Is running bad for your knees?

It's that time of year where many of us are embarking on new fitness regimes. If you're taking up running, you may be wondering if running is bad for your knees. In fact, this cardiovascular exercise can help to keep your knees and other joints healthy.

The key is not to put more stress on your knees than your body can handle.

Is running bad for your knees?

It is not running that's bad for your knees, but running when your knees can't take the stress that the activity places on them. If you have no existing knee or other joint problems, fitness experts like Laura Williams advise running as a way to keep your knees healthy:

"Nowadays, it's thought that running helps to keep your joints healthy, as it increases strength in both your bones and muscles. Running involves several joints, including your hip, knee, and ankle joints," explains Williams.

The knee is one of the largest joints in your body, and is the area where your thighbone (femur) joins your kneecap (patella), shinbone (tibia) and the smaller bone that runs alongside it (fibula). Muscle-strengthening exercises are great for joints because they build the muscles that surround your joints. This provides more support for your connecting bones, which in turn reduces stress and weight on your joints.

Why do my knees hurt when I run?

If running isn't bad for your knees, why then do knee pain and injuries sometimes occur? Running is high-impact because it involves jolting movements as your feet leave and hit the ground. This can be jarring on your joints and particularly your knees, the impact putting a high level of stress on them.

Experiencing knee pain during or after a run may be due to excessive pressure between your kneecap and thighbone. This pain may come and go and is usually felt at the front of your knee, although the exact site of pain is often hard to pinpoint.

Throughout your life, your joints will go through inevitable wear and tear. Regular physical activity is integral to maintaining a full range of motion in your joints, but it's important to balance high-impact exercise with low-impact activity and rest.

Williams summarises the essential considerations for runners: "Ultimately, how running impacts your joints will depend on how you run, how often you run, and how far you run, as well as any injury history."

The long-term effects of running

Having joint wear and tear is a natural part of ageing, and may lead to joint problems such as pain, stiffness, joint replacement surgeries, and osteoarthritis later in life. Contrary to popular belief, high-impact activities like running do not increase the likelihood of joint complaints on their own. 

For instance, many studies have found no correlation between running and osteoarthritis - the wearing down of joint cartilage. When research has shown an association between high-volume or high-intensity running with osteoarthritis, it hasn't been possible to determine whether other factors such as previous injury have played a role.

On the other hand, a 2020 study not only found running to have no effect on joint cartilage volume or thickness, but also suggested that it promoted cartilage nutrition.

How do runners avoid joint damage?

To reduce the risk of knee injury, there are steps you can follow to keep your knees supported while running.

Running shoes

The first step is to find a supportive running shoe: "Ensure you run in shoes that offer some cushioning and stability, and are suitable for the surface you'll be running on too," says Williams.

Factors include finding the perfect shoe width, cushion level, and arch support for your feet. Research shows that your shoes can significantly reduce your chance of running-related injury. If possible, it helps to have your shoes fitted properly in-store.

Stretching

Stretching before and after you run can help prevent knee injury. If you run with tight muscles, you're more likely to run with poor form and your muscles won't support your joints as effectively. Stretching after a run while your muscles are still warm will help maintain muscle flexibility - removing stress from your joints.

Running form

Good running form can significantly reduce the impact placed on your knees. This includes maintaining a good posture, looking ahead, keeping your elbows at 90° angles, and striking the ground with your mid-foot as opposed to your heel.

Adequate rest and gradual increases

"Allow your body to recover fully after each run," Williams cautions. "Take sufficient rest days, and avoid any sharp increases in mileage."

If you are embarking on a new running programme this year, don't ramp up the training routine too quickly. It's crucial to build up your running distance gradually and to start with plenty of rest days. Your body, including your knees, needs time to adapt to regular high-impact exercise.

This advice is not just for beginners. Many seasoned runners follow the 10% rule, increasing their weekly mileage by a maximum of 10% per week.

Softer surfaces

While running is high-impact, studies show that the impact exerted through your knees can be reduced by running on softer surfaces - including grass, woodchip, or a treadmill - as opposed to hard surfaces such as cement.

Adding variety to your fitness routine

Williams also recommends mixing up your fitness routine with other exercises that are low-impact: "In order to keep your running as joint-friendly as possible, you should aim to combine it with other sports that are lower in impact: cycling, swimming, and rowing will all help to maintain fitness, minus the load."

When should I avoid running?

Experts have identified the main risk factor for knee problems - or indeed any other running-related injuries - as previous injury in the previous 12 months. Running is bad for your knees if you attempt to run before existing knee pain, stiffness, and injury have fully healed.

If you experience knee pain or stiffness during or after running, listen to your body and rest until your joints have recovered. If after a few days of rest your knee is still causing you discomfort, you can consult your GP who may refer you to a physiotherapist.

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