Is Running Bad for Your Knees?

Running is not bad for your knees. In fact, running makes your knees stronger because it helps build cartilage. The stress of running on your bones and tissues such as cartilage creates microtears that build back stronger during proper recovery.

Therefore, the more you run, the stronger your knees will be.

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Being sedentary puts you at much greater risk for knee pain and arthritis than someone who is a recreational runner.

Related: How I Healed My Knee Bursitis

What the research says:

Here’s a round-up of some of the research on knee injuries and running.

One study followed runners and non-runners for almost 20 years, X-rays showed signs of arthritis in 32 percent of the non-runners and only 20 percent of runners.
This study and this study found that veteran marathoners have much less occurrence of knee arthritis compared to non-runners.
A recent study of beginner, middle-aged runners found that distance running rebuilds the health of specific essential components of middle-aged knees, even if the joints are already worn.
A cross-section of studies found there is no increased risk of knee osteoarthritis in runners.
Another study found positive adaptation in knee cartilage following a lifetime of running.
Another f ound running significantly reduced knee OA and hip replacement risk due to, in part, running’s link to a lower BMI, especially compared to other lower-strenuous exercises such as walking.
This study found lower rates of knee osteoarthritisin recreational runners (3.5%) versus non-runners (10.2%). Elite runners did have the highest occurrence of knee arthritis with 13.2%, indicating that to a degree running can prevent arthritis in the knees.
And this one found that most runners don’t get knee osteoarthritis because the ground contact time is short and the length of strides blunt the effect on joints, especially compared to walking.

https://www.youtube.com/watch?v=naBtvlxIRb8

Is it OK to run with bad knees?

Yes, according to the research, it is good to run with bad knees as they may help strengthen your knees.

The study found that the knee health of novice, middle-aged marathon runners improved with running: “Improvement to damaged subchondral bone of the tibial and femoral condyles was found following the marathon in novice runners.”

The researchers note: “This is the most robust evidence to link marathon running with knee joint health and provides important information for those seeking to understand the link between long distance running and osteoarthritis of the main weight-bearing areas of the knee.”

Do marathon runners have bad knees?

No, studies show that marathon runners don’t have bad knees. In fact, recreational marathon runners have better overall knee health, having a lower risk of knee osteoarthritis. However, marathoners and runners who run long distances do suffer from overuse injuries of the knee.

Most Common Running Injuries of the Knee

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Patellofemoral pain (pain in the front of the knee)
Iliotibial band (ITB) syndrome (pain in outer part of the knee)
Knee bursitis (characterized by pain, tenderness, and warmth in one or more of the 11 bursae, jelly-like sacs, in your knee.
Knee tendonitis (pain at the attachment of the quadriceps muscles or hamstring muscles)
Cartilage degeneration (pain in the entire knee joint that may feel like stiffness, friction or grinding)

What should I do if my knee hurts when running?

If your knee hurts when running above a 3/10, the pain increases as you run, or causes you to change your running gait, then it’s important to stop running, walk home, ice and heat three times a day, and take a break from running for several days. Do cross-training exercises that do not aggravate the knee like swimming or the elliptical.

If your knee pain has not improved after a week of a rest from running, see a physical therapist or sports medicine doctor to assess what may be causing the pain and if you have any imbalances or weaknesses that need to be addressed.

Who is at risk for knee pain from running?

So, what causes pain in the knee from running? Below are risk factors that may cause knee injuries from running.

Common Causes of Knee Injuries in Runners

1. Body weight.

Runners who are 20 pounds or more overweight are at a greater risk for knee injuries since the extra weight causes extra stress on your joints. Losing just one pound can make a huge difference in lowering your risk, considering one step of running can increase force by more than 11 times. Reduce your knee injury risk by starting with a run/walk program.

2. Muscle weaknesses.

If the surrounding muscles of the knee are weak, then that will put extra force on the knee with each foot strike. Muscle weakness or muscle imbalances of the core, hip, and glutes can lead to poor tracking and strain. Strength training of these areas can fix this issue!

3. Running history.

bad knees post — Running isn’t bad for your knees! It makes them stronger!

New runners and young runners are at greater risk for knee injuries because the muscles around the knee aren’t strong enough to withstand he impact. Once again, ensure you are supplementing your running routine with a strength routine that targets your hips, core, glutes, quads, and hamstrings! Also, if you have a history of injuries, then it’s likely you are more at risk for a knee injury because you likely have a muscle or gait imbalance, or structural issue that predisposes you to injury.

Related: Faster as a Master’s Runner

4. Bad form.

People who run with poor form when running are at risk for knee injuries. This is particularly if they heel strike or overstride as this shows that it causes excessive force on the knee rather than if they landed mid-foot. When running, keep your strides short, light and quick with your foot landing under your knee. If you aren’t sure if you are running with good form, it’s a good idea to get a gait analysis from a physical therapist or preferred healthcare provider.

Related: How to Fix Bad Running Form

5. Hard surfaces.

If you tend to run on hard surfaces such as concrete versus asphalt, gravel, grass, or dirt trails, you may injured your knees. Concrete is 10 times harder than asphalt, so choose asphalt or a natural surface when you can.

6. Wrong shoes.

If you are wearing the wrong shoes for your running gait or old shoes, then you’re more at risk for a knee injury or running injury. Don’t choose running shoes based on price or look. Go to a running store and try on shoes, take them for test run, and see what feels the best. Choose shoes based on comfort and keep track of that mileage. Most running shoes need to be replaced after 400 miles or so, some sooner.

7. Cutting corners.

Runners who don’t stay on top of the little things such as a proper warm-up, cool-down, and strength training are at greater risk for injury. These practices help your body prepare for and recover from hard work. Just as risky is a sudden increase in mileage which puts stress on your bones, ligaments, tissues, and joints before they are strong enough to handle the load. The general rule of thumb of a 10 percent increase in total volume week to week (with a down week every month) will insure you against injury.

8. Poor nutrition.

If you aren’t eating enough, including fueling before, after, and during your runs, then you’re at risk for getting hurt. Your body needs calories and macronutrients to work hard, recover, and build back stronger. If it doesn’t have what it needs, it’ll start to break down. Also important is hydration, especially as hydration helps keep joints lubricated.

How do you prevent runner’s knee and other knee injuries?

To prevent knee injuries, avoid the above causes as much as possible. Here are some quick tips to help you keep your knees healthy!

Always warm-up and cool-down. Do a dynamic stretching routine before running and take the first 1-2 miles to ease into the run. When you’re down, walk to allow your heart rate to come down and then do some light stretching and foam rolling.
Wear the right shoes. Make sure your shoes are comfortable and not too worn down.
Eat and drink well. Ensure you are fueling your runs and refueling after your runs, and drinking plenty of water. This allows your body to word hard and recover harder. Get a complete fueling guide here.
Train right. Don’t ramp up mileage too quickly. Your running program should abide by the 10 percent rule of increasing only 10 percent week to week of total volume, take cutback weeks with reduced mileage, and don’t run two hard days back-to-back. If you feel a running injury coming up, take a rest day or three.
Seek soft surfaces. When you can, try to run on soft surfaces, avoiding concrete as much as possible. Even if it is just one recovery run a week on grass, it can help you recover faster and keep injuries at bay!
Take a joint supplement. I am a huge proponent of the Previnex Joint Health Supplement as it’s helped my knees feel less creaky whenever I start a training cycle. It’s also helped my athletes with chronic OA feel and run better. Save 15% with code TMR15, plus a moneyback guarantee.
Strength train. Aim to lift twice a week for all major muscles groups, including your core! Lift on harder run days to optimize recovery on easy days.

How can I make my knees stronger?

Whitney Heins lifting weight — Strength training is key for keeping your joints healthy.

You can make your knees stronger by doing the following exercises at least once per week as part of your strength training regimen!

7 Knee Exercises for Runners

Knee bends: Start with your back up against the wall an exercise ball between your knees. Squeeze the ball between your thighs, and slide your back down the wall, with a slight bend of the knees. Keep your knees behind your toes, with toes pointed at a slight angle out. Squeeze your butt and stand back up. Do 3 sets of 10 reps.
Thigh contraction. Sit in a chair with your legs bent in front of you. Extend one leg straight out. Hold for 15 seconds with your quad tense. Do 3 sets of 15 seconds on each leg.
Straight leg raises. In the same position seated in a chair, lift one leg straight out with your toe flexed towards you. Pulse leg up and down 10 times, keep your quad flexed. While doing this exercise, do not let your raised foot touch the floor. Do 3 sets of 10 reps on each leg.
Hamstring stretch with thigh contraction. Still in a chair, keep one leg straight out in front of you. Bend at the waist with a straight back towards your leg. Feel the stretch in your hamstring. Meanwhile, tense your quad. Hold for 15 seconds. Do 3 sets of 15 seconds on each leg.
ITB (iliotibial band). Stand up and cross one leg in front of the other. Now, bend over and try to touch your toes. Hold for 15 seconds. Do 3 sets of 15 seconds for each leg.
Air squat. Stand with your legs shoulder-width apart. Slide down like you are going to sit in a chair. Do 3 sets of ten. Make it more challenging by then doing a single-leg squat.
Air lunge. Now twist so that one foot is in front of the other, with your front foot slightly in front of your body and the other behind your body. Sink straight down until your knees at close to a 90 degree angle with the floor, with your knee touching (or almost touching) the floor. Stand up. Do 3 sets of 5 reps on each leg.

If you want guidance with your running goals, check out my run coaching services. Also, be sure to check out my free training plans:

Is Running Bad for Your Knees?

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