I'm not a marathoner and not qualified to offer advice on this.

However, a word of caution about who you DO ask for advice. Asking active marathoners about the wisdom of long-distance running is sort of like asking smokers about the wisdom of cigarettes. The ones with the real horror stories have already died off (i.e. quit running). Instead, you're left with the 80-year-olds who say, "****, I've smoked 3 packs a day for 60 years and it hasn't bothered me!"

Before I get banished from this site, I'm NOT saying running marathons is inherently unhealthy (unlike smoking cigarettes) but let's face it, there are down sides to running hard and/or running long. Just take a look at the Med Tent to hear the laments of the walking wounded or visit sites for bicyclists to find the armies of former marathoners whose knees couldn't take the pounding any more.

You're asking a legitimate question that deserves a response from people who may be familiar with the research literature on this. Hopefully some will chime in with their thoughts.

quote:<HR>Originally posted by Tramps:
I'm not a marathoner and not qualified to offer advice on this.

However, a word of caution about who you DO ask for advice. Asking active marathoners about the wisdom of long-distance running is sort of like asking smokers about the wisdom of cigarettes. The ones with the real horror stories have already died off (i.e. quit running). Instead, you're left with the 80-year-olds who say, "****, I've smoked 3 packs a day for 60 years and it hasn't bothered me!"

Before I get banished from this site, I'm NOT saying running marathons is inherently unhealthy (unlike smoking cigarettes) but let's face it, there are down sides to running hard and/or running long. Just take a look at the Med Tent to hear the laments of the walking wounded or visit sites for bicyclists to find the armies of former marathoners whose knees couldn't take the pounding any more.

You're asking a legitimate question that deserves a response from people who may be familiar with the research literature on this. Hopefully some will chime in with their thoughts.<HR>

Very objective take on this topic.

I ran one marathon and would like to run more. My DH brought this exact question several times to my attention. My Dr. friend (radiologist) thinks it definately has some negative sides and you can achieve good physical fitness without pounding miles and miles year after year.

I am curious what others have to say.

Here's an abstract from a meta-analysis (they took previously published studies, pooled the statistics, and ran statistics on all the results) of risk of arthritis of the hip from running. Sounds like no really big studies have been done, so data is not optimal. This abstract says there was a slight increased risk of developing pre-mature hip arthritis from running, but it did not reach statistical significance. In other words, no increased risk proven.

Z Orthop Ihre Grenzgeb. 2004 Mar-Apr;142(2):213-20. Related Articles, Links


Is running associated with premature degenerative arthritis of the hip? A systematic review

Article in German

Walther M, Kirschner S.

Lehrstuhl fur Orthopadie der Universitat Wurzburg. m-walther.khl@mail.uni-wuerzburg.de

AIM: The study was performed to investigated correlations between running and degenerative arthritis of the hip, according to the principles of evidence-based medicine. METHOD: The database Medline, the Cochrane Library, the centre for Evidence Based Medicine in Oxford and the sports science database Spolit, Spofor and Spowis were scanned systematically for the keywords "arthritis, osteoarthritis, degenerative, hip, sports, running, jogging, walking". RESULTS: 10 retrospective case control studies and 3 prospective studies were included for further analysis. The clinical examinations reported in the prospective studies did not reveal a significant difference between runners and non-runners. In one study a slightly increased risk for signs of arthritis at the X-ray was found in runners below 50 years with a very high mileage. No increased risk for degenerative arthritis was reported in most of the retrospective studies. A few authors of retrospective studies reported a slightly to moderately increased risk. The pooled estimate of the included studies showed a slightly increased risk for degenerative arthritis in runners (pooled OR 1.24 95 % CI 0.87-1.85). However, the increased risk did not reach a level of statistical significance. The graphic analysis of the data with the technique of the funnel plot gives an OR of 1.04. CONCLUSION: There is no evidence that running is associated with an increased risk for degenerative arthritis of the hip. There is no evidence for a different risk in men and women.

Clearly, prior knee injury is the biggest risk factor in developing arthritis, not repetitive use. While you are right Andy that all of the studies have design flaws, and it is not possible to draw a definitive conclusion, the few studies that have been done do at least "suggest" that there is an increased risk in people who run high miles (read more elite runners). I know no one wants to (nor do I) believe that, but that is what the few, small in number retrospective studies show (again, suspect data, but suggestive of a correlation). Here is the key paragraph cut and pasted from the article:

--The data from studies of runners have been a little more difficult to understand but it may be that the risks for OA depend on the amount and rate of mileage run. In a retrospective cohort study, examinations were performed in 1973 and 1988 on a number of former athletes: 27 long distance runners (averaging 60 miles/week in 1973), nine bobsleigh riders, and 23 controls.38 The athletes had a mean age of 42 years at the second examination. Radiographic OA hip was found in 19% of the runners, but in neither of the other groups. Age and number of miles run per week in 1973 were the positive predictors of radiographic OA. Spector et al39 compared 67 female elite middle and long distance runners and 14 female tennis players (aged 40?65) with a large matched control group.39 Radiographic hip and knee OA rates were significantly higher in the former athletes, with a tendency to more patellofemoral OA in the runners. There are a number of negative association studies but design problems are clear. In a retrospective cohort study, no higher rates of radiographic OA were seen in 60 ex-marathon runners than in controls, although the timing of radiographs differed for the two groups.40 A study comparing 504 university level cross country runners with similar level swimmers found no difference in levels of hip and knee pain but x ray examinations were not performed.41 A small prospective study of 17 male runners (nine were marathon runners) compared with controls found no difference in radiographic OA at the hip, knee, ankle, or feet.42

Lane and colleagues43?45 have presented a series of reports from a well described, prospective cohort of subjects from a long distance running club?perhaps closer to recreational runners than the elite athletes studied above. At baseline, 41 runners aged 50?72 years and averaging 25 miles a week were compared with controls matched for age, sex, years of education, and occupation.43 There was no difference in clinical and radiographic OA findings in the knee and lumbar spine. Follow up of this cohort at five44 and nine45 years showed similar rates of progression for radiographic OA of the knee in the runners and controls with no significant between group differences. For the runners, regression analysis disclosed that the predictors of progression of radiographic knee OA were baseline radiographic score and a faster pace per mile. Hip radiographs taken after nine years also showed no differences in OA between the groups.45 Another study of 30 long distance runners, 90% of whom averaged 12.5?25 miles a week over a median of 40 years, found no differences in rates of radiographic OA at the hips, knees, and ankles when compared with controls matched for age, body mass index, and occupation.46 --

Although not huge numbers, and a retrospective study, the first one listed in the paragraph basically had 31 people (23 controls and 9 bob-sledders (sprinters, not high mileage runners) who essentially didn't run, and 27 runners who averaged 60 mpw. Nearly 1/5 of the runners were found to have arthritis radiographically vs. none of the non-runners. Now, who knows if these people were symptomatic, or just had joint space narrowing radiographically. Anyway, in my mind that points to a probable increase in risk for OA when running high miles. Like you said, though, the benefits of running probably well outweigh this possible risk.

I've only run 2 marathons, so I may not be as qualified to reply as many people on this site. But my advice is that you should stick with running half's for at least another year maybe longer before starting to train for a marathon. I had been running 20 to 25mpw for about 8 months before I started training for a marathon in 2002. I finished close to my goal time but had hamstring pain for about 4 months after. Nine months later I did my second marathon but almost quit running due to burnout. For the rest of 2003 and all of 2004 I just ran short runs with an occasional 10 to 12 miler and a couple of halfs. This year I have run 2 half's and have done something like 25 long runs over 13 miles but none over 17. I'm running much more consistently now and enjoy it much more than I ever did while training for a marathon. I've been injury free for over 2 years. I don't know if I'll ever do another marathon, but hope to be able to maintain the ability to go 15 on any given weekend. Just remember that there is more to life than being able to say that you've run a marathon.

Well obviously the best way to live a long and healthy life is to sit on your arse with the remote control drinking beer and eating potato chips. Eventually you may actually fuse in to the the sofa like that woman in Florida did.

Here's my uneducated take. Yes, marathons are extreme particularly if you are undeprepared. For the average Joe, like me, one or two marathons a year is probably fine building up the mileage accordingly as you approach the events.

For the rest of the year, if you take it fairly easily, 15-30 miles a week is fine. Run some shorter races and watch out for signs of injury and rest accordingly you will be fine.

Even better, mix up the running with other sports, cycling, swimming, some weights and a good diet for optimal health.

I would be interested to know whether the guy who had his knees replaced had ignored the warning signs. Also, is there anyone else in his family with joint problems?

Two old sayings are as relevant today as they ever were.
- "Moderation in everything"
- "Variety is the spice of life"



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