Is excessive running predictive of degenerative hip disease? Controlled study of former elite athletes

Abstract

Objective - To determine the effects of regular long distance running on the state of the hips in later life. Design - Retrospective study of a cohort of elite athletes and a group of normal, healthy, untrained controls examined 15 years after initial testing. Setting - Research project at school for physical education and sports. Subjects - 27 Former long distance runners (mean age 42), nine former bobsleigh riders (mena age 42), and 23 normal, healthy, untrained men (mean age 35) who had been examined in 1973 and who agreed to re-examination in 1988. Main outcome measure - Radiological evidence of degenerative hip disease in 1988. Results - Physiological and exercise characteristics of all subjects had been recorded in 1973, and in 1988 these measurements were repeated together with radiological examination of the hips. An additive radiological index of hip disease based on grades of subchondral sclerosis, osteophyte formation, and joint space narrowing was significantly increased among runners as compared with bobsleigh riders and untrained controls. After adjustment for age the significant effect of type of sports activity remained (p = 0.032). In multivariate analyses age and milage run in 1973 (97 km/week) emerged as independent, significant, and positive predictors of radiological signs of degenerative hip disease in 1988 (p = 0.017 and p = 0.024 respectively). Among runners alone running pace in 1973 rather than milage run was the stronger predictor of subsequent degenerative hip disease. The milage run in 1988 was not particularly predictive of the radiological index, but endurance in 1988 was inversely related to degenerative hip disease seen radiologically. Conclusion - Long term, high intensity, high milage running should not be dismissed as a potential risk factor for premature osteoarthritis of the hip.