Why running after 40 won’t wreck your knees – The Australian

However, this particular fitness misconception, upheld by generations of the anti-jogging brigade, has been so firmly rebuffed by scientists that it is likely to prompt an upsurge of those in their 40s, 50s and beyond lacing up a pair of trainers, even if they have not previously run farther than the length of their back garden — no matter how worn and battered their body might be before they start.

Jogging naysayers always run with the argument the activity is destructive to hips and knees. Yet researchers have struggled for decades to find a conclusive link between running and joint pain.

A new study, the first of six to be conducted by researchers from London and Basel in Switzerland over five years and led by Alister Hart, an orthopaedic surgeon and research professor at University College London and the Royal National Orthopaedic Hospital, is set to challenge our preconceptions about age and running.

Hart ran the New York Marathon in 2012, aged 42, and was struck by the effect it had on his body: “I got back to work a few days after it and I could hardly walk. I had to use a handrail to go down the stairs and my legs were in pieces. My colleagues seriously questioned why I was doing all this running and it prompted the inspiration for some research.”

With the help of the organisers of the Virgin London Marathon, he and his team recruited 115 novice middle-aged runners taking part in the 2017 event, in each case their first attempt at completing the 42.2km race.

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Most of the study’s participants were in their mid-40s and far from super-fit, with many claiming not to have run, or indeed exercised much at all, before agreeing to take part in the trial.

Crucially, none of the group had suffered hip or knee problems before their first run.

All underwent an MRI scan of both knees six months before the event and two months before starting the standard four-month marathon training schedule issued to race entrants.

“We used 3T MRI scans of the highest resolution available so that we could accurately detect even tiny abnormalities in the joint’s tissues or signs of erosion,” Hart says.

“By middle age most joints have some level of wear and tear, so we needed to establish what their joints were like before they started running.”

While the participants had declared themselves injury-free before taking part in the study, results of the initial MRI scan suggested otherwise.

“More than half of the knees of those that went on to finish the marathon already had cartilage damage (92 knees, 65 per cent),” Hart says.

Tendon injuries were present in 60 knees (42 per cent), while 36 per cent of knees had meniscal tears and 41 per cent displayed signs of bone marrow oedema, a build-up of fluid that often occurs as a result of overuse.

By the time race day arrived in April, 31 of the newbie runners had failed to make the start line — mostly due to a lack of training because of non-health-related reasons — although 83 successfully made it from Greenwich to The Mall in a respectable average time of five hours and 20 minutes. But at what cost to their knees?

A second MRI scan conducted two weeks after they had crossed the finish line would prove telling and, for the 71 runners who agreed to undergo it, provided a direct comparison to pinpoint if any degeneration or damage had occurred during the hundreds of kilometres they had covered by foot in the intervening months.

What Hart and his colleagues found was surprising because he “expected to see additional damage to the knees”.

“Remarkably, that was far from the case. Many of the existing problems had improved — damaged cartilage was partially repaired and bone-marrow lesions had shrunk,” Hart says.

“I was completely amazed when we saw that pre-arthritic bone marrow oedema had improved. It seems that blood supply and stress responses somehow lead to these positive changes.”

Regular running helps to strengthen muscles surrounding the knee, which protects it and prevents overloading of the joint.

It wasn’t all good news. One participant who started the marathon had failed to finish — it was someone who had been identified as having a meniscal tear in the pre-training scan.

In some of those who did finish, there were signs of recent tears in tissue and cartilage, although mostly around the kneecap, where bone erosion and osteoarthritis are less common.

Overall, knees were in better shape after training and completing a marathon than they were before it. A second, yet to be published phase of the research suggests similarly impressive results for hips. For this, the team also looked at a subset of regular runners, including one woman in her 40s who had completed 250 marathons and who was constantly told by friends and colleagues that she was destroying her joints and setting herself up for a hip replacement in later life.

“She was very worried they might be right and yet her MRI scans showed her joints were in perfect condition,” Hart says.

Professor John Brewer, the author of Run Smart: Using Science to Improve Performance, says running gets an undeservedly bad rap: “There is actually minimal evidence it damages knees and plenty that it is far more beneficial for our bodies than people think.”

He cites a study from Stanford University, published in 2008, which tracked nearly 1000 running-club members and non-runners for 21 years and found no difference in the state of their knees at the end of the inquiry.

Another study involving 55,000 adults (with an average age of 44) that was published in the Journal of the American College of Cardiology found running for as little as five to 10 minutes a day at a manageable pace of 10 minutes per 1.6km was associated with a 28 per cent lower overall risk of early death during the study and a 58 per cent reduced risk of death from heart disease.

Running might not be your thing, but whichever way you choose to get moving in 2020, it could add years to your life.

It really is never too late to start — even if you don’t possess a pair of trainers until you are in your 60s. In 2013, public health researchers from University College London tracked 3500 people with an average age of 64 for eight years. Their findings, published in the British Journal of Sports Medicine, showed people who had been exercising regularly at least once a week before and during the study were up to four times more likely to be classed as a healthy ager — in good physical, mental and cognitive health — by the completion.

Those who were couch potatoes in the beginning and didn’t take up exercise until their 60s also made vast improvements. They were three times more likely to be healthy agers than inactive people by the time the trial finished.

Hart’s perspective on running has been transformed, thanks to his research.

“After running my first two marathons I was so concerned about the after effects on my body that I switched to skiing marathons,” he says.

“But I’m back to doing long runs as I think it’s going to help me in the long term.

“There’s no reason anyone shouldn’t run into old age.”

The Times