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Couch Potatoes and Higher Incidence of Hip & Knee Osteoarthritis

This is the second blog post from our new team member Dr P.J. Pruszynski PT, DPT.

You may be thinking, did I read that right?

….Now that I have your attention, let’s dive deeper into this statement.

An analysis of current research on hip and knee osteoarthritis incidence in runners of varying experience levels was performed. Runners were defined as competitive (professional/elite athletes or participated in international competitions) or recreational (running in a non-professional capacity). These two subgroups of runners were compared to sedentary, non-runners labeled as the control group. The prevalence of hip and knee osteoarthritis (OA) broke down as followed.

Competitive runners – 13.3%

Recreational runners – 3.5%

Non-runner/sedentary controls –10.2%

What does this mean? Recreational runners have a lower incidence of knee and hip OA than sedentary individuals.

Runner groups were further broken down by years of experience running: less than 15 years and more than 15 years.

The group who ran for less than 15 years had a lower incidence of knee and hip OA than sedentary individuals.

So good news for our newer and amateur runners….and maybe not so good news for our competitive clients.

BUT, the study reminds us that this higher incidence in knee and hip OA in our competitive and seasoned runners does not mean it is CAUSED by the volume or intensity of their running. For those who remember statistics class: correlation is not causation. Another thought - typically runners with more than 15 years of experience are older than those with less than 15 years experience. And we know that osteoarthritis occurs naturally with increasing age! So maybe this was going to happen anyway!

This is great news for all of us that have been lectured that our knees and hips are going to be shot because our crazy habit of running! However, what if you do have hip or knee pain? Or want to prevent future injury?

Great news, exercise can help with that too!

Strength training can significantly improve your pain levels and performance with running. Our muscles act as shock absorbers as we move through our world. If we have strong muscles less force is arriving directly at our joint surfaces.

Additionally, arthritis does not have to cause pain. You heard that correctly.

There have been countless studies performed that demonstrate a person’s level of “degeneration” does not correlate to pain levels. This may seem counter-intuitive, but exercising actually helps joint related pain. The inflammation that may exist due to irritation at a joint is what causes the pain. Our body is well equipped to remove that inflammation through pressure gradients we create. As I load and unload a joint, I am alternating increasing and deceasing pressure. The pressure change acts as a pump to bring new fluid and joint lubricant in, while flushing out the inflammation. How do we increase this pumping action even more… employ our bodies biggest pump, the heart. If we get our heart rate up and have more cycles of fresh blood being pumped and delivered to our cells, we can flush out that inflammation even quicker.

If you are running with pain and don’t know where to start, you should see a physical therapist. The Physical Therapists at Precision Performance are well equipped to analyze your running form, strength, and flexibility to determine what is contributing to this dysfunction. Come in for an assessment to maximize your performance.

Thanks for reading,


Source: Alentorn-Geli, E., Samuelsson, K., Musahl, V., Green, C. L., Bhandari, M., & Karlsson, J. (2017). The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 47(6), 373–390.


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