Background: Prior studies of the relationship of physical activity to osteoarthritis (OA) of the knee have shown mixed results. The objective of this study was to determine if differences in the progression of knee OA in middle- to older-aged runners exist when compared with healthy nonrunners over nearly 2 decades of serial radiographic observation.

Methods: Forty-five long-distance runners and 53 controls with a mean age of 58 (range 50 –72) years in 1984 were studied through 2002 with serial knee radiographs. Radiographic scores were two-reader averages for Total Knee Score (TKS) by modified Kellgren & Lawrence methods. TKS progression and the number of knees with severe OA were compared between runners and controls. Multivariate regression analyses were performed to assess the relationship between runner versus control status and radiographic outcomes using age, gender, BMI, education, and initial radiographic and disability scores among covariates.

Results: Most subjects showed little initial radiographic OA (6.7% of runners and 0 controls); however, by the end of the study runners did not have more prevalent OA (20 vs 32%, p !0.25) nor more cases of severe OA (2.2% vs 9.4%, p!0.21) than did controls. Regression models found higher initial BMI, initial radiographic damage, and greater time from initial radiograph to be associated with worse radiographic OA at the final assessment; no significant associations were seen with gender, education, previous knee injury, or mean exercise time.

Conclusions: Long-distance running among healthy older individuals was not associated with accelerated radiographic OA. These data raise the possibility that severe OA may not be more common among runners.

(Am J Prev Med 2008;35(2):133–138) © 2008 American Journal of Preventive Medicine

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Abstract

Objective: The primary objective of this review was to synthesise the literature related to risk factors for running injuries, with an emphasis on predicting the risk of injury based upon biomechanical variables. Data sources: Literature sources from a broad range of scientific journals were searched, focusing primarily on literature describing studies which directly related to risk factors for overuse running injuries of the lower extremity. Study section: There were a total of 74 studies reviewed. Data were primarily reviewed from experimental and epidemiological studies. Data extraction: Only data from research published in refereed journals or professional conference proceedings were presented in this review. Data synthesis: Although many sources suggest that about 60% of running injuries are due to training errors, from a practical standpoint, it could be stated that all overuse running injuries are attributable to training variables. In order to sustain an overuse injury, a runner must have exceeded his/her limit of running distance and/or intensity in such a way that the remodelling of the injured structure predominated over the repair process. Biomechanical and anthropometric variables are very important in determining where the limits exist for an individual. Conclusions: Since all overuse running injuries could be attributed to training errors, then it would follow that these injuries should be preventable. A proactive approach may enable practitioners to predict running injury risk based upon biomechanical and anthropometric profiles of runners. Future prospective studies could further identify variables which are most responsible for running injuries, and determine easily measurable variables that may correlate to these risk factors. Keywords: chronic injuries, training errors, running, prevention, gait 

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Over the past 25 years, women’s participation in sports has increased six-fold.  Unfortunately, these increases have been outpaced by even more dramatic increases in certain sports-related injuries among women. Female runners are twice as likely to experience patellofemoral pain syndrome (anterior knee pain), iliotibial band friction syndrome, and tibial stress fractures as compared to male runners (Taunton et al, 2002).  Researchers have hypothesized that differences in anatomical structure, muscular strength and flexibility, and running biomechanics may predispose female runners to these injuries.