Is Running Bad for Your Knees?

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Getting outside for a run comes with many health benefits. From cardiovascular health and stress relief to improved sleep quality, there is no doubt running is great exercise for both the body and mind.

Running can also be hard on the body with so much repetitive impact. As we age, our joints, ligaments, tendons, and muscles may not be able to withstand this high impact and you may notice more aches, pains, or soreness after a run.

Knee pain is frequently a common complaint amongst runners and many wonder if running is bad for knee health. But, the truth is that running itself is not inherently bad for knees. There are many protective and preventative measures you can take to help your body continue to run as long as it is able to.

Running with correct form, building up mileage slowly, and taking enough rest days are just some of the ways you can protect your knees from pain during running. Below you will find more about why your knees may hurt and how to protect them.

Why Do My Knees Hurt When I Run?

While many runners may experience knee pain, the sport itself is probably not to blame. The good news is there are many precautions you can take to fix knee pain and prevent future knee pain.

Some variables that contribute to knee pain are bad form, old shoes or shoes that aren't good for your specific body, and running on hard surfaces. Running-related injuries such as runner's knee, patellar tendinitis, and iliotibial band (IT) syndrome, can also cause knee pain and are preventable and typically treatable.

Running Form

You may be surprised to hear that good running form is actually quite complex, but it can certainly be learned and improved. Over striding, low cadence, and striking the ground with your heel can all contribute to knee pain. Practicing increasing your cadence by taking quick steps and landing on your mid-foot helps to improve form and prevent knee pain.

The surface you run on may affect how your joints feel as well. Running on asphalt or cement may be harder on your knees than grass, dirt, or even a treadmill. One study showed that running on a wood chip trail can help reduce injury risk.

Shoes

Shoes can play a big role in how your body feels during a run. Finding the proper shoe for your foot and gait is key. If you can, it may be helpful to visit a running store and have them assess your gait. They can recommend shoes that address appropriate cushion level, arch support, and width for your foot.

Additionally, switch out your shoes for new ones regularly, especially if you run long distances. Although there are no formal studies on when to replace your running shoes, most running coaches suggest replacing them every 300 to 400 miles or when you notice a lack of springiness in the shoes and you are feeling more aches and pains.

Runners and Osteoarthritis

There is quite a bit of research done on running's association with knee pain and osteoarthritis. Much of the data involving osteoarthritis of the knee in runners is conflicting. One review study gathered data on hip and knee osteoarthritis in competitive runners, recreational runners, and controls, which were considered sedentary, non-running individuals.

The prevalence of hip and knee osteoarthritis was 13.3% in competitive runners, 3.5% in recreational runners, and 10.2% in controls. Additionally, running for less than 15 years was associated with a lower rate of hip and knee osteoarthritis compared to controls.

The study concluded that because recreational runners had a lower prevalence of osteoarthritis compared to competitive runners and controls, it is not possible to determine a causative relationship between running and osteoarthritis.

Running causes bones and cartilage to adapt, leading to stronger knees in the long term. When running with correct form and taking enough time off to allow your body to recover and repair, runners may not need to worry about developing osteoarthritis in the knee.

How to Protect Your Knees

There are several ways to protect your knees for years of pain-free running. If you are a new runner or coming back from an injury, it is important to start slow and conservative. Do not go out too fast or increase your mileage too quickly. The majority of injuries are due to overuse injuries, so ramping up mileage and speed slowly will better set you up for success.

Another important way to prevent injury and protect your knees is through dynamic warm-ups and stretching before a run. One study looked at the difference between static stretching and dynamic stretching before exercise to determine its effect on athletic performance and knee joint position sense.

The researchers concluded that both types of stretching improve knee joint position. Because static stretching has a negative impact on muscle strength while dynamic stretching should be performed as part of a pre-exercise warm up for improved athletic performance.

When runners experience knee pain, they are quick to blame the running. However, knee pain is often due to weak hips, glutes, quadriceps, and hamstrings and strengthening these muscle groups stabilizes the knee and improves the pain.

According to the American Academy of Orthopaedic Surgeons, stretching and strengthening the lower body may help improve range of motion and flexibility in the knee joint, further preventing injury. If you are experiencing knee pain, talk to a healthcare provider who can evaluate you and provide many strengthening exercises.

Knee braces can also help support and stabilize the knee during activity without worsening any knee injuries. One study compared individuals with osteoarthritis wearing a soft knee brace to individuals wearing no brace.

Wearing a soft knee brace significantly reduced pain level during walking and reduced self-reported knee instability. Wearing a knee brace also may help you continue activity while rehabilitating the injury.

When to See a Healthcare Provider

While there are many things you can do to protect your knees from new injuries or from making current discomfort worse, it is also important to listen to your body. Rest when the pain is lingering, unbearable, or causing you to change your running form.

If the pain does not improve with rest, you should contact a healthcare provider for evaluation. You could have an injury or condition that requires treatment.

A Word From Verywell

Running with good form, stretching, and strength training are all excellent ways to protect your knees from pain and injuries. Unfortunately, runner's do experience knee pain sometimes and it is important to not push your body too hard. Know when to cut back on mileage, speed, and even take more rest days. Be sure to seek help from a medical professional such as an orthopedic surgeon or physical therapist when the pain is lingering.

Frequently Asked Questions

  • How long does runner's knee last?

    Patellofemoral pain syndrome, also known as runner's knee, is indicated by dull pain around the front of the knee and rubbing, grinding, or clicking sound of the kneecap when you bend and straighten your knee. Runner's knee may be caused by a number of issues including weak thigh muscles, tight hamstrings, tight Achilles tendons, and excessive training. Most people can return running in 6 to 12 weeks after treatment and rest.

  • How much can I run without damaging my knees?

    With good form and proper precautions in place, you should be able to run as long or as far as your body can handle. Learn to pay attention to what your body is telling you so you can prevent injury before it is too late. If you are feeling pain, assess if it is sharp pain and if it is making you change your form or compensate in any way. If this is the case, you should stop running. Try not to run through pain that does not feel normal. Keep in mind that running should not hurt. If it does, take some time off or speak to a physical therapist about working on your running form.

  • Should you exercise with knee pain?

    If your knee pain is causing you to change your form or continues to linger after resting, it may be a good idea to seek advice from a medical professional. They can assess your injury and give you recommendations about the safety of continuing to exercise and any rehabilitation steps you can take to heal faster.

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7 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Hannelore Boey, Jeroen Aeles, Kurt Schütte & Benedicte Vanwanseele (2017) The effect of three surface conditions, speed and running experience on vertical acceleration of the tibia during runningSports Biomechanics, 16:2, 166-176. doi:10.1080/14763141.2016.1212918

  2. Alentorn-Geli E, Samuelsson K, Musahl V, Green CL, Bhandari M, Karlsson J. The association of recreational and competitive running with hip and knee osteoarthritis: A systematic review and meta-analysisJ Orthop Sports Phys Ther. 2017;47(6):373-390. doi:10.2519/jospt.2017.7137

  3. Miller RH, Krupenevich RL. Medial knee cartilage is unlikely to withstand a lifetime of running without positive adaptation: a theoretical biomechanical model of failure phenomenaPeerJ. 2020;8:e9676. Published 2020 Aug 5.

  4. Walsh GS. Effect of static and dynamic muscle stretching as part of warm up procedures on knee joint proprioception and strengthHum Mov Sci. 2017;55:189-195. doi:10.1016/j.humov.2017.08.014

  5. American Academy of Orthopaedic Surgeons. Knee conditioning program.

  6. Cudejko T, van der Esch M, van der Leeden M, et al. The immediate effect of a soft knee brace on pain, activity limitations, self-reported knee instability, and self-reported knee confidence in patients with knee osteoarthritisArthritis Res Ther. 2017;19(1):260. Published 2017 Dec 1. doi:10.1186/s13075-017-1456-0

  7. Gaitonde DY, Ericksen A, Robbins RC. Patellofemoral pain syndrome. Am Fam Physician. 2019 Jan 15;99(2):88-94. PMID:30633480

Additional Reading
  • Eliza F. Chakravarty , Helen B. Hubert, Vijaya B. Lingala, Ernesto Zatarain, James F. Fries. "Long Distance Running and Knee Osteoarthritis: A Prospective Study." American Journal of Preventive Medicine, Volume 35, Issue 2, August 2008, Pages 133–138.
  • Eliza F. Chakravarty; Helen B. Hubert; Vijaya B. Lingala; James F. Fries. "Reduced Disability and Mortality Among Aging Runners: A 21-Year Longitudinal Study." Arch Intern Med. 2008;168(15):1638-1646.
  • Interview with James Fries, MD. Professor of Medicine Emeritus, Stanford University Medical School. Conducted August 23, 2013.
  • Pamela Hansen, Michael English, Stuart E. Willick. "Does Running Cause Osteoarthritis in the Hip or Knee?" American Academy of Physical Medicine and Rehabilitation 1934-1482/12/$36.00 Vol. 4, S117-S121, May 2012.
  • Stuart E. Willick and Pamela A. Hansen. "Running and Osteoarthritis." Clin Sports Med 29 (2010) 417–428.