Is Running Bad for Your Knees?

Every runner has heard it at one point or another: “Running is bad for your knees!”

(Insert grimace). 

But is running bad for your knees? We circled the globe to find out.

The short answer? NO!

While running can lead to knee pain – and we’ll explore the factors that can influence this and how to mitigate them, the evidence is clear that over the long-term, runners actually have better knee health than non-runners.

Variables ranging from muscle weakness to improper shoes can cause knee pain and injuries while running.

But as we’ll look discuss, these short-term issues are usually caused by an imbalance of some type or something to correct in your training practice.

In this article, we will cover:

• Why do people think running causes knee pain?

• What type of runners may experience knee pain?

• How can runners avoid knee pain while running?

• What should runners do if they experience knee pain from running?

• The long-term effect of running on your knees: is running actually good for your knees?

Why do people think running causes knee pain?

There are two main reasons there is an assumption that running causes knee pain.

First, there’s the force that goes through your knees with each stride. If the joints can’t take the pressure of each foot strike, they’re going hurt.

“Running is bad for your knees WHEN the muscles surrounding the knee joints cannot support the joint and therefore cause more pressure to go through the joints versus having the pressure be absorbed by joint and muscle,” explains Lisa Mitro, DPT. 

Second, naturally having the knee strength required for running is rare, therefore it’s common to have some knee pain when someone begins running. 

“If you ask any seasoned marathon running veteran, they have all battled through it. If you can get through the initial pain and understand what your body needs, you can quickly move past knee pain and get into awesome running shape!” notes running coach Ryan Lange.

• Related: Does Running Help You Live Longer?

What kind of runners might experience knee pain?

Some people are more at risk for knee pain from running than others. The factors that lead to knee pain in runners include:

Weight

Runners who are 20 pounds overweight or more are at a greater risk for knee pain, says, Jason Kozma, a fitness expert and celebrity trainer.

“The additional weight causes stress to the joints in the knees, the back, and feet.  Reducing your weight by 1 pound takes 4 pounds of pressure off of your knees, for example.”

Muscle weakness

As noted, muscle weakness around the knee can lead to knee pain when running. Lack of strength in the core, hip, and glutes can also lead to knee pain while running.

“Poor tracking of the knees is usually due to weakness in these areas and can be avoided with proper cross and strength training,” advises Kristin Williams, DPT. 

Poor form

People who run with poor running form, particularly people who strike with their heels or overstride, are more likely to have knee pain when running.

“Studies show that landing midfoot causes no excessive force on the knee whereas running heel to toe multiplies your body weight in force on knees,” shares certified personal trainer and running coach Justin Weissner. 

Related: Proper Running Form: Here’s How to Make it Effortless

Age

New runners who are older are more likely to get knee pain because their bone and joint health is declining. Older runners who have been running most of their life are less likely to have knee pain. 

“Someone who jumps into running at the age of 55 is more likely to have knee issues compared to someone of, say, 25 doing the same thing.” says, Thomas Watson, UESCA Running Coach. “The older you get, the more you’re fighting the aging process and have to take things gradually”.

Previous injuries

Additionally, runners who have had previous injuries to the knee or injuries that may cause misalignment are at a greater risk for knee running injuries. 

Ramping Up Mileage Too Quickly

People who do not take the time to gradually ramp up their mileage, skimp on warming up and cooling down, stretch and strengthen are more likely to get a running injury. 

• Related: The 10% Rule – Is It A Valid Way To Increase Mileage?

Surface type

Those who run regularly on concrete are more likely to get injured as concrete is pretty much the hardest surface you can run on. Asphalt is much softer and obviously dirt and grass are even better. 

A Good Pair of Running Shoes

Runners who do not find and purchase proper running shoes are setting themselves up for injury. Lange puts it simply, “People who start running in $40 Nike shoes are going to get hurt.”

How can a runner prevent knee pain?

There are steps all runners can take to prevent knee pain (or any sort of pain for that matter). 

Strength train. Runners must strengthen the hips, knees, and core to avoid knee injuries. “Weight training helps to condition the muscles to handle longer durations of repetitive loading of the tissues and support the joints preventing injuries,” notes Samantha Parker, certified yoga therapist and personal trainer.

• Related: Weightlifting guide for runners

Stretch. Runners should do dynamic stretching before a run and static stretching after a run. “Joints like knees often get damaged and become painful when the muscles that support their function are too tight,” explains Annie Gibbons, a certified personal trainer and running coach.

Wear proper shoes. Go to a store and get fitted, then keep track of the wear on them. Most shoes last between 300 and 500 miles. “The foundation of your run is your shoes. When they become too worn, the support in all the important places for your gait and foot strike are compromised,” says Gibbons.

• Related: Our Pick Of The Best Running Shoes On The Market Today

Run on soft surfaces. When running, your feet hit the ground with up to 6 times your body weight in some cases. To decrease the amount of impact, runners should run on softer surfaces which absorb the impact on the joints. 

“The best type of surface to run on is rubberized running tracks which provide some cushion. Concrete is the worst type of surface to run on because it is so hard.  It will not provide any shock absorption,” advises Lauren Sheu, running coach at Running for Wellness.

Ramp up mileage slowly. Runners, especially new runners, need to be careful in how many miles they run per week. It is generally advised that runners should not increase mileage more than ten percent per week. Many running coaches find that keeping mileage the same for 3-4 weeks and then increasing by 30 percent decreases risk of injury. 

Cross train. While building mileage, you can still build your heart. New runners (and smart runners) take days to cross-train so they can work their muscles in different ways, build their cardiovascular strength, while taking a break from the impact of running. 

“Cross-training helps strengthen the muscles, so they are able to better support the joints when running,” adds Parker.

Run hills. Hill sprints are a great way to balance out your strength. “They increase cardiovascular strength along with loading the body is multiple different planes that help to strengthen the smaller stabilizer muscles limiting potential injury,” adds Gibbons.

Recover well. Seasoned runners know the secret recipe of the hard/easy/hard sandwich. In other words, they know to never run two difficult days in a row. They also honor recovery. They take scheduled rest days and take a day off or take it easy when their bodies are telling them to. 

What should runners do if they experience knee pain while running?

If you experience knee pain while running—do not give up! It is time to readdress your training. 

Stop or ease off your training, incorporate cross-training or walking, ice after your workouts, consider seeking a professional to pinpoint any weaknesses and assess your gait. 

“If pain with rest and ice last more than 7 to 10 days you should seek medical attention,” suggests certified athletic trainer Bill Romaniello. A good starting point would be a physical therapist, orthopedic surgeon or sports medicine trained physician. 

Getting a running coach to teach you proper running form and draft a running schedule that is right for you would also help set you up for a life of healthy, happy running. 

The Long Term View: Is Running Good For Your Knees?

Yes.

Running is GOOD for your knees because it strengthens them. 

As Williams puts it: “Running helps to build cartilage. Being sedentary gives one a higher chance of developing arthritis in the knees than running recreationally.”

Consider this study which examined knee arthritis in three groups: recreational runners, non-runners, and competitive runners. The incidence of knee arthritis in the three groups were as follows:

• Recreational Runners – 3.5%

• Non-Runners – 10.2%

• Elite/Competitive Runners – 13.3%

“This large systematic review shows that running, up to a certain point, can actually help prevent arthritis of the knees,” Dr. Jordan Duncan explains. “One reason is that the cartilage in the knees of a runner is likely thicker and stronger than that of a sedentary individual, because it has adapted to the mechanical stress of running. As long as, the demand does not exceed the body’s ability to repair itself, remodeling will occur.” 

Dr. Gbolahan Okubadejo, an orthopedic surgeon, points to two other studies that show running is beneficial to the knees. In one study that followed runners and non-runners for almost 20 years, X-rays showed signs of arthritis in the knees of 20 percent of the runners, but 32 percent of the non-runners.

A recent study actually found that veteran American marathoners had only half as much arthritis as non-runners. 

“Therefore, it is a fallacy that running increases your risk of osteoarthritis in your knees,” says Dr. Okubadejo. 

This all means that generally, the more you run, the stronger your knee will be. 

Thus, when someone tells you that your running is bad for your knees, you can politely tell them that they are WRONG!