By Will Boggs MD
(Reuters Health) - Participation in some sports, including soccer, wrestling and elite-level long-distance running, may increase your risk of getting arthritis of the knees, researchers say.
"While the typical athlete is not at a greater risk of knee osteoarthritis, it was interesting to see that certain athletes may be more likely to have knee osteoarthritis later in life, specifically, elite and non-elite soccer players and elite-level long-distance runners, elite-level weight lifters and elite-level wrestlers,” lead author Jeffrey B. Driban from Tufts Medical Center in Boston told Reuters Health by email.
“It was reassuring that even in these high-risk sports less than 1 in 10 former athletes had knee osteoarthritis,” he added.
More than 40 percent of people will experience osteoarthritis of the knee at some point in their lives, especially if they have a history of knee injury or are obese. Whether sports participation increases this risk remains unclear, however, the authors note in the Journal of Athletic Training.
Driban’s team reviewed the medical literature and analyzed 17 past studies that examined links between participation in specific sports and the odds of developing osteoarthritis of the knee.
Overall, the rates of knee arthritis did not differ meaningfully between sport participants and non-participants. Among the sport participants, 7.7 percent developed knee arthritis, and among those who didn't participate in sports, it was 7.3 percent.
But participation in certain sports was associated with a much higher risk. Elite-level long-distance running, soccer, weightlifting and wrestling were tied to knee osteoarthritis rates three to seven times higher than those of nonparticipants.
“It is important to note that most of these sports involve a high risk of injury and have lots of loading on the knee joint,” Driban said. “For example, Olympic-level marathon runners expose their joints to many more miles per week than a typical runner. Or alternatively, elite-level weight-lifters expose their joints to much greater forces during each repetition than the typical person in a weight room. These elite athletes really are unique and they may also start competitive sports at a younger age, compete for more years, put in more hours per year, be more likely to play through pain, or rush back to competition too soon.”
Still, among some non-elite athletes, there was also some added risk. For example, the risk of knee arthritis was nine times higher in those who played high school football compared with those who didn't.
On the other hand, elite basketball, boxing, shooting and track and field did not appear to be associated with knee arthritis.
“Physical activity is commonly recommended for children and adults,” Driban said. For people who want the health benefits of sport participation, but are worried about the risk of knee arthritis, they may want to choose non-contact and low-impact sports where the risk of injury is lower, such as swimming and cycling, he said.
“For people playing sports like soccer, where injuries are common, it is important that they encourage their teams to adopt injury prevention programs into their warm-ups,” he added. “These 10-15 minute programs can prevent over 40 percent of injuries, which could help keep athletes active and reduce the risk of the long-term consequences of joint injuries.”
In a setting where the athlete, coach and parents are “focused on today,” Driban said, “it is important that the certified athletic trainers and other sports medicine professionals be the ones thinking about the athlete's health tomorrow.”
"Knee injuries are the greatest risk factor for developing osteoarthritis, whether you are an athlete or not,” said Dr. Robert Brophy from Washington University School of Medicine in St. Louis, Missouri, who has extensively studied knee osteoarthritis and various aspects of sports and recreation injuries.
“This emphasizes the importance of injury prevention programs and optimal management of knee injuries once they occur,” said Brophy, who was not involved in the current study.
“I do not think there is enough data supporting these findings to make any recommendations regarding participation of non-elite athletes in sports,” he said in an email. “The documented benefits of physical activity and participation in sports far outweigh the evidence presented by this study.”