Running Gait

It was approximately 5 or 6 years ago when I had this one particular patient who was a long distance runner.  He explained to me he typically would not have any issues that would have him laid out for any time from training and was pretty proud of this.  His running background went to his teenage years and he came in on that day to our office in his early 50's.  Pretty impressive running history also as he has qualified for the big races in the marathon distance.  So, he comes in that day complaining of some knee discomfort and was a little concerned that all the years of running may have finally took a toll on his body, particularly in his knees.   We followed through an evaluation and while performing his evaluation he displayed some good range of motion, no other really noticeable deficits other than your colloquial term, "patellofemoral syndrome."  A lot of runners are plagued with this at one point in running depending on distance, training or running through pain that could throw your entire gait off.  We videotaped him outside the office and replayed it back to him so he could also see in slow motion.  He displayed good mechanics otherwise but noticed he was dropping too much in his gait, really bending his knees a lot when he landed. We call this vertical displacement.  We'll talk about this in greater detail in another article but much to my patient's dismay we thought that because of these mechanics year after year that he may have had some osteoarthritis to say the least.  We sent out for x-rays of his knees since both were bothering him with pain and discomfort. To our disbelief, he had as clean of an x-ray as a 20 year old.  No arthritis, perhaps a little tracking of the patella but nothing that cannot be fixed.  So many years of running and he was a tall guy but yet, no osteoarthritis noted on the x-ray.  This got me thinking, if we are running with some decent biomechanics and take care of our bodies are we really doomed for osteoarthritis?  It is contrary to popular belief that running long distances will cause inevitable osteoarthritis.

I was searching what the latest research states and came across an article that said, "Runners did not have increased OA (osteoarthritis) on xray at 10 year follow-up."  This research was submitted by Lo et al (2018).   In the past, a lot of doctors, in general proposed that we stop running because it is bad for our joints.  This research kind of said the opposite.  What else is important to note is that if you have pretty bad running mechanics and altered gait from injuries or lack of endurance muscular strength, you might get some osteoarthritis as a result.  Wolf's Law suggests that if there is a stress on a particular area of a bone, more bone will be laid down to stabilize the area.  This may be a good reason to see your sports medicine specialist to see if you are strong in your mechanics and if you are not, what to do so we can slow the possibility of osteoarthritis.  Your sports chiropractor (either CCSP or DACBSP designations) or physical therapist that has a strong sports background could help you with those concerns.  Thank you for reading and happy running!

Giuseppe Giovatto Jr, DC, DACBSP®, CSCS

Ridgewood Spine and Sport, LLC;;

Working with triathletes since 2007, working with sports medicine in Kona, HI, Panama City Beach, FL and Sarasota, FL with Ironman and USAT elite and professionals. Also on the medical advisory board for a US National Governing Body and consultant to a MLB team.

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