For years, some people avoided exercise because they feared it would damage their knees. A new study shows that to the contrary, people who participated in bicycling had a lower prevalence of frequent knee pain and radiographic and symptomatic osteoarthritis later in life.
Jeffrey B. Driban, PhD, professor of population & quantitative health sciences, is corresponding author on a multicenter study published in the journal Medicine & Science in Sports & Exercise.
“There’s a bit of a misperception that physical activity could be bad for joints when, in fact, we know that many exercises are actually beneficial for protecting our joint health,” said Dr. Driban.
Driban explained that a lot of the previous literature reinforced this concept that exercise perhaps is bad for joints because it was driven by studies of elite athletes from the 1940s to the 1980s, especially Olympic male athletes. He said it wasn’t clear how some of those findings may apply to a more general population that is not competing at that high level, but instead self-selecting to do exercise for leisure.
Also, he said, earlier studies tended to lump physical activities together, so his research team wanted to dig down to the specific activities. “There’s a big difference between somebody who is running versus doing soccer, versus doing American football versus swimming,” Driban said.
Working with researchers led by Grace Lo, MD, MS, at Baylor College of Medicine and the Michael E. DeBakey VA Medical Center in Houston, investigators had access to a large cohort database as part of the Osteoarthritis Initiative (OAI). The retrospective, cross-sectional study of people within the OAI used a self-administered questionnaire at the 96-month OAI visit to identify participation in bicycling during four time periods throughout a person’s lifetime (ages 12-18, 19-34, 35-49 and >50 years).
A total of 2,607 participants were included: 44.2 percent were male and mean age was 64.3.
Not only did researchers find an association between less pain and imaging or symptomatic evidence of osteoarthritis among people with a bicycling history, but they observed a dose response among those who participated in bicycling during more time periods.
Driban said the findings “echo the idea that one, we certainly should avoid recommending against bicycling, because it doesn’t seem to contribute to harm later in life, and also that it could be a beneficial form of physical activity, not just for their overall well-being but potentially also for their joints.”
In the sports medicine literature, there are nuances in the connection between participating in exercise and osteoarthritis, however, according to Driban. In an earlier systematic review he had done, he found that certain sports and certain types of athletes were at higher risk. For example, male soccer players, elite male long-distance runners, elite male competitive weightlifters, elite male wrestlers and participants in American football seem to be at higher risk later in life for osteoarthritis.
But advising people not to do sports misses the point, and it’s a dangerous public health message, he said.
“It’s ignoring the fact that there may be reasons why those sports are causing somebody to have a higher risk of osteoarthritis,” said Driban. For example, participants in these sports may be more susceptible to injuries, a major reason that people get osteoarthritis. Or they may push through pain and injuries in training to reach their competitive goal. “So rather than say, don’t do a physical activity, say, what can we do to make the same sport safer? For example, we could adopt 10-minute injury prevention warm-up programs that can reduce someone’s risk of an injury by up to 50 percent.”
Driban has published studies of runners and found that they didn’t seem to have a greater risk for pain, radiographic osteoarthritis or symptomatic osteoarthritis. In fact, there were signs that a history of running may be protective.
“I think the big take home is if you’re active, find ways to stay active; and if you’re not active, find the activities that you enjoy doing and do them,” said Driban. “Not only will you reap the benefits for your cardiovascular well-being and your mental well-being, but some of those exercise like bicycling, running, strength training, swimming could also be good for your joints.”
