Athletes: Cross-Train to Reduce Arthritis Risk

Encouraging people to get moving is a key component of the national osteoarthritis awareness campaign. But certain sports can increase the load on joints, raising the risk of osteoarthritis over time. So how do you get fit while protecting your hips, knees, and ankles?

The answer is cross-training. It’s good to give your body a rest and switch to other activities from time to time. If you run, for example, take a day off every now and then and do something else, like work out on an elliptical trainer or bike. Also, during the same exercise session, it’s best to incorporate numerous small workouts (rather than just one long workout) to target all the major muscle groups. Taking a break from the same repetitive motions that exert a heavy load on your joints reduces stress and gives your joints a chance to rest.

In athletes — both professionals and amateurs — the risk of osteoarthritis rises with certain movements and injuries. For example:

  • The risk of osteoarthritis in the knee climbs if you experience an injury to an anterior cruciate ligament (ACL) and/or to the meniscus — even if you have had it surgically repaired. Knees that are unstable due to an injured ACL become more prone to arthritis. When the meniscus becomes damaged or is removed, it increases the stress on the cartilage in the knee and promotes arthritis. Blood in the knee during such an injury also causes pain and swelling.
  • Activities that are associated with friction between the bottom of the shoe and the sports surface may also place higher loads on the knee. For example, hard tennis courts, artificial turf and basketball courts can all cause friction on the shoe and exert more stress on the joints. Similarly, running on a synthetic track, dirt, or gravel is better for the joints than pounding the pavement.
  • Repetitive twisting, such as that in golf or baseball, may exacerbate the load placed on hips, knees, and shoulders. Professional baseball players, for example, place extraordinary stress on their hips when practicing batting, and on their shoulders during pitching.
  • Sports that cause repetitive falling during training, such as competitive gymnastics or figure skating, often cause acute injuries that may raise the risk of hip and knee arthritis over time.
  • If you’re active or interested in pursuing an exercise program to reduce your osteoarthritis risk, congratulations! Just follow these tips to stay safe:
    • Include weight-training in your regimen. Strong muscles do a better job of supporting joints than weak muscles. There’s no need to pump serious iron: use low weights with a high number of repetitions to get the best results.
    • Learn how to land properly. If you are involved in a sport that requires a lot of jumping, like basketball or volleyball, learn how to land so pressure is placed more evenly on the knees, reducing the risk of injury.
    • Be sure to stretch gently before exercising to keep muscles, tendons, and ligaments supple. You can stretch afterward as well. 
    • Replace athletic shoes when they lose their ability to provide adequate support and shock absorption, which is usually after a few hundred miles of wear or when you see an uneven wear pattern. 
    • Incorporate no-impact activities (such as swimming or cycling) or low impact routines (such as walking or inline skating) into your exercise regimen. After returning from a break, ease back into sports. There’s a reason professional athletes have preseason training: it takes time for the body to adjust to heightened physical activity. If you ski, be sure to do some preconditioning to get ready to take on the mountain, including incorporating some light weight training to gain strength, and some moderate stretching before you get on the lifts to enhance flexibility.

With a little planning and variety, you can pursue the sports you love while being kind to your joints.


This article was adapted from the Spring 2011 issue of Health Connection, Hospital for Special Surgery’s patient education newsletter.


Anil S. Ranawat, MD
Attending Orthopedic Surgeon, Hospital for Special Surgery
Professor of Orthopedic Surgery, Weill Cornell Medical College

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