Debunking the Myth: Running is Bad for Your Knees
As an exercise physiologist, I hear it all the time: “Running is bad for your knees.” But the evidence tells a very different story—one that might change how you think about your joints.
As an exercise physiologist, I often hear the same belief from clients and friends:
"Running is bad for your knees”, “Running is bad for your joints and causes arthritis”.
Running seems to have earned the reputation as being a “joint destroyer”, largely because it is a high-impact activity. However, research reveals that recreational running does not increase the risk of knee osteoarthritis (OA), and that it can actually be protective for your knees (Dhillon et al., 2023). Multiple studies have shown no increase in knee OA incidence in recreational runners compared to non-runners, and the literature does not reveal any causal relationship between low and moderate distance running and osteoarthritis (Hansen et al., 2012). Although, one study showed that recreational runners had a lower occurrence of OA compared to competitive runners and non-runners, indicating that being sedentary and running at an elite level may share a similar risk for developing osteoarthritis (Alentorn Geli et al., 2017).
How Running Protects Your Knees
- Strengthens Muscles Around the Knee
Your knees require the quadriceps, hamstrings, and hip muscles for support. Running regularly can help to strengthen these muscles. - Maintains Healthy Cartilage
Cartilage needs load to stay healthy. Running stimulates cartilage metabolism, improving its resilience and repair capacity. Moderate, consistent loading encourages nutrient delivery to the joint, keeping it healthier than a sedentary lifestyle. - Supports a Healthy Weight
Excess body weight is a major risk factor for knee osteoarthritis. Running is an efficient way to manage body composition, thereby reducing mechanical stress on the knees over time. - Increases Bone Density
Running is a great type of weight bearing exercise which can help to simulate bone activity and thus increase bone density.
So why does this myth persist? Maybe because there are many cases of runners developing knee pain. However, pain does not equal osteoarthritis or joint damage. These reports are often due to soft tissue injuries, training errors, or biomechanical factors, which can be addressed with proper guidance.
Tips for Knee-Friendly Running
- Increase mileage gradually – avoid sudden jumps in distance or intensity to allow your muscles/tendons/ligaments/and bones to adapt to the load you are giving them.
- Prioritize strength training – especially for the hips, glutes, and quads to help support your knees and enhance running efficiency.
- Address any knee pain early – early discomfort may be a warning signal for you to adjust your running load to prevent any further aggravation and allow for a quicker recovery.
- Running surfaces and footwear– Varying footwear types can reduce the risk of your knee being overloaded the same way during every run. Consider reducing down-hill running if managing knee pain.
- Look at your sleep, nutrition, and stress management- running injuries are often multifactorial and can be reduced by improving your health habits holistically.
The Bottom Line
Running is not always bad for your knees, it can be one of the best things you do for them. Combined with the protective effects on cartilage, muscles, and body weight, running can be a powerful preventative tool against knee osteoarthritis. An exercise physiologist can help you manage your training loads and strength train appropriately to ensure you can run pain free!
References
Dhillon J, Kraeutler MJ, Belk JW, et al. Effects of Running on the Development of Knee Osteoarthritis: An Updated Systematic Review at Short-Term Follow-up. Orthopaedic Journal of Sports Medicine. 2023;11(3). doi:10.1177/23259671231152900
Eduard Alentorn-Geli, Kristian Samuelsson, Volker Musahl et al. The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis. Journal of Orthopaedic & Sports Physical Therapy. 2017:47 (6) Pages373-390. https://www.jospt.org/doi/10.2519/jospt.2017.7137
Pamela Hansen, Michael English, Stuart E. Willick. Does Running Cause Osteoarthritis in the Hip or Knee?, PM&R, Volume 4, Issue 5, Supplement, 2012, Pages S117-S121, ISSN 1934-1482, https://doi.org/10.1016/j.pmrj.2012.02.011
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