In an era where clean eating and rigorous fitness challenges have become almost a rite of passage for younger generations, there is growing concern among experts about the potential long-term health risks these trends might pose. According to top orthopaedic surgeons, there has been a noticeable uptick in young adults suffering from injuries to their knees, hips, feet, and backs, conditions often linked to the intense physical demands of modern exercise regimens.

The rise in popularity of demanding fitness competitions such as CrossFit and Hyrox, coupled with a shift from traditional social gatherings like pub nights to time spent in the gym, has created an environment where extreme physical activity is the norm. However, this zealous pursuit of fitness, often accompanied by strict ‘clean eating’ diets, might inadvertently be placing undue stress on bodies that are still maturing into early adulthood.

Experts caution that many young fitness enthusiasts may not fully realize how their passionate commitment to exercise could be compromising their health. The developing bones and joints of young adults are particularly vulnerable to injury, and the constant pressure of intense workouts can lead to serious issues such as fractures and joint problems, potentially culminating in conditions like osteoarthritis.

While exercise is widely recognized as one of the most effective defenses against osteoarthritis—a debilitating condition that causes joint pain and stiffness—there is a pressing need to educate the younger demographic about the importance of balanced nutrition and proper resistance training. Without this awareness, they risk sustaining cartilage damage and soft tissue injuries, which are becoming increasingly prevalent in younger patients.

Tim Sinnett, a prominent trauma and orthopaedic consultant, highlights a worrying trend: “We are seeing younger and younger patients presenting with more advanced cartilage damage. The assumption is that these are the results of extreme and intense exercise regimes.” As such, a more informed approach to fitness, incorporating a balance of exercise types and dietary habits, is crucial to safeguarding the health and well-being of future generations.

‘We are seeing younger and younger patients presenting with more advanced cartilage damage, and the presumption there is that they’re picking up more soft tissue injuries around the joint, as a result of more extreme and more intense exercise,’ explained Tim Sinnett, a leading trauma and orthopaedic consultant. 

By the age of 70, around half of people will develop arthritis, but some are affected much younger. Osteoarthritis, which affects around 10 million people in the UK, is the most common type of the condition, and is increasingly being diagnosed in the younger generations. 

As part of normal life, our joints are exposed to a constant low level of damage. In most cases, the body repairs the damage itself.

Mr Sinnett said they are seeing a lot more stress fractures and tendon injuries in younger people at their clinic, Grosvenor Orthopaedic Partners

But in osteoarthritis, the protective cartilage on the ends of bones breaks down until the joints are no longer able to fully repair themselves. 

A range of factors is thought to cause this increase in cartilage degradation, including genetics, obesity, repeated stress on joints, age, smoking and injury. 

Post-traumatic osteoarthritis is related to fractures that extend into a joint such as the ankle, wrist and knee. 

These can cause improper healing which alters joint mechanics and leads to cartilage breaking down more rapidly. 

The condition typically develops from the age of around 45, although experts warn more and more younger people are being affected.  

But unlike osteoporosis – where fragile bones sharply increase the chance of serious, and even life-threatening fractures – osteoarthritis can be reversed with lifestyle changes. The problem is that young people aren’t aware that exercise and diet can exacerbate the risk. 

Eating well with a focus on calcium rich anti-inflammatory foods such as dairy products, has long been shown to help protect joints and lower inflammation. But many youngsters are guilty of cutting out dairy, increasing the risk of nutrient deficiencies. 

‘We want patients to be healthy and exercise – and fuelling the body is massively important.

‘But there’s a whole group of people, mainly women, who cut out dairy, for example, resulting in bone inflammation because they’re not getting enough calcium,’ Mr Sinnett added. 

As such, Professor Lanham-New, clinical advisor to the National Osteoporosis Society, warned: ‘Without urgent action being taken to encourage young adults to incorporate all food groups into their diets and avoid particular ‘clean eating’ regimes, we are facing a future where broken bones will become just the “norm”‘. 

‘For younger people, this can be particularly devastating,’ Dr Atiqah Aziz, a senior researcher at the National Orthopaedic Centre of Excellence for Research and Learning, wrote for The Conversation.

‘Pain and stiffness can limit physical activity during years when work, caregiving and family life are often most demanding. 

Pain and stiffness can limit physical activity

More young adults are developing osteoarthritis than ever before 

‘And unlike older adults, younger patients may also face decades of managing symptoms and repeated treatments.’ 

As such, experts agree it’s crucial that young people are able to identify the warning signs early enough to act. 

Alongside diet, experts say the most effective intervention is exercise –  as long as it’s weight-bearing and focuses on both strength and resistance training. 

Bone mineral density peaks at around 30 years old, which means young adults who do not form strong bones are at an increased risk of the bone thinning condition. 

The surgeon said the best way to maintain bone mineral density – which helps keep bones healthy and reduces pain – is through cross-training, combining exercises like running and jumping which create the small shocks that stimulate bone growth, with resistance training like Pilates. 

But, he cautioned, most bodies are not ready for this level of loading without preconditioning – which has essentially resulted in an increase in injuries. 

‘The slight catch 22 is that this stretching and resistance training can cause soft tissue injuries when people push through what they think is a stretch, but is actually a tear or injury. 

‘It’s just another example of everything in moderation,’ he said.  

Mr Sinnett recommends cross training, combining impact sports with Pilates or yoga to build resistance and strength 

These practices, which focus on facilitating a full range of motion, help increase the amount of synovial fluid feeding the surface of cartilage. 

Synovial fluid, also known as joint fluid, reduces friction during movement and nourishes the cartilage and surrounding tissue, helping protect against wear and tear. 

Osteoarthritis develops when the cartilage that cushions joints breaks down over time. Cartilage normally acts as a shock absorber, allowing bones to move smoothly. 

As it wears away, joints lose this protection and bones eventually rub together, resulting in swelling, tenderness, and grating when moving the affected joints. 

The severity of the condition can vary, and usually takes years to develop. Early symptoms such as mild knee or hip pain or stiffness that comes and goes are often dismissed as a sign of needing to exercise more. 

As a result, many people delay seeking medical advice until joint damage is already advanced, especially if they live a healthy lifestyle. 

But experts maintain that early prevention and intervention are enough to reduce pain and in doing so relieve pressure on the NHS.