title: Is There an Association Between a History of Running and Symptomatic Knee Osteoarthritis? A Cross-Sectional Study From the Osteoarthritis Initiative.
abstract: OBJECTIVE
  Regular physical activity, including running, is recommended based on known cardiovascular and mortality benefits. However, controversy exists regarding whether running can be harmful to knees. The purpose of this study is to evaluate the relationship of running with knee pain, radiographic osteoarthritis (OA), and symptomatic OA.
  
  
  METHODS
  This was a retrospective cross-sectional study of Osteoarthritis Initiative participants (2004-2014) with knee radiograph readings, symptom assessments, and completed lifetime physical activity surveys. Using logistic regression, we evaluated the association of history of leisure running with the outcomes of frequent knee pain, radiographic OA, and symptomatic OA. Symptomatic OA required at least 1 knee with both radiographic OA and pain.
  
  
  RESULTS
  Of 2,637 participants, 55.8% were female, the mean ± SD age was 64.3 ± 8.9 years, and the mean ± SD body mass index was 28.5 ± 4.9 kg/m2; 29.5% of these participants ran at some time in their lives. Unadjusted odds ratios of pain, radiographic OA, and symptomatic OA for those prior runners and current runners compared to those who never ran were 0.83 and 0.71 (P for trend = 0.002), 0.83 and 0.78 (P for trend = 0.01), and 0.81 and 0.64 (P for trend = 0.0006), respectively. Adjusted models were similar, except radiographic OA results were attenuated.
  
  
  CONCLUSIONS
  There is no increased risk of symptomatic knee OA among self-selected runners compared with nonrunners in a cohort recruited from the community. In those without OA, running does not appear to be detrimental to the knees.
authors.affiliation: Baylor College of Medicine and the Michael E. DeBakey Medical Center, Houston, Texas.
authors.forename: Grace H
authors.initials: GH
authors.lastname: Lo
authors.affiliation: Tufts Medical Center, Boston, Massachusetts.
authors.forename: Jeffrey B
authors.identifier: http://orcid.org/0000-0001-6098-4273
authors.initials: JB
authors.lastname: Driban
authors.affiliation: University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Kriska
authors.affiliation: Tufts Medical Center, Boston, Massachusetts.
authors.forename: Timothy E
authors.initials: TE
authors.lastname: McAlindon
authors.affiliation: University of California, San Francisco.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Souza
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Petersen
authors.affiliation: Indiana University of Pennsylvania, Indiana.
authors.forename: Kristi L
authors.initials: KL
authors.lastname: Storti
authors.affiliation: Memorial Hospital of Rhode Island and Alpert Medical School of Brown University, Pawtucket.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
authors.affiliation: University of Maryland School of Medicine, Baltimore.
authors.forename: Marc C
authors.initials: MC
authors.lastname: Hochberg
authors.affiliation: Ohio State University, Columbus.
authors.forename: Rebecca D
authors.initials: RD
authors.lastname: Jackson
authors.affiliation: University of Arizona, Tucson.
authors.forename: C
authors.initials: C
authors.lastname: Kent Kwoh
authors.affiliation: University of California, San Francisco.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nevitt
authors.affiliation: University of Texas MD Anderson Cancer Center, Houston.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Suarez-Almazor
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000453:epidemiology*; D012189:Retrospective Studies; D012420:Running