You’ve probably heard it countless times from your non-running family and friends: “Isn’t all that running going to ruin your knees?”
And if you’ve only been able to muster a half-hearted “I hope not,” while secretly wanting to throw your Garmin at them, I’m here to add some fuel to your fire. With all that pavement pounding and repetitive stress on the lower extremities, it’s understandable how running gets a bad rap. However, barring a few exceptions, research shows that running might actually be good for your knees. When done mindfully, this high-impact exercise can be an excellent way to boost knee and joint health. (1)
But before you grab your shoes and run off happily into the sunset, there are a few things you need to know. Set yourself up for success, so you can chase those PRs to your heart’s content without ending up with a knee injury from running. Read on to find out how!
Plot Twist: Running Can Actually Be Good for Your Joints
Yep, you read that right. Several recent studies have demonstrated that long-distance runners are no more likely to develop osteoarthritis than non-runners or walkers. (1-8) As a lifelong runner with chronic knee pain, I approached this research with some skepticism (okay, a lot of skepticism). I admit that constantly being told that I was doomed to a knee replacement, and it wasn’t a matter of ‘if’ but ‘when’ made me feel a little jaded. But I was happily proven wrong. The data is robust, and the various studies demonstrating the positive effects of running on joint health transformed my skepticism into optimism.
One of the explanations for this positive effect on the knee joint is cartilage adaptation. Until recently, it was believed that cartilage was a tissue that did not adapt to exercise stimuli, as it has neither nerve nor blood supply feeding directly to the tissue. However, in a 2010 study, researchers observed thicker, more cushioned cartilage in the knee joints of subjects who had a moderate running practice when compared with subjects who did no running at all. (2) This suggests this soft tissue is, in fact, capable of adaptation when presented with a stimulus (running) that just slightly overloads its capabilities.
So, what does this mean exactly? Slow and mindful is the name of the game. That’s not to say your running pace needs to be slow every time you train, but to focus on a gradual increase of overall weekly mileage. This allows your joints to build up tissue and synovial fluid that will allow you to take on the high-impact nature of running, safely. Knee injuries from running typically arise when you add in too much mileage too soon, without giving your body adequate time to adapt.
Of course, this advice does not come without some noteworthy caveats. If you already have knee pain (whether it’s from running or not), it is best to back off and assess what’s going on. Your joints will need time to heal and recover before starting or returning to a running routine. If you have arthritis, talk to your doctor before beginning a running program. (3)
Running Mindfully
One way you can protect those knees throughout your running career is to be mindful. These places focus on a variety of factors that you may not otherwise think about. Speaking from experience, it is easy to step out the door for a run and completely zone out. While this can be one of the many benefits of running, especially when your mind needs a break, taking the time to pay attention to a few key details can make all the difference for your knee health.
Pay Attention to Running Form
Common pitfalls when it comes to distance running form are overstriding and heel striking. Both actions over-stress your knee joint and can lead to overuse injury down the road.
Pro tip: When running, try to land on the mid-foot rather than the heel. Keep your center of gravity below you rather than striding too far out in front of your body, and maintain forward momentum.
Find the Right Fit
Wearing running shoes that are good for your body will help keep your joints happy. Everyone’s body, stride, and gait are a little different, so make sure you find a shoe that works for you, not against you. In general, look for a wide toe-box and avoid having too narrow of a fit. This allows your toes room to move around while your arch and heel are supported.
Pro tip: Find a local running shoe store where you can get your gait analyzed (for free!). Experts can recommend shoes that will address your particular needs.
Vary Your Running Surfaces
Running on the pavement every day can be extremely hard on your body. Try to change up where you run by finding a dirt or bark trail, or even a large grass field. If you have access to a treadmill, this is also a great way to lessen the impact on your body while still getting those steps in. Check out all of Sunny’s awesome treadmills here!
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You can also follow along with our trainer, Sam Candler, for some treadmill fun in the SunnyFit® App!
Pro tip: If you can’t make it to a trail, swap sidewalk runs for the street’s softer asphalt surface. Of course, be safe and make sure you are on a road that has a wide shoulder or a protected bike lane.
Listen to Your Body
Runners are notorious for running through injuries (again, speaking from experience). Be honest with yourself, and if you start to feel pain when running, it’s time for a break. This can be especially hard when you are training for a specific race, but in the long run (pun intended) it’s better for you to take some time off. Unaddressed injuries that might otherwise be quick fixes, can potentially turn into something more serious. Enjoy not having to get up for that early morning run and take your well-earned R & R.
Pro tip: When dealing with an injury, adhere to the RICE principle. Rest, Ice, Compression, and Elevation will help expedite the healing process. If you can do so without pain, cross-training activities in place of running can help sustain your fitness level while your injury heals.
Warm Up and Cool Down
Prepare your body for the increased demand of exercise by warming it up! Getting your muscles warm increases your body’s temperature and decreases the likelihood of straining or pulling a muscle. Finish your run with a cool down and bring your body back to a resting state.
Pro tip: Warm up with dynamic stretches to get your body moving. Cool down with static stretches to bring length back to your muscles and prevent the hips from becoming too tight.
Avoiding Injury
The best way to combat a knee injury from running is to have a good injury prevention practice. These tips will keep your knees healthy and supported for each step of your run.
Prioritize Strength Training
Running is a repetitive movement that happens in one plane of motion (forward and back), so it is easy for runners to develop muscular imbalances. This typically looks like strong quads and underactive hamstrings and glutes. Without enough musculature to adequately support your knee joint, the brunt of the force from your foot striking the ground will be in your joint rather than in your muscles. This is why strength training is crucial for runners.
Pro tip: Find workouts that incorporate strength exercises for the glutes and hamstrings, core stability, lateral movements, and upper body posture. Coach Sam has just the workout to get you started!
Stretch It Out
Stretching after a run often feels like a chore, but it’s one of the most beneficial things you can do for your body. This post-cool down activity keeps your muscles flexible and optimizes your mobility for more effective movement. Tight muscles are often followed by movement dysfunction and injury, so don’t skip your daily stretch sesh. (3)
Pro tip: Runners often suffer from tight piriformis (a deep muscle in the posterior hip) and hip flexors (the front of the hip). Focus on full-body stretching, but make sure you don’t miss the hips. Check out this 10-min full-body stretch with Sunny Trainer, James King III!
Ease Into It
Don’t stress your body with more than it is equipped to handle. For running this means starting small with shorter runs (or maybe even a walk/jog) and slowly building as you become stronger and more comfortable with running.
Pro tip: A good rule of thumb is to increase your weekly mileage by no more than 10%. For example, if your current weekly runs add up to 10 miles, the following week you would run a total of 11 miles. It seems like slow progress, but it will help you stay injury free.
Don’t Underestimate the Power of Cross Training
If you’re feeling a little worn down, opt for a cross-training day in place of a run. Workouts like cycling, elliptical, and rowing keep the impact low but the intensity high! You will still get your daily dose of cardio while giving your joints and muscles a break.
Pro tip: Not sure where to start? Check out these free workouts in the SunnyFit® App!
Don’t Skip Rest Days
I get it, when you’re on a roll with your training it’s easy to have a “more is better” mentality. However, that’s not always the case with exercise. Even if you’re feeling great, 1-2 rest days are necessary for your body to recover and build back stronger.
Pro tip: Schedule your rest days in advance so you can structure your workouts around your recovery. Use the extra time for another hobby you love or take a walk outside for an active rest day.
The Finish Line
As a runner, I feel relief knowing running isn’t inherently bad for my knees. In some ways, this information makes me feel empowered, bringing my awareness to how I can be in control of my joint health. Rather than submitting to the idea that running will ruin my knees, I can take the initiative and prepare my body to sustain a healthy running plan.
Having a well-rounded training routine including strength and stretching workouts that complement running, being mindful of your body, and giving yourself rest all contribute to happy, healthy knees. In fact, you may even be better off than if you decided not to take that first step out your front door. Enjoy the fact you are doing something amazing for your body and can continue to do so for many years to come.
1. Coburn, S. L., Crossley, K. M., Kemp, J. L., Warden, S. J., West, T. J., Bruder, A. M., Mentiplay, B. F., & Culvenor, A. G. (2023). Is running good or bad for your knees? A systematic review and meta-analysis of cartilage morphology and composition changes in the tibiofemoral and patellofemoral joints. Osteoarthritis and Cartilage, 31(2), 144–157. https://doi.org/10.1016/j.joca.2022.09.013 . Accessed 2 June 2023.
2. Van Ginckel, A., Baelde, N., Almqvist, K. F., Roosen, P., McNair, P., & Witvrouw, E. (2010). Functional adaptation of knee cartilage in asymptomatic female novice runners compared to sedentary controls. A longitudinal analysis using delayed gadolinium enhanced magnetic resonance imaging of cartilage (dgemric). Osteoarthritis and Cartilage, 18(12), 1564–1569. https://doi.org/10.1016/j.joca.2010.10.007. Accessed 2 June 2023.
3. MILLER, R. H., EDWARDS, W. B., BRANDON, S. C., MORTON, A. M., & DELUZIO, K. J. (2014). Why don’t most runners get knee osteoarthritis? A case for per-unit-distance loads. Medicine & Science in Sports & Exercise, 46(3), 572–579. https://doi.org/10.1249/mss.0000000000000135. Accessed 2 June 2023.
4. Alentorn-Geli, E., Samuelsson, K., Musahl, V., Green, C. L., Bhandari, M., & Karlsson, J. (2017). The association of recreational and competitive running with hip and knee osteoarthritis: A systematic review and meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 47(6), 373–390. https://doi.org/10.2519/jospt.2017.7137. Accessed 2 June 2023.
5. Horga, L. M., Henckel, J., Fotiadou, A., Hirschmann, A., Torlasco, C., Di Laura, A., D’Silva, A., Sharma, S., Moon, J., & Hart, A. (2019). Can marathon running improve knee damage of middle-aged adults? A prospective cohort study. BMJ Open Sport & Exercise Medicine, 5(1). https://doi.org/10.1136/bmjsem-2019-000586. Accessed 5 June 2023.
6. Horga, L. M., Henckel, J., Fotiadou, A., Hirschmann, A. C., Di Laura, A., Torlasco, C., D’Silva, A., Sharma, S., Moon, J. C., & Hart, A. J. (2020). Is the immediate effect of marathon running on novice runners’ knee joints sustained within 6 months after the run? A follow-up 3.0 t MRI study. Skeletal Radiology, 49(8), 1221–1229. https://doi.org/10.1007/s00256-020-03391-2. Accessed 5 June 2023.
7. The importance of stretching. Harvard Health. (2022, March 14). https://www.health.harvard.edu/staying-healthy/the-importance-of-stretching. Accessed 5 June 2023.
8. (2020). Peer Review #1 of “Medial Knee Cartilage Is Unlikely to Withstand a Lifetime of Running without Positive Adaptation: A Theoretical Biomechanical Model of Failure Phenomena (v0.2).” https://doi.org/10.7287/peerj.9676v0.2/reviews/1. Accessed 5 June 2023.
