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 In an analysis of past studies filled with conflicting results,
researchers found that long-distance running was the only
elite-level sport that didn’t seem to raise arthritis risk, though
even that question requires further study, they conclude.
The team looked at the top 32 most popular sports in the UK by
participation to see whether individual sports, or intensity of
sports participation, particular joints and particular types of
injury are linked to the likelihood of developing arthritis. But
they didn’t find a strong association across most studies or for
amateur-level participation.
“This should be reassuring to consumers, particularly those who have
had an injury,” said senior author Philip Conaghan, a professor of
musculoskeletal medicine at the University of Leeds in the U.K.
Conaghan and his colleagues analyzed 46 studies, 31 of which showed
a slight increased risk of osteoarthritis after sports exposure,
including 19 with an increased risk in elite athletes. However, for
all the questions they were examining, the researchers concluded
that the studies were “low-quality” or “very low-quality” due to
imprecision, inconsistency and poor study design.
“These analyses should be viewed with caution,” Conaghan’s team
writes in the British Journal of Sports Medicine. “The relationship
between sports participation and osteoarthritis remains complicated
and controversial since it’s currently based on low-quality
evidence.”
Since the studies include self-reported questionnaires, different
methods of diagnosing osteoarthritis and different participants,
it’s difficult to determine what factors actually contribute to
osteoarthritis, the researchers note. For instance, most studies
focused only on lower-body injuries and didn’t include high-impact
sports such as American football.
“People often question whether participating in sports increases
their risk of injury or long-term joint damage,” said Edward
Laskowski, co-director of the Mayo Clinic Sports Medicine Center in
Rochester, Minnesota, who was not involved with the study.
“However, we are in the midst of a global epidemic of obesity and
sedentary lifestyle,” he told Reuters Health by email. “The benefits
of exercise have been well documented, and there is a great need to
incorporate movement and activity into our lives.”
Americans develop 3 million new cases of osteoarthritis each year.
Those who are older, obese, previously injured or have weak muscles
are the most vulnerable.
“We should be encouraging, rather than discouraging, that sport
participation and physical activity give multiple physical and
mental health benefits,” Laskowski said.
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In the current review, 24 studies looked at the relationship between
the level of sport participation and osteoarthritis, of which 19
showed an increased risk for elite athletes.
Ten studies evaluated the relationship between intensity of sport
participation and osteoarthritis. Nine showed an association with
greater intensity, and two reported that higher mileage and higher
pace were related to greater prevalence of osteoarthritis in elite
athletes, but not amateurs.
Soccer was the most common sport examined and was included in 15
studies, 12 of which found a link to osteoarthritis but at a low
level for most but elite athletes.
Long-distance runners were included in 12 studies, two of which
focused only on runners and did find an increased arthritis risk,
but the other 10 found no link.
Five studies assessed previous sporting injuries. One observed an
association between arthritis risk and meniscus tears in former
soccer players, and two reported an association with anterior
cruciate ligament (ACL) injuries in soccer players.
“The next question is, what is a safe dose of exercise for those
with injuries or preexisting joint problems?” Conaghan said. “It’s a
subtle balance we don’t have a good handle on.”
When Conaghan cares for patients with injuries or preexisting knee
problems, he suggests low-impact activities such as swimming to
build strength and stamina during rehabilitation before
incorporating high-impact, weight-bearing exercise such as running.
“It’s safe to exercise,” he said. “But first, get strong, then get
fit.”
SOURCE: http://bit.ly/2dWzBQy British Journal of Sports Medicine,
online September 28, 2016.
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