The Truth About Knee Osteoarthritis and Running

Knee Osteoarthritis  and Running

What exactly is Knee Osteoarthritis?

The term osteoarthritis means inflammation of the joint and bones. This definition presents several problems. A diagnosis of osteoarthritis doesn’t actually explain what the cause of the joint pain is. Pain and inflammation occur as a reaction to a threat in the body. These symptoms are the effect of an underlying problem, not the cause. It is important to acknowledge that people diagnosed with osteoarthritis are often in a lot of very real pain, but the overdiagnosis of this disorder can lead to ineffective treatment and a misunderstanding of the underlying cause.

Does an osteoarthritis diagnosis cause unnecessary fear?

When people hear the words osteoarthritis knee pain treatment, they think about getting older and their body wearing out. They may begin to fear that their quality of life will be diminished due to an impending decrease in mobility and activity. Many definitions of osteoarthritis claim that it is a serious disease, which brings up negative connotations. However, if we look at alternative methods of explaining joint paint, some of this fear may subside.

Can damage to the cartilage be one of the causes of arthritis?

Visible injury of the cartilage is often portrayed as one of the causes of arthritis. Cartilage lacks pain receptors and is extremely unlikely to be a direct cause of any pain. The theory is that the cartilage between the bones begins to disintegrate and the bones in the joints rub together which causes joint pain. However, a study conducted by Dr. Ali Guermazi, found that several participants who do not suffer from osteoarthritis knee pain had signs of cartilage damage. If cartilage damage is the reason that people experience joint pain, it does not make sense that these participants wouldn’t have any.

What else does Dr. Guermazi’s study say?

Dr. Guermazi studied the prevalence of abnormalities in the joints that were visible on an MRI scan that may be associated with osteoarthritis. 72 of the participants in the study showed signs of osteophytes, which are bony outgrowths associated with joint cartilage degeneration, but had no pain. The study also showed that many participants had cartilage damage and bone marrow lesions, but were experiencing no pain. The study actually showed that there were more people not experiencing pain from their meniscal lesions, than participants who were. Guermazi and his associates did find that these changes occurred much more often in older participants than in younger ones. It is clear that there are a lot of changes that take place in the human body as we age, but scans do not effectively show the appropriate levels of pain associated with these changes.

What causes joint pain in the knee?

Knee pain can be caused by a multitude of factors and health care professionals need to address all of them to effectively provide joint pain relief. The cause of joint pain varies depending on the person and health care providers need to take a holistic approach by treating the whole person and not just the afflicted joint. It is important to acknowledge that inflammatory arthritis might just be another word for knee pain and not a valuable diagnosis.

Is it possible that osteoarthritis causes knee pain?

A common belief is that running puts a lot of added stress on the joints and runners are therefore more prone to develop knee osteoarthritis. However, a study by Cymet&Sinkoc finds that those who engage in long distance running are not more likely to develop knee osteoarthritis. Another study evaluated 45 participants who regularly engaged in long distance running and 53 control participants who did not do any running and found that the runners were not more likely to develop knee osteoarthritis.

What else does the Cymet&Sinkoc study say?

Their study shows that there might be an increase in visible evidence of cartilage damage in long distance runners or endurance athletes, but there is not an increase in associated symptoms, such as pain. This is another study that proves that visible features of osteoarthritis do not always correlate with knee pain. The study also found that these activities may even be effective in protecting against joint damage.

What are the health benefits of running?

In addition to protecting against joint degeneration, running has many cardiovascular and mental health benefits. Healthcare professionals should now acknowledge that running is not bad for the knees, but actually increases bone mass and prevents bone loss. Athletes should continue to run without fear of developing inflammatory arthritis.

What is adaptation and how can it provide joint pain relief?

Joints will adapt to the amount of stress that are put on them. If you never put stress on your joints and then begin exercising, it will be easy to overload the joint and injury or pain may occur. Additionally, if you put too much stress on your joints by overexercising, injury is likely to occur. However, if you put the right amount of stress and rest on your joints, the joint will strengthen and adapt.

How do you know what the right amount of stress is?

The right amount of stress to put on your joints, known as the adaptation zone, can vary depending on the person. Other factors, such as fatigue or emotional stress, can also affect your adaptation zone. If you are experiencing pain during or after exercise or stiffness in the morning, you may be putting too much stress on your joints. Paying attention to your body and having a professional prescribe the right amount of exercise can be extremely helpful in preventing injury and pain.

What is severity and irritability?

The amount of exercise that is appropriate for each individual should depend on SI factors. SI factors are based on the amount of severity and irritability you are experiencing. Severity ranges in scale from 0-10, with 0 representing no pain, while 10 represents extreme and unbearable pain. Irritability refers to how long the pain is present. Low irritability means the pain disappears quickly, while high irritability means the pain is present for longer periods of time, such as hours or days.

What types of exercise should you engage in?

If you are suffering from high SI factors, begin with gentle, low-stress activities. You can work your way up to more difficult exercises as your adaptation zone changes. The right exercise for your knee pain can vary depending on the individual, but it is important to be aware that some exercises place more stress on the afflicted joint than others. A combination of strengthening exercises around the knee and hip area, in addition to cardiovascular exercises, seems to be effective.

What types of cardiovascular exercises?

Each person should engage in cardiovascular activities that they enjoy the most. Swimming, riding a bike and walking are all examples of cardiovascular exercises to start with. Increase the length of the activity and intensity as time goes on.

What types of knee rehabilitation exercises?

There are many exercises that can help relieve knee pain, but there is no specific exercise plan that will work for everyone. Some low stress activities include hydrotherapy, cycling and bridging. Pilates, yoga, squats and lunges put a little more stress on the joints. Jogging, sprinting and plyometrics put the most stress on the body.

Should you feel pain when exercising?

Exercise should generally be pain free. Your level of severity should be under three out of ten with a low level of irritability. If the pain is more intense than that, adjust the exercise so that you are putting less stress on the body and experiencing less pain.

What do other healthcare experts have to say?

The National Institute for Healthcare Excellence states that inflammatory arthritis is not caused by aging and does not always cause deteriorating joints. The institute also explains how there is a poor link between the structural damage that is visible on an X-Ray and the amount of pain a person may feel. They also reiterate that pain is a biopsychosocial issue that is influenced by many different factors.

Reactive Neuromuscular Training on Kineo


Kineo – the most versatile muscle testing using artificial intelegence


Kineo – the most versatile muscle testing using artificial intelegence


Kineo – the most versatile muscle testing using artificial intelegence


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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