A common question that arises in sporting individuals who start suffering with joint pain, earlier than expected or later on in life: is sport worth the toll? There is no simple answer.
Playing sport regularly from a young age can lead to earlier degenerative changes in the spine and the peripheral joints. I have seen this in Premier League footballers and top 10 tennis players in their early to mid 20s. And it is not exclusive to elite athletes. Those who play football two or three times a week (and tennis on the rare occasions when the sun is out) are also more likely to suffer earlier degenerative changes.
An example: a female footballer in her mid 20s presented with x-rays showing disc degeneration and spondylolisthesis. Such changes are not usually seen until the late 30s and into the 40s. This may be due to the increased loading and pressures applied to the spine and discs from regular vigorous activity.
However, such degenerative changes are not always a consequence of sport. Anatomical variations from birth can also enhance the possibility of early degenerative changes, regardless of the person's activities. For example, those developing an increased curvature in the lumbar spine (hyperlordosis) are prone to earlier degenerative changes due to abnormal loading patterns on the disc and spine, which the body was not designed to cope with. Not everyone is affected in a similar way though, and not everyone will be symptomatic.
Testament to this are football players who have achieved incredible feats well into their 30s and 40s, and the rowers, boxers and golfers who win at the very top in their late 30s.
So, would one be better off not participating regularly in vigorous sporting activity? Not really. Activity is always better than no activity, which itself can lead to far worse injury and disease through issues such as obesity. It is also not possible to predict who, if undertaking regular sport, would or would not get early degenerative changes. There is so much to be achieved in life, and if you were to ask Muhammad Ali whether he would swap the achievements of his boxing career for better health now, the answer would be an emphatic no.