due to, in part, running’s association with lower BMI, whereas other exercise increased OA and hip replacement risk.

This one, unlike the previous ones that showed there was no increased risk for osteoarthritis from running, actually showed that running reduced the risk. Given that the vast majority of runners heel strike and wear supportive and cushioning running shoes, then its even clearer that they are not risk factors for osteoarthritis (not that there was any doubt before this study as the evidence was clear before it!).

Will this myth ever die? Or will it be, for example, something like the myth about vaccines causing autism: it does not matter how much research there is and how good the research is, the fan boys just don’t want to let it go?

As always, I go where the evidence takes me until convinced otherwise, and its time to put this myth to bed, but I said that last time.

Williams PT (2013). Effects of running and walking on osteoarthritis and hip replacement risk. Medicine and science in sports and exercise, 45 (7), 1292-7 PMID: 23377837

Last updated by .

3 Responses to Running and the Risk for Osteoarthritis

  1. Bionic July 26, 2013 at 3:00 am #

    I’ve had the misfortune of being a (former) competitive runner with low BMI who got OA at a young age. I never ran a marathon in 25 years of running pre-OA diagnosis. In my case, an undetected minor hip dysplasia was the probable culprit. I was more of a forefoot striker, by the way.

    I glanced at the paper and considering when the follow-ups were done (1999-2002 for NRHS-I and 2006 for NRHS-II), before the rise in hip resurfacing, you might see more runners from 2007 to 2011 or 2012 who have hip replacements. This is because resurfacing was targeted to younger more active patients (until the negative results starting coming in). In 2006, no one would give a total hip replacement to a 40 year old. I was actually told by a top orthopedic surgeon that I’d have to wait until I was 50.

    At any rate, I’d imagine the revised numbers for hip replacement would be minimal, and would not affect the final outcome of the study. Yet it is personally (though not statistically) significant for those of us in this unlucky category. I’m one of the most unlucky, as my resurfacing devices failed within 5 years and I had to get them replaced.

  2. blaise Dubois July 27, 2013 at 2:32 pm #


    Is this type of study justified to wear big bulky shoe or to heel strike? Is the incidence of OA is really lower with this type of shoe (what’s most of the retailers try to convince us)? Is there any advantage for OA to wear BBS?

    The study show one thing. The ‘mechanical stress of running’ is a good thing to create tissue adaptation… whatever the type of shoe.

    • Craig Payne July 27, 2013 at 7:10 pm #

      Its just says BBS’s do not increase the risk for OA.

Leave a Reply