Running again with knee osteoarthritis at 79 years old
In short, it is a myth that you cannot run with knee osteoarthritis. Some facts:
- Joints need exercise and loading
- Participation in exercise and physical activity is safe and beneficial for people with osteoarthritis
- Regular physical activity prevents at least 35 chronic diseases, and is beneficial in treating at least 26
- We do not have adequate evidence to determine how much running, or what intensity, is safe in the presence of knee osteoarthritis
Understanding, that I want to discuss a recent patient – Neil. He had just completed the GLA:D program under the guidance of physiotherapist Jason Wallis. As a result he had a new found confidence in his knee, and much less pain. However, at the age of 79, he had not met his number 1 goal – returning to running. His comment to Jason, who referred him to me was “this will be a waste of time unless you can get me back to running.”
Up until the age of 76, Neil had been a runner. In fact his knee began to become painful during training for a half marathon. Like many people, Neil identified with being a runner and not being able to participate was depressing.
He was assessed by a private orthopaedic surgeon who advised that a joint replacement was not appropriate for him. He was diagnosed with moderate knee osteoarthritis (Grade 3). He received a series of Synvisc injections and diligently completed home exercises to strengthen his quadriceps. His pain was better but any attempt to return to running was unsuccessful due to pain.
Neil refused to give up on running.
In early 2018, he completed the GLA:D program, receiving education and understanding of the many physical and non-physical influences on his pain. His XRay was just one small piece of the puzzle. Neil was also taught that his knee needed more exercise, not less to optimise his joint health. He worked hard at the GLA:D exercise program, improving confidence in his knee, along with his hip and knee strength.
I first consulted with Neil in July 2018. I was impressed by his muscle strength, and enthusiasm to return to running at 79 years of age. We chatted about what running meant to him, and discussed the importance of staying active to manage his osteoarthritis. I explained we did not know whether running again would be good, bad or indifferent for his knee osteoarthritis. But, considering the numerous health benefits and what it meant to him, I would do my best to help him get back.
Following further assessment of his running mechanics and some coaching to improve his technique, Neil began a gradual return to run program. He started with just a few minutes per run, having a day’s break between each run session. The aim was to add a couple of minutes per run each week. Neil also started some more challenging strength and power exercises to improve his ability to absorb the loads of running.
Fast forward to December 8th, and Neil was doing well. There were a couple of small pain flares along the way, but these did not occur during or following running. Neil decided to put a stamp on his return to running by participating in his local Park Run, a great volunteer initiative to help Australians become and remain active.
He completed the event in 34:58, and was understandably very happy. He has been participating in Park Run fortnightly since, pain free.
When I last consulted with Neil (February 2019), he was up to 8km for his long run, and planning a 10km race – I wished him luck.
In Part 2 of this blog, I will explain further details about the exercise program and running technique changes Neil used to help get back to running.