Running and IVD

Does Running Impact the Intervertebral Disc?

The aim of our Movement blog’s research showcase is to inform professionals about significant findings related to neck and lower back pain. Physiotherapists, osteopaths, chiropractors, and spine surgeons all deal with problems that are associated with specific activities, such as running. These medical professionals can assist the patient in understanding their symptoms in an informed manner by using a Dynamic Disc Model. For instance, by demonstrating dynamic disc height loss, a compressive intervertebral disc model (having an annulus and a nucleus) can help to explain why runners may feel pain and discomfort after running for a while. Alternatively, if a patient finds that jogging helps, the practitioner might show how the disc bounces during compression and decompression to support the nutrient-rich tissues around it. Education can be more accurate when it matches a patient’s complaints to their lower back findings using a realistic anatomical model.

Does Running Impact the Intervertebral Disc?

Running is a popular sport with both physical benefits and injuries. Current research focuses on muscle, bone, and cardiovascular systems, but there is limited research on how running may affect other connective tissues, such as intervertebral discs (IVD). The IVD can be divided into the nucleus pulposus and the annulus fibrosus. Healthy nucleus pulposus is a gelatinous tissue rich in water and glycosaminoglycans, which decreases linearly from the center to the outer ring of the nucleus pulposus. The annulus fibrosus comprises about 15 to 25 concentrated sheets of inclined collagen fibres and surrounds the nucleus pulposus. When axial pressure generated by running is applied to the IVD, pressure acting on the nucleus may be dispersed to the annulus fibrosus.

Studies that evaluated how running may affect human IVD date back to the 1990s, generally finding that runners’ stature or vertebral column height decreased after acute bouts of jogging. With advancements in imaging technology, IVD conditions can now be detected noninvasively using magnetic resonance imaging (MRI) techniques. The characteristics of IVD degeneration include reduction in IVD height, loss of IVD signal intensity, uneven structure, and other functional MRI-detected changes in the IVD component.

Despite these findings, controversies exist regarding how running may affect IVD in humans. The nature of the studies, evaluation methods employed, and participant characteristics may impact the conclusions drawn. Therefore, a study summarizing current knowledge regarding this topic is needed. This study1 aims to systematically review literature that measured IVD changes associated with running to answer the question: what is the impact of running exercise on IVD?

Main Results

Five of the studies evaluated in this study looked at intradiscal fluid (IVD) changes by measuring stature and vertebral column height as surrogates. Four of these studies found that the subjects’ stature or vertebral column height decreased after running, which was more obvious in athletes after jogging 25 km compared to 6 km. Nine studies measured IVD changes by different MRI sequences, with two studies finding no significant difference in IVD abnormalities between runners and controls. Two studies conducted longitudinal experiments and found no significant difference in IVD morphology or degeneration between baseline and follow-up.

Six studies evaluated the acute effects of running on IVD. All four studies found that the stature or vertebral column height decreased after running compared with pre-run. Two studies performed measurements after jogging for 30 minutes and one hour, finding that IVD height or volume decreased after running compared with pre-run. In general, studies that evaluated the acute effects of running on IVD generally indicate that running negatively impacts IVD when evaluated within a short period after running.

Cross-sectional evaluation was conducted in five studies to compare IVD status between runners and controls, and MRI was used to examine IVD parameters in all five studies. Runners in 4 of the 5 studies had >5 years of jogging experience, and in 1 of the 5 studies, had >10 years of running experience. For quantitative assessments, one study found higher IVD height and a higher ratio of IVD to vertebral body height in runners than in controls. In contrast, no significant difference in T2-times or ADC values between runners and controls was detected.

The Pfirrmann grading system, which has a score between 1 and 5, is commonly used for qualitative assessment of IVD. Two studies employed the Pfirrmann grading system to compare IVD qualitatively between runners and controls. In general, most studies found that runners possess better IVD health-related parameters compared to their counterparts. Still, exceptions do occur, and more high-quality studies are needed to draw definitive conclusions.

Discussion about the Study

The NOS study quality of included studies ranged from 4 to 7, with a median of 5. The low study quality may be due to selection bias, an inherent limitation of nonrandomized studies. Studies in this systematic review examined the acute effects of running on intravertebral disc disease (IVD). They found a decrease in spine height or IVD volume within a short time after running compared to pre-run, indicating a negative impact on IVD. Cross-sectional studies showed lower Pfirrmann scores of IVD in habitual runners compared to controls, while other parameters showed an upward trend compared to controls. Two cohort studies did not indicate that running exercise specifically harmed IVD. These results suggest that runners have healthier IVD compared to those who do not run. However, the results need to be interpreted with caution due to the nature of these studies.

The Bottom Line

Yes, running impacts the intervertebral disc in the short term; however, it looks to be reasonably healthy in the long run. After jogging, there are transient negative changes in IVD that could be caused by the disc’s water content being temporarily forced out by compression. According to cross-sectional research, long-term jogging may modestly benefit IVD; however, solid longitudinal research has not supported this conclusion.

At Dynamic Disc Designs, we create realistic anatomical models to show compression and decompression of the intervertebral disc so healthcare professionals can educate adequately. Explore our growing line of 3d spine modelling products.