Does running damage your knees? What the research shows
"Running will wreck your knees" is one of the most persistent beliefs in fitness. It puts many people off running, and worries those who already run. The research tells a more reassuring story.
Is running bad for your knees?
For recreational runners, the evidence suggests not. A meta-analysis of 25 studies covering more than 125,000 people found hip and knee osteoarthritis in 3.5% of recreational runners, compared with 10.2% of sedentary, non-running people and 13.3% of elite or professional-level competitive runners (Alentorn-Geli et al., JOSPT, 2017). In other words, recreational runners had less arthritis than people who didn't run at all.
Does that mean running protects your knees?
Not necessarily. These are observational studies, so they can't prove cause. Runners tend to be lighter and more active overall, and people with sore knees may give up running. But the findings do contradict the idea that recreational running wears knees out. Cartilage and the tissues around the joint adapt to regular, sensible loading.
Why did competitive runners have more arthritis?
The same analysis found higher rates in elite and professional runners. Very high training volumes and intensities over many years, and a history of injuries, may play a role. For the average person running a few times a week, that level of exposure doesn't apply.
So why do my knees hurt when I run?
Knee pain in runners is common, but it's usually not arthritis. The most frequent causes are patellofemoral pain (around or behind the kneecap), ITB-related pain on the outside of the knee, and patellar tendon pain just below the kneecap. These are mostly load-related: increasing distance, speed or hills faster than your body can adapt. They usually respond well to adjusting your training and strengthening.
Our posts on runner's knee, ITB syndrome and patellar tendinopathy explain each.
Can I run if I already have knee arthritis?
Often, yes, with guidance. Many people with mild to moderate knee osteoarthritis can run without making it worse, particularly if they build up gradually, keep runs shorter and more frequent, and do strength training. Let symptoms guide you: mild discomfort that settles within a day is generally fine; swelling or pain that lingers means reduce the load. If running isn't comfortable, cycling, swimming and walking are good alternatives.
See our post on managing knee osteoarthritis.
Who should be more careful with running?
People with a previous significant knee injury, such as an ACL rupture or meniscus surgery, have a higher risk of arthritis regardless of running, and benefit from a structured approach. Carrying a lot of extra body weight increases load on the knees, so starting with walking, cycling or walk-run intervals and building slowly makes sense.
How do I look after my knees as a runner?
Build up gradually, especially distance, speed and hills. Strength train twice a week, focusing on quads, glutes, hamstrings and calves. Keep some variety in surfaces and paces. Don't ignore a niggle that's getting worse run by run. Shoes matter less than load; choose a pair that feels comfortable.
Is running on roads worse for your knees than grass or trails?
There's no strong evidence that hard surfaces cause more knee damage. Your legs adjust their stiffness to the surface. Varying surfaces spreads load differently and can make running more enjoyable, but a sudden switch, such as from treadmill to hilly trails, is a change in load and should be eased into.
Is running bad for your knees as you get older?
Age alone isn't a reason to stop. Many people run comfortably into their sixties and beyond. Recovery tends to take longer, so spacing out harder runs, keeping up strength training and building up gradually become more important. If you're starting running later in life, walk-run intervals are a sensible way in.
Does being heavier make running riskier for your knees?
Higher body weight does increase the load through the knees, and is a risk factor for knee osteoarthritis in general. That doesn't rule out running, but it's a reason to start gently, perhaps with walking, cycling or walk-run intervals, and to build strength alongside it.
Do knee braces or supports help runners?
A simple sleeve or kneecap strap can make running more comfortable for some people with kneecap pain. They're fine as a short-term aid, but strengthening and load management are what address the cause.
When should knee pain be checked?
Book in if knee pain isn't improving after a couple of weeks of reduced running, or is affecting stairs and daily life. Get seen promptly if your knee swells significantly, locks, gives way, or you can't fully straighten it.
See our knee and ankle pain guide and our post on common running injuries. Book an assessment at our Berwick clinic. A 60-minute initial consultation is $149, with no referral needed and HICAPS on-site.
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Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
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