Saturday, July 5, 2014

More Evidence That Running Doesn’t Destroy Your Knees

What group would you expect to suffer the worst repercussions from the relentless pound-pound-pound act of running?

What about marathoners -- and not only marathoners, but first-timers?

Surely, they must be asking for trouble, right?

Apparently not.

A study of five men and five women (yes, small sample size) showed that:
High-impact forces during long-distance running are well tolerated even in marathon beginners and do not lead to clinically relevant cartilage loss.
The researchers from Germany’s Freiburg University Hospital measured cartilage volume and thickness, using the very precise 3-D quantitative MRI, before the runner’s training began and immediately after the marathon. The small changes that were detected were not judged to be meaningful.

Incidentally, the subjects averaged 40 years of age, with a mean BMI of 25.9.

To be sure: running a marathon, especially if you’ve never done one before, can be disastrous for your knees. But the good news appears to be, with some sensible training, it doesn’t have to be. Running isn’t bad for your knees per se. Running dumb is what’s bad.

12 comments:

  1. I've read your book and many of your blog articles and I'm trying to repair my knees by walking 3 times per day. Your book has been out for a few years. Have any doctors or scientists done any studies to confirm and agree that your approach works? It would be nice if they stopped publishing articles saying that knee cartilage can't heal.

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    1. Progress will be made when Doctors (scientists) admit that the healing of cartilage is idiopathic: cartilage can heal but we can't always (or ever, if you're an MD) know how or why. Which is the same as admitting you don't necessarily know how or why it went bad in the first place. Not knowing how or why, put's a lot of limitations on diagnosis, procedure and prognosis ($).

      Still, it would be nice to hear the word idiopathy as opposed to "cannot," when making the choice to roll the dice of arthroscopy, steroid injection, whatever cartilage healing de jour... . R-X

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    2. There are a number of studies (some of which are cited in the book) that support the principles that guided me. But, to my knowledge, no one has tried to run a study that tests the effectiveness of this type of program as a therapeutic approach. Eventually I'm sure it will happen.

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  2. I suspect it was cycling that destroyed my knees, not the running. Weekly hard grinding big gear sets on the windtrainer, 100km time trials that left me wrecked, and lots of rides in very cold (sub-zero) temperatures, in riding gear that was probably not adequate. Add to that an on-line coach who could not see my body-type (very skinny legs, despite cycling 100s of kms per week), so no specific strength training to address likely muscle imbalances (VMO being overpowered by lateral quads), and no down-time (on-line coaches don't get paid if the program says take a month or two off).

    I'm also hoping like Hell cartilage can heal. I had anecdotal evidence - one ex-triathlete who healed his by taking 6 years off, and a runner who beat knee pain after 20 years away from his sport.

    I can tell you that platelet injections definitely ease the pain (jury is out if they actually heal cartilage). I've had 1 injection, 2 more to go over the next 10 weeks, so stay tuned. I suspect to get the most out of it though, I need to be very smart for 6-12mths afterwards so as not to undo the good work.

    TriAgain

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  3. TriAgain, I've been following your posts for the past couple years. Just want you to know how much I appreciate all your methodical details. Keep it coming! -Erik

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    1. Thanks Eric. If I was smarter (read not exercise-addicted) I'd probably not have been posting here for a couple of years as I'd not have pushed the envelope so much.

      I suspect few people would be able to conduct the controlled experiment Richard did, taking 12mths off work, and tracking their movements so carefully. I'm sure spending a lot of a time at a desk is a big part of my knee pain, though I have recently ordered a device for my computer so I can spend time standing to work (which should help my general health, even if it does not fix my knees).

      The other problem is life gets in the way, and you find yourself doing household tasks, or carrying things which send you backwards. Even if you are not an exercise junkie, you have to be very disciplined (and risk divorce) to avoid knee overload.

      I'm still stunned that in the space of 1-2mths, I could go from cycling 200+kms/week to not being able to ride a bike at all and having constant knee pain, with even simple activities causing trouble. It is the speed of my demise I find so hard to fathom.

      TriAgain

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    2. Agree! My knee has radically improved since reading Richard's book a couple years ago. But recently I became too confident and created setbacks. I briefly mentioned my knee in post below if curious. But overall I'm experiencing knees do heal and correlate with Richard's findings. Hang in there! http://www.hikinginidaho.com/14/slide_140404/slide_140404.htm

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  4. Hi Richard,

    At what point in your program did you no longer continue with your walkarounds? Was it when you began to include hills in your regime or when your walks were 5,000+ steps? Thanks!

    Rachael

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    1. Huh, I can't recall exactly, but I think I mainly did the walkarounds early in my recovery. So by the time I was doing hills (which was a good 7 or 8 months in), I had stopped the walkarounds. Your mileage may vary of course if you choose to do them. The walkarounds were basically a way of giving movement to a pair of cranky knees that couldn't walk much distance early on and were weak. I was obsessed with moving but couldn't move much (without regressing), so I found that to be a good compromise activity.

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  5. I started using green clay to calm down the inflamation and thus the pain. I have no scientific backup for this, but since it seems to work for me, maybe others will want to try it too.
    Years ago, I suffered with a terrible eczema that nothing would heal. I spent a small fortune on specialists and expensive steroids and creams, but to no avail. Eventually I landed in A&E with a massive infection that almost cost me my foot. When she heard of my misfortune, my mother in law suggested I try green clay poultices. If I hadn't been beside myself with worry and pain, I would have laughed it off. But at the time, I would have stood on my head if someone had told me it could cure me.
    So I tried it, and within a week the eczema was gone, never to come back

    So when my best friend mentioned he used green clay to calm down his painful ankles after dancing, I decided it was worth a try. I first applied it on my knee for 20mn to 1 hour at a time, and the effects were pretty immediate, but didn't last. I then tried to keep it overnight, covering it with gauze and bandage. The next day, it was dry and I brushed it off, and my knee felt a bit stiff. But after moving a couple of steps it felt much better and I was able to sit on the bus journey to work without pain (1 hour), then didn't feel any pain at all during the day.

    I don't think it helps at all with cartilage regeneration, but at least it takes the pain away, which means that I can move around more, which hopefully will help with the cartilage healing.

    To prepare clay, you need milled (ground) green clay - I got mine on Amazon. Mix it with a little water (apparently, you can't use a metal spoon as it interacts with the clay's properties) until you get a thick paste. Spread it thickly on the affected joint and leave it for anytime from 20mn to overnight. Waiting until it is dry is much less messy as you can just brush it off.
    Added bonus, it makes your skin very soft, so now I have lovely skin on my knees :-)

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  6. The other piece of advice I heeded from Richards book was watching my weight to reduce pressure on the knees. I'm a light-weight anyway (63kgs when I raced and was training 8-14hrs/week) but when my knees went, my weight crept up over the 65kg mark, as my aerobic exercise has dropped radically to 2-3 swims/week and some gentle 25min walks, plus strength/balance work in the gym 4-5x/week.

    So I changed my diet (far less processed carbs including bread, less refined sugar, more veges and protein - a bit paleo). That helped stabilise the weight gain, but recently I actually counted the calories consume,d and it was still too much, so I've cut down on intake too - mostly my between meal snacks of almonds & dried fruit & rice cakes with peanut butter. That seems to be working.

    It is difficult as I used to eat anything, anytime with no weight gain.

    TriAgain

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  7. totally agree if you have no knee issue than running is not going to effect your knee but you already have any knee pain or knee injury than it might get worse with running.

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