Arthritis

Updated 06 February 2016

Lots of exercise in midlife may lead to osteoarthritis

Like a pothole that worsens over time, so do knees' internal injuries, study finds

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If you're a middle-age weekend warrior who likes to hit the soccer pitch or rugby field, take note: a new study suggests that high levels of physical activity boost the risk of internal knee damage that could lead to osteoarthritis.

The study found that the injuries occurred in middle-age people who showed no symptoms of osteoarthritis and had a healthy weight. They were more common and more severe in those who exercised more, although lower-impact activities such as swimming and cycling might actually be beneficial, according to the researchers.

The findings "speak to the importance of low-impact aerobic activity, especially in knees that are aging and may not be as resilient as they used to be," said Dr. Joseph Guettler, an orthopaedic surgeon and sports medicine specialist at William Beaumont Hospital in Bingham Farms, Michigan.

The problem is that bone and cartilage in the knee can develop cracks and fissures that worsen over time, "much as a pothole or crack in the pavement can become significant as cars keep driving over that area," said Guettler, who's familiar with the study findings but didn't take part in the research.

When people develop these sorts of problems, "we know that they're going to have an increased risk for osteoarthritis later on in life," he said.

Osteoarthritis, the most common form of arthritis, develops when cartilage deteriorates in joints and causes bones to rub against each other.

In the study, radiologists examined MRI scans of the knees of 236 people who had enrolled in an osteoarthritis study. The participants, aged 45 to 55, included 136 women and 100 men. All participants completed questionnaires about their physical activity levels, which formed the basis for their assignment to high-, medium- or low-level activity groups.

The researchers then looked for links between levels of physical activity and the health of the participants' knees. The findings were to be presented Monday in Chicago at the annual meeting of the Radiological Society of North America.

Those who engaged in high levels of physical activity - including such things as sports, exercise, gardening and housework - had the highest levels of injuries. The injuries included fluid buildup in bone marrow and lesions in cartilage and ligaments.

"This study and previous studies by our group suggest that high-impact, weight-bearing physical activity, such as running and jumping, may be worse for cartilage health," the study's co-author, Dr. Christoph Stehling, a research fellow in the radiology and biomedical imaging department at the University of California, San Francisco, said in a news release. "Conversely, low-impact activities, such as swimming and cycling, may protect diseased cartilage and prevent healthy cartilage from developing disease."

Guettler, the Michigan surgeon, said that activities involving twisting, jumping and pivoting are especially hazardous. Don't overdo it when it comes to activities like rugby and soccer, he advised.

Instead, consider alternatives like walking, swimming, cycling and training on elliptical machines, he said.

The researchers' next goal is to figure out whether low-impact and high-impact physical activity affect the progression of osteoarthritis differently, Stehling added.

Read more:

Diagnosing osteoarthritis

Preventing of osteoarthritis

 

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Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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