Recreational Running Benefits Hip and Knee Joint Health

    Recreational runners are less likely to experience knee and hip osteoarthritis (OA) than sedentary individuals and competitive runners, according to a study published in the Journal of Orthopaedic & Sports Physical Therapy.

    The study concludes that running at a recreational level for up to 15 years – and possibly more – may be safely recommended as a general health exercise. Further, the evidence suggests recreational running may have benefits for hip and knee joint health.

    An international team of researchers in Spain, Sweden, the United States, and Canada aimed to evaluate the association of hip and knee OA with running and to explore the influence of running intensity and years of exposure on that association. In their systematic review, they found that only 3.5% of recreational runners developed hip or knee OA. This was true for both male and female runners.

    Comparatively, remaining sedentary and forgoing running for exercise was associated with a 10.2% rate of knee and hip OA, while training and running competitively increased the incidence of OA in these joints to 13.3%.

    The study’s authors noted that other researchers who have also found a link between high-volume and high-intensity runners and knee and hip OA define exercise at this level as running more than 57 miles (92 km) per week.

    “The principal finding in this study is that, in general, running is not associated with osteoarthritis,” said lead author Eduard Alentorn-Geli, MD, MSc, PhD, with Fundación García-Cugat; Artroscopia GC, Hospital Quirón; and Mutualidad Catalana de Futbolistas-Delegación Cataluña, Federación Española de Fútbol in Barcelona, Spain, as well as Mayo Clinic in Rochester Minnesota.

    “The novel finding in our investigation is the increased association between running and arthritis in competitive, but not in recreational, runners.”

    Dr. Alentorn-Geli and colleagues used PubMed, Embase, and Cochrane Library databases to identify studies investigating the occurrence of OA of the hip and/or knee among runners. They reviewed 25 studies that included 125,810 patients, and ultimately selected 17 studies involving a total of 114,829 patients.

    The researchers then conducted a meta-analysis of studies, comparing hip and knee OA between runners and sedentary individuals who did not run. Runners were considered “competitive” if they identified themselves as professional/elite athletes or participated in international competitions. Recreational runners were those individuals who ran in a non-professional, or amateur, context.

    The researchers calculated the prevalence rate and odds ratio (with 95% confidence interval) for OA between runners at both competitive and recreational levels and sedentary individuals. They also performed subgroup analyses for OA location (hip or knee), gender, and years of exposure to running (less or more than 15 years).

    They were not able to determine the amount of running that is safe for these joints, and they cautioned that they had not assessed the impact of obesity, occupational workload, or prior injury on the future risk of hip and knee OA in runners.


    Alentorn-Geli E, Samuelsson K, Musahl V, Green CL, Bhandari M, Karlsson J. The association of recreational and competitive running with hip and knee osteoarthritis: a systematic review and meta-analysis. J Orthop Sports Phys Ther 2017;47(6): 373-390. Epub May 13, 2017. doi:10.2519/jospt.2017.7137.