Does running cause knee arthritis?

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Exercise is the most powerful longevity tool we have, but after 50 the recovery curve, injury risk, and bone/muscle changes mean the smartest plan blends strength, power, impact, and slightly more recovery—so you can train hard without derailing progress.

What we cover

• Why this matters now: record-setting older endurance athletes (and I’m racing at 69) show what’s possible—if we train wisely.
• The “aging triad”: loss of muscle (especially fast-twitch/power), bone density shifts (sharpest around menopause), and rising osteoarthritis risk.
• The injury paradox: the fitter you are, the more a single layoff can cost; preventing setbacks is a longevity strategy.
• A practical framework: build strength, protect fast-twitch fibers, add tolerable impact for bone, and consider an extra rest day after hard sessions.

Evidence, in plain English (linked)

• Muscle changes: We preferentially lose type-2 (power) fibers with age; quads are especially affected. Training can target this. Review
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• Women & men both lose muscle mass percentage-wise; patterns differ but loss is universal. Same review
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• Bone density: Women can lose ~2–3%/yr at the spine around menopause; men decline more gradually. CDC data brief
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• Running & knees: Long-term cohorts show no higher knee OA in runners vs. non-runners (Stanford cohort
  ; systematic review, ~14k people
  ), and even runners with established OA didn’t worsen—and reported less pain. Prospective OA cohort
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• Strength at any age: Even adults 85+ can add ~10% quad size and ~40% leg strength in 12 weeks; heavy strength work is safe when programmed well. Overview
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• Power/fast-twitch support: Short (30–120 s) high-intensity efforts and plyometrics can improve type-2 fiber function and neuromuscular drive in older adults. Narrative review
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• Bones respond to signal: In 80 trials (5,500 postmenopausal women), combined resistance + impact training improved spine and hip BMD regardless of menopause timing or baseline status. Meta-analysis
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• Recovery with age: Some data show more soreness and temporarily lower strength 24–72h post-lifting in middle-aged vs. young adults—supporting a touch more recovery after hard days. Study
  .

Practical takeaways

• Lift twice weekly
• Add brief power: 20–30-second hard intervals or controlled mini-hops/step-downs; keep impact tolerable.
• Build bones: pair resistance work with  impact (jog/jump rope as tolerated). If you have osteopenia/osteoporosis, get your plan cleared first.
• Recover like it matters: if a session is truly hard, consider one extra easy/recovery day.
• Audit risk: dial back higher-risk activities that would sideline you for weeks; prevention preserves gains.

If this episode helped, please rate the show and share it with a friend. To get my newsletter with practical, evidence-backed steps for living long and well, visit DrBobbyLiveLongandWell.com.