“We should be encouraging, rather than discouraging, that sport participation and physical activity give multiple physical and mental health benefits,” Laskowski said.
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.”
Reference
Tran G, Smith TO, Grice A, et al. Does sports participation (including level of performance and previous injury) increase risk of osteoarthritis? A systematic review and meta-analysis. Br J Sports Med. 2016 Sep 28. pii: bjsports-2016-096142. [Epub ahead of print]
