“Is running bad for your knees” is a question I get asked. A lot. For many people, when they think of running, they think of knee pain. Along with that comes the assumption that as so many people feel pain in their knees during or after running, that running must be bad for the knees. The repetitive impact must contribute towards the development of conditions such as Osteoarthritis and what many G.P’s may ‘diagnose’ as general ‘wear and tear’, right?
Well, let’s look at the evidence!
Research has shown that weight bearing, impact exercise such as running is actually good for the knees! The on-off loading of the cartilage promotes cartilage cell regeneration! As you can imagine, more and stronger cartilage reduces the risk of developing Osteoarthritis.
Researchers as Stanford University (1) performed a long-term study looking at the effect of running on the cartilage of the knee joint. 1000 runners and non-runners (all OA free at the start of the trial) were tracked over 21 years! The results, published in 2008 in the Archives of Internal Medicine, showed that the runners knees were no worse off than the non-runners knees, regardless of how far or often the runners had run!
Research from the American Journal of Sports Medicine, also in 2008 (2) showed that knee cartilages recovered rapidly post-run, to pre-run cartilage volume levels within 1 hour of finishing a 20km race. This indicates that the cartilages (articular and menisci) are able to adapt to and rapidly recover from the demands of running.
Whilst this evidence looks great for those concerned about any link between Knee OA and running, there are some things to consider if you are just starting out with running.
Poor running form can increase the pressure on the knee joint, especially the medial (inner) compartment of the knee and this is where Osteoarthritis typically occurs first and worst! Biomechanical issues such as excessive hip adduction (causing the knee to fall inwards) and overpronation at the foot are both really common problems that can increase pressure on the medial compartment rather than spreading it uniformly across the whole knee joint.
Strengthening exercises for the hip abductors and external rotators to reduce hip adduction (think clams, hip hitches and side lying leg raises) as well as for the Tibialis Posterior to slow and control overpronation, are great for all runners to do. You should also ensure you wear the right footwear to help support and reduce any excess foot motion.
You are more prone to developing Osteoarthritis if you have a family history of the condition. So, if your parents or grandparents have it, the chances are increased that you may develop OA at some point regardless of whether you run or not.
But my advice in this case is that if you don’t currently have symptoms, then starting out with running could be a great way to help strengthen and protect your cartilage from the condition. Just ensure you are extra vigilant when it comes to good form.
Weight is another factor to consider. When running, it is estimated that the impact through our knees is anywhere between 4 and 8 times our own body weight (running style variations cause this large discrepancy). Obviously, the heavier you are, the more impact and stress you are putting your knees under and the more you are testing that cartilage.
Whilst running is a great way to lose weight, if you do need to lose more than a few pounds, you may be best to just run short distances to start with and use other forms of exercise (and of course a healthy diet) to help with some initial weight loss. Once you are closer to your target weight you can increase the miles safe in the knowledge that your knees will thank you for it!
Previous Knee Injury
If you do have a history of previous knee joint injury – especially to the cartilage (articular or menisci), or even the internal ligaments (ACL / PCL) or something like a tibial plateau fracture then you do need to be a little more wary. Knee joint injuries such as this do increase your risk of developing OA at a later date. My advice is to keep running as long as it is pain free to do so and ensure your form is as good as it can be to reduce further unnecessary pressure on the knees.
What About Other Knee Injuries?
Whilst we have only really dealt with knee OA and cartilage damage in this post, it is true that knee injuries are among the most common problems encountered by runners. Conditions such as IT band syndrome; Patellofemoral Pain Syndrome; Pes Anserine Injuries etc are common, but will usually resolve with rest and not impact the overall joint health in the future. All of these conditions (as with most running injuries) are overuse problems caused in the most part by either poor biomechanics or poor training methods. Getting both of these aspects right, considerably reduces the risk of knee injury.
So, in answer to the question, “Is Running Bad for Your Knees?” I’m sticking with no. But there is a large caveat here! The real answer is “No, provided you have strong, healthy joints and make sure you look after them and respect the impact that running can have on the knees”.