marathon running and osteoporosis

[Julie]

I am newly diagnosed with osteoporosis of the lower spine and osteopenia of the hip. I am due to run my first and only marathon at the end of September and do not know if this will cause any long term damage. Can anyone please advise me if they have done any long distance running or knows of anyone with osteporosis who has run long distance/

[Dean]

***, what a challange that you are taking on, 26 miles is even a long way when you go by car!

I have just done a quick search on pubmed and pulled a few papers. None of which are in particularly conclusive.

I found this one from Jama

Forty-one long-distance runners aged 50 to 72 years were compared with 41 matched community controls to examine associations of repetitive, long-term physical impact (running) with osteoarthritis and osteoporosis. Roentgenograms of hands, lateral lumbar spine, and knees were assessed without knowledge of running status. A computed tomographic scan of the first lumbar vertebra was performed to quantitate bone mineral content. Runners, both male and female, have approximately 40% more bone mineral than matched controls. Female runners, but not male runners, appear to have somewhat more sclerosis and spur formation in spine and weight-bearing knee x-ray films, but not in hand x-ray films. There were no differences between groups in joint space narrowing, crepitation, joint stability, or symptomatic osteoarthritis. Running is associated with increased bone mineral but not, in this cross-sectional study, with clinical osteoarthritis.

Calcium supplementation
This paper tells of the maintainace of bone density in long distance runners who take calcium supplements.

Normalisation of bone
This single patient study tells a story of a young athlete diagnosed with three conditions, during the time of the study she gained both weight and bone mass. Though a specific case due to the eating disorder, it does seem that the running was beneficial.

I feel a lot depends on your own specific diagnosis, I suspect that running a long way will have a large impact in the knees of anybody. It is something to talk about with your doctor who will know a lot about you. I suspect that your previous running history will be very important also; if it is your first running of any type I suspect that your body will be less use to it than if you have been running a few miles everyday.

Anyway, not really much of an answer, but good luck with the running

[Dean]

Hi Julie,
I have just registered on a runners forum and I am trying to find out some more information for you
Dean

[Dean]

Well I did manage to find this post on runners world.
Maybe it would be best to take things steady; maybe run a lesser distance this september (especially if you are new to running), and build yourself up to the big one at a later date; following your bone density tests carefully.

[Dean]

Hi julie,
I posted on runners world like I mentioned above. Lots of experienced runners there. This is what one of them said; it seems like very good advice, though perhaps not what you want to hear.

She should seek a second opinion from an orthopedist, ideally one with some knowledge of both runners and osteoporosis/osteopenia.

Certainly it is well known that people with low bone density (such as this woman) are at greater risk of stress fractures. The type of training she is doing puts her at even greater risk. However, if she has been training smart, she may not develop a fracture; and even if she does, it doesn't mean it'll cause long term damage necessarily.

Whether or not someone with a diagnosis of this nature should be running long distances is really a question for a medical professional, though. If she developed this bone density problem from an eating disorder then chances are good she should NOT be doing this sort of training.

[Sam]

I also think you should ask a doctor who is a runner. There is much more to this question than osteoporosis. If your bone density is low, what about your joints? How is the fluid in your joints? At what point is there unreasonable stress rather than bone building? You are not just running the 26 miles, but every other day or so are you not running 13 miles?

How was your osteoporosis diagnosed? Have you had an MRI scan to see what is happening where? Just curious.

Do you have any pains that you are living with because running is so thrilling?

Ask a doctor, but let us know what he/she says.
Sam