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Can You Run with Knee OA?

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Can You Run with Knee OA?

Here's What You Need to Know!

So you’ve just been diagnosed with knee osteoarthritis (OA)…this is how you might be feeling (Pic 1)…

Pic 1 - This is a common reaction to being diagnosed with knee arthritis…!

There may be many questions running through your head

  • What exactly is knee osteoarthritis (OA), and how did I get it?

  • What are the best treatment options for managing knee OA?

  • Will I need surgery at some point, or are there other alternatives?

  • Can I use knee OA as an excuse to skip leg day at the gym forever?

  • Can I blame knee OA for my newfound ability to predict the weather with my knees?


But if you’re like me, your most important concern will be:

“Can I still lace up my running shoes and hit the pavement?”

Running: the only sport where you are willing to suffer, sweat, and swear, but somehow still come back for more.

Well, you're not alone!

Many folks in your shoes (pun intended) are curious about the same thing.

Let's dive in and explore whether running with knee OA is a good idea, and how it might even help ease your knee pain.

Understanding Knee Osteoarthritis (OA):

First off, let's talk about knee OA.

The old view of OA is that it a result of wear and tear and inevitable joint degeneration.

This is known as the biomedical model and it offers an overly simplistic view that OA happens when the cartilage in your knee joint starts to wear down, causing pain, stiffness, and all-around discomfort.

It's not exactly an inspiring way to view the problem.

New view of OA:

Thankfully some very smart researchers, clinicians and doctors have come together to provide an updated explanation for knee OA and this involves taking a broader view of knee OA as an integrated whole body problem - that involves inflammation, metabolic health, immune system, diet, nutrition and even things like our beliefs and knowledge.

Essentially we have updated our model from a simple mechanical system (body is a machine that needs fixing) to seeing the body as an ecosystem (complex adaptive system) that is capable of regenerating given the optimal environmental conditions.

This new approach is no shortage of a revolution and paradigm shift in how we see the body and it’s potential for healing.

It opens the door to many treatment options that were previously not even considered until very recently.

Benefits of Running with Knee OA:

Believe it or not, running can actually have some perks for folks with knee OA:

  1. Improved Joint Function: Running can help keep your knee joints flexible and moving smoothly, which is super important when you've got OA.

  2. Strengthening Muscles: When you run, you're not just working out your legs – you're also giving those supporting muscles around your knees a good workout. It's like building a sturdy support system for your knees!

  3. Weight Management: Running is a great way to burn calories and keep your weight in check. And when you're carrying around less weight, there's less stress on your knee joints.

  4. Mood Boost: Ever heard of a runner's high? It's a real thing! Running releases feel-good hormones in your brain, which can help lift your mood and ease stress – definitely a win-win!

Considerations for Running with Knee OA:

Before you lace up those shoes and hit the pavement, here are a few things to keep in mind:

  1. Talk to a Pro: It's always a good idea to chat with a healthcare pro before starting any new exercise routine, especially if you've got knee OA. They can give you the lowdown on whether running is safe for you.

  2. Take It Slow: Start with a gentle jog or brisk walk, and gradually build up your speed and distance over time. Rome wasn't built in a day, and neither is a runner!

  3. Shoe Game Strong: Invest in a good pair of running shoes with plenty of cushioning and support. Your knees will thank you!

  4. Watch Your Form: Pay attention to your running technique – aim for a mid-foot strike, keep your posture upright, and try to land softly to reduce impact on your knees.

  5. Mix It Up: Running is great, but it's not the only game in town! Mix in some strength training and flexibility exercises to give your knees a well-rounded workout.

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Could running actually be the BEST way to protect your knees?

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A recent study with 14,000 participants revealed some fascinating insights:

  • Non-runners had a HIGHER prevalence of knee pain.

  • Running could actually PROTECT your knees by inducing beneficial adaptations through mechanical loading.

But here’s the kicker:

When we try to shield our knees by avoiding movement, we might actually be reinforcing a cycle of pain and fear.

Running, under proper guidance, sends a powerful message to the brain that everything’s OK!

Here are three tips to keep you going strong:

- Maintain a high cadence of 170-180 steps per minute to reduce stress on your knees.

- Invest in well-supported shoes to cushion impact and provide stability.

- Strike a balance between walking and jogging to build endurance while minimizing strain.

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When Biomechanics DOESN'T Matter

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Greg Lehman has been a pioneer in helping us to understand pain and biomechanics and finding out when they matter.

He is a advocate for “Movement Optimism” - an approach that helps you build confidence in your body and avoid the common trap (fueled by well meaning health care professionals) of getting stuck in sometimes irrelevant biomechanical narratives that create fear and entanglement in the body.

I would encourage you to watch at least the first five minutes as he pulls apart the most common things you might hear coming from your health care professionals mouth.

“What I often say is, it’s not the pain science or neuroscience that challenges these biomechanical ideas, it’s the biomechanics itself. And if you know the biomechanics well, you can really see the holes in the common arguments.”

I hope you enjoy this eye opening lecture at the San Diego Pain Summit (click on image below to watch on youtube).

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"Back to the Body": Charting a New Course in Physiotherapy

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In the dynamic field of physiotherapy, a transformative wave is reshaping our traditional approaches to pain and injury.

This evolution, termed "Back to the Body," represents a significant departure from past practices, integrating modern science's revelations with a renewed focus on the body's intricate signals.

As we delve into this shift, it's essential to appreciate the context from which we're moving and the promising direction in which we're headed.

The Traditional Paradigm: A Focus on the Physical

Historically, physiotherapy has been deeply anchored in a biomedical model, concentrating on the body's physical aspects—its joints, muscles, and tissues.

This approach, while foundational, often adopted a reductive lens, aiming to "fix" what was perceived as broken or misaligned.

Diagnoses frequently highlighted deficiencies: a "weak" core, "tight" muscles, or "improper" posture.

While these assessments were made with the best intentions, they inadvertently introduced a nocebo effect, where the negative framing of conditions could exacerbate patients' perceptions of pain and disability, sometimes with minimal relevance to their actual experience of pain.

The Shift Toward Mind and Emotion

The field's expansion to encompass beliefs, emotions, and the broader neurocentric model—largely influenced by the pioneering work of researchers like Lorimer Moseley and David Butler—marked a significant leap.

This phase brought to light the brain's integral role in pain perception, advocating for a more comprehensive understanding that transcends mere physicality.

However, this shift, for all its merits, occasionally led to an overemphasis on the psychological at the expense of the physical.

Patients sometimes felt their pain was being dismissed as purely a construct of the brain, leaving them feeling invalidated and overlooked.

"Back to the Body": A Holistic Reintegration

Today, we stand at the precipice of a new era, inspired by Bud Craig's insights into homeostatic emotions and the complex interplay between mind and body.

"Back to the Body" advocates for a return to a more integrated approach, where pain is recognized as an interoceptive signal—a cue from our body indicating a need for attention and care.

This perspective sees pain not as a mere symptom to be eradicated but as a critical piece of feedback within our body's attempt to maintain balance.

With advancements in technology—such as heart rate variability monitors, blood glucose tracking, and sensors for lactate and inflammatory markers—we're now equipped to decode the body's signals with unprecedented clarity.

This technological leap, combined with principles of load management as outlined by Tim Gabbett, empowers us to identify and respond to the body's cues more effectively, fostering an environment where positive adaptations are more likely.

Empowering Through Understanding

This shift towards an integrated mind-body model is about empowerment and education.

It's about guiding patients to tune into their bodies' messages, recognizing the signals of overload and stress.

It encourages a response to discomfort informed by understanding and mindfulness, rather than fear or the pursuit of immediate fixes.

This approach demystifies the sensations we've labeled as pain, reframing them as part of our body's broader context of response.

Moving Forward

"Back to the Body" heralds a return to physiotherapy's roots, enriched by our journey through the realms of psychology and neuroscience.

It's a call to embrace the body's complexity, leveraging science and technology to deepen our connection with ourselves.

As we chart this new course, we embrace a model of care that is both empowering and educative, one that places the patient's experience at the forefront of the healing process.

In doing so, we not only address pain more effectively but also foster a holistic sense of well-being.

Daniel O’Grady