By Marc Dellière, Medical Consultant & Trainer – Specialist in Stress, Prevention & Integrative Health
Osteoarthritis is no longer a condition exclusively linked to age. Among intensive athletes—both young and adult—there has been a significant increase in early cases, particularly in the knees, hips, and lumbar spine.
But should this discourage people from participating in intense sports?
What the data shows
-Knee osteoarthritis is common among soccer players, judokas, and skiers.
-Hip osteoarthritis is common among long-distance runners and dancers.
-Lumbar spine damage is common among gymnasts and weightlifters.
-High-impact and/or rotational sports (football, wrestling, handball, ice hockey) expose athletes to an increased risk of early osteoarthritis, especially in cases of prolonged intensive or competitive practice
-Tennis, although repetitive and asymmetrical, is not classified as a high-risk sport for osteoarthritis. However, intensive or poorly supervised practice can lead to localized wear and tear (shoulder, elbow, knee). Prevention involves technique, recovery, and muscle strengthening.
Mechanisms at play
-Repeated microtrauma
-Overtraining without sufficient recovery
-Poor joint alignment or untreated traumatic sequelae
-Low-grade chronic inflammation and biomechanical imbalance
-Healthy cartilage can adapt to mechanical stress, provided it is gradual, intermittent, and well supervised.
What we need to adjust in practice
As healthcare professionals:
-Do not demonize intense exercise
-Tailor recommendations based on body type, joint history, and the sport practiced
-Optimize recovery, injury prevention, and compensatory muscle work
-Monitor any persistent mechanical pain from adolescence or young adulthood onwards
In cases of diagnosed osteoarthritis
High Intensity Training (HIT), or high-intensity interval training, consists of short but sustained efforts interspersed with recovery time. When properly supervised and adapted, it can improve pain, joint function, muscle strength, and quality of life, including in patients with knee osteoarthritis (Tarantino et al., 2023). It is a dynamic alternative to adapted physical activity programs, provided that the patient's abilities and limitations are respected.
Conclusion
Early osteoarthritis in athletes is neither inevitable nor a contraindication to exercise. It invites us to rethink our approaches to targeted prevention, individualized support, and listening to weak signals, starting in adolescence.
Learn more about Xelflex® for joint health!
Scientific sources :
✍️ Tarantino D, Theysmans T, Mottola R, Verbrugghe J. High-Intensity Training for Knee Osteoarthritis: A Narrative Review. Sports (Basel). 2023 Apr 20;11(4):91. doi: 10.3390/sports11040091. PMID: 37104165; PMCID: PMC10141118.
✍️ Kong H, Wang XQ, Zhang XA. Exercise for Osteoarthritis: A Literature Review of Pathology and Mechanism. Front Aging Neurosci. 2022 May 3;14:854026. doi: 10.3389/fnagi.2022.854026. PMID: 35592699; PMCID: PMC9110817.
✍️ Zeng CY, Zhang ZR, Tang ZM, Hua FZ. Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis. Front Physiol. 2021 Dec 16;12:794062. doi: 10.3389/fphys.2021.794062. PMID: 34975542; PMCID: PMC8716769.
✍️ Bestwick-Stevenson T, Ifesemen OS, Pearson RG, Edwards KL. Association of Sports Participation With Osteoarthritis: A Systematic Review and Meta-Analysis. Orthop J Sports Med. 2021 Jun 14;9(6):23259671211004554. doi: 10.1177/23259671211004554. PMID: 34179201; PMCID: PMC8207281.
✍️ Radiological Society of North America. "Racket sports may worsen knee arthritis." ScienceDaily. ScienceDaily, 17 November 2020. <www.sciencedaily.com/releases/2020/11/201117085934.htm>.
✍️ Papalia R, Torre G, Zampogna B, Vorini F, Grasso A, Denaro V. Sport activity as risk factor for early knee osteoarthritis. J Biol Regul Homeost Agents. 2019 Mar-Apr;33(2 Suppl. 1):29-37. XIX Congresso Nazionale S.I.C.O.O.P. Societa' Italiana Chirurghi Ortopedici Dell'ospedalita' Privata Accreditata. PMID: 31169000.
✍️ Amoako AO, Pujalte GG. Osteoarthritis in young, active, and athletic individuals. Clin Med Insights Arthritis Musculoskelet Disord. 2014 May 22;7:27-32. doi: 10.4137/CMAMD.S14386. PMID: 24899825; PMCID: PMC4039183.
✍️ Bosomworth NJ. Exercise and knee osteoarthritis: benefit or hazard? Can Fam Physician. 2009 Sep;55(9):871-8. PMID: 19752252; PMCID: PMC2743580.
✍️ Maquirriain J, Ghisi JP, Amato S. Is tennis a predisposing factor for degenerative shoulder disease? A controlled study in former elite players. Br J Sports Med. 2006 May;40(5):447-50. doi: 10.1136/bjsm.2005.023382. PMID: 16632577; PMCID: PMC2653874.