Is Running Bad for Your Knees? What the Research Actually Says

Runners are a unique breed. Admit it.

Unlike a lot of other athletes, runners have no reservations about telling you what they love to do, and how they plan to keep doing it despite whatever injuries happen to be flaring up.

Running is an endurance sport, and like any athletic pursuit, you're going to pick up the occasional minor injury. Too often those injuries get ignored or patched over so the running can continue. It turns into a game of "stroke the symptoms," massage, cupping, stretching, KT taping, anything to splint a problem area through a race or a PR attempt, without the actual source ever getting identified or resolved.

To be clear, this flawed approach isn't only a runner's preference. Most clients would rather have someone work on them, because passive treatment feels good.

And it has its place. Passive treatment is a fine way to bring symptoms down. But if the overall plan isn't also working to resolve the source of those symptoms by building strength, flexibility, and mobility, you're missing the part that creates lasting results.

This, I think, is where the reputation comes from. Long-term games of stroke-the-symptoms play out, the source never gets resolved, the pain persists, and so we blame the running. It's easier to blame the activity than to identify and explain tissue limitations. Unfortunately, even some healthcare providers who should know better describe running as a high-impact way to shave years off your joints.

So Is Running Bad for Your Knees, Really?

Short answer: no. Thanks for reading.

Longer answer: no BUT you do have to make some considerations to do it well and protect your joints at the same time.

It helps to swap the question out. "Is running bad for you?" is really the same question as "Is any exercise bad for you?"

Is squatting bad for you? No. Is deadlifting bad for you? No. You get the point.

The Four Things Every Runner Needs

To run efficiently, you need a baseline inventory of four structural qualities: strength, flexibility, joint mobility, and body control or awareness. (Cardiovascular endurance matters too, but that's an engine question, and right now we're talking about the structure.)

What causes problems with any exercise is when one of these four is lacking.

So, is running bad for your knees? Absolutely not. Is running without a baseline of strength, flexibility, mobility, and body control bad for you? Yes. And even then, it isn't the running that's the problem. It's how your body finds paths of least resistance around its tissue limitations, something we call compensatory motor patterning. The good news is that those limitations can usually be improved, and in most cases fully resolved, with the help of a skilled physical therapist.

Does Running Cause Arthritis?

When someone calls an activity "bad," what they usually mean is that it will prematurely degenerate the joints and lead to osteoarthritis (OA). A lot of research has gone into whether running causes early OA, and the findings are genuinely interesting.

Researchers found that recreational runners had lower rates of hip and knee arthritis. The higher rates showed up in two other groups: sedentary individuals and elite, competitive runners. So while sitting around or running at an elite level may both raise your risk, recreational running may actually help prevent the development of knee arthritis.

"But I've Been Told I Have Knee OA. Won't Running Make It Worse?"

This is where a lot of bad advice lives. Plenty of clients I've worked with have been told by physicians, chiropractors, and even other physical therapists to cut back or stop running to keep their knee or hip OA from progressing. The research doesn't support that advice.

In one study, participants who already had OA and continued running showed reduced knee pain and no observable degeneration of the joint surfaces. The key detail is that these runners were "self-selecting" their distance, duration, and intensity based on how they felt. When symptoms were high, they shortened the run or slowed down. When symptoms were low, they ran farther or pushed the pace.

That self-regulation produced shorter, lower-intensity runs and preserved the joint surfaces. In other words, running does not make arthritis worse, and it does not need to be discouraged. So when you ask "is running bad for your knees" even with existing arthritis, the evidence points to no. Running is beneficial to knee health and is safe for people with arthritis and other degenerative changes, without advancing the condition.

Run Better With Help From Southeast Physical Therapy

We work with runners across Roswell, Alpharetta, East Cobb, and Marietta, and we regularly see clients from neighboring states come through our doors with all kinds of running-related aches and pains. We specialize in treating runners and endurance athletes of every level, working one-on-one with Dr. Will Duncan to get to the root of the problem, not just the symptom. If you'd like help resolving a new or long-standing injury, call or text us directly at 678-640-4606. We'd love to help.