If you’re a runner, chances are you’ve been told by a friend or family member that running is bad for your knees. They often cite information they “heard” or “saw” on the internet that running day in and day out will cause you to limp around in old age and require you to have surgery to fix the irreparable damage you are doing to your knees. On the other hand, there are those who argue that running will improve bone density, strengthen muscles, and that nothing else could be better for your knees.
Lucky for you, EndurElite can cut through the bullshit found on the internet and set the facts straight through science. So, the question remains; is running good or bad for your knees? As you’ll see in the information presented below the answer is not straightforward. This article will briefly summarize the available research on running and knee health and settle the age-old debate if running is doing more harm than good for your knees. It will also discuss other practical solutions to keep your knees in tip-top ship so you can have many more miles of smiles!
The Case For Running Being Good For Your Knees
The encouraging news for runners is the majority of research done on running and knee health demonstrates daily jaunts are good for your protruding patellas. Despite what all your concerned non-running friends tell you, runners seem to be less likely to develop osteoarthritis in their knees than their sedentary peers. Really. This is a finding that has been replicated many times over. Let’s take a brief look at two research studies that support this.
Study #1: Running Decreases Markers Of Knee Inflammation
A recent study done at BYU found that 30 minutes of running lowered inflammation in runners’ knee joints [1]. In the report, published in the European Journal of Applied Physiology, researchers brought 15 healthy runners ages 18 to 35 into a lab where they took samples of their blood and knee joint fluid before and after they ran for 30 minutes on a treadmill. They also assessed the same samples when they were sedentary.
The researchers expected to find an increase in molecules that spur inflammation in people’s knee fluid after they ran, but they didn’t. Instead, they found that pro-inflammatory markers decreased after a 30-minute run. The scientists ended up only getting complete information from six of the people in the study, but they saw the same results in all of those people.
Study #2: Runners Are Less Likely To Develop Knee Arthritis Than Non-Runners
The data from this next study comes from the Osteoarthritis Initiative that follows thousands of patients with regular assessments, X-rays, health questionnaires, and so on [2]. What’s crucial, the authors point out, is that the subjects were recruited from the community. They’re not a special running cohort. In this particular analysis, there were 2,439 participants, average age 65, of whom 28 percent reported running at some time in their life.
The participants filled out a questionnaire that included listing the three most frequent physical activities performed at various stages of their lives (12-18, 19-34, 35-49, over 50). The researchers then looked for any links between people who reported running at various stages of life (or any or all stages) and their subsequent risk of developing knee osteoarthritis.
The results are pretty straightforward: for any combination you can think of (running when young, running when old, running throughout life, etc.), the runners were less likely to develop arthritis than non-runners, by between 16 and 29 percent. Some of this was because of the fact that runners tend to weigh less—which is, indeed, one of the benefits of running—but even when the results were adjusted to account for that difference, the runners still came out ahead.
From the information above it appears that running is good for your knees. For the most part, this is true, but there is one caveat. Read on to find out what it is.
The Case For Running Being Bad For Your Knees
While the above information about running and knee health paints a rosy picture, there is one recent meta-analysis (a review of many studies) that demonstrated that running could lead to higher rates of knee osteoarthritis in competitive runners. Let’s take an in-depth look at the meta-analysis.
The purpose of this meta-analysis was to find out if there was any association between running and hip and knee osteoarthritis. Beyond that, the researchers wanted to find out if the running intensity and history of years running had any influence on this association. The researchers ended up being able to analyze 25 studies, which gave them a good sample of information to help them answer their questions.
Overall, this analysis of studies found that running was not necessarily associated with osteoarthritis and, in fact, recreational runners had lower odds (3.5%) of hip and/or knee arthritis when compared to competitive runners (13.3%) and sedentary non-runners (10.23%).
Regarding years running, the people that ran less than 15 years had a lower association with osteoarthritis than those who ran more than 15 years. That being said, most of the studies that looked at running for more than 15 years were focused on competitive runners, who already had higher odds of developing arthritis. They were unable to find conclusive information on recreational runners that ran for more than 15 years. The definition of competitive runners were runners that were reported as professional, elite, or ex-elite athletes, but the number of miles of running was not necessarily described.
So, what’s the takeaway? It seems that recreational runners may be better off for having lower odds of developing hip or knee osteoarthritis than those who run competitively and those who don’t run at all and are more sedentary in general, especially if they run for less than 15 years total. As far as knowing about the impact of running recreationally for more than 15 years, there is not quite enough information to tell!
The Bottom Line on Running & Knee Health
Most of the research agrees that the benefits of running outweigh the risks of not running (especially if done in moderation.) Other factors, like weight or genetics, may also contribute to whether a person is more likely to get knee arthritis or other injuries from running. More research is needed to fully understand the risks and benefits. In the meantime, people who run can reduce their risk of knee problems by:
- Cross-training
- Taking time to recover
- Getting to the gym on a weekly basis (here’s a free program to get you started)
- Paying attention to any pain or swelling
References:
- Hyldahl, R. D., Evans, A., Kwon, S., Ridge, S. T., Robinson, E., Hopkins, J. T., & Seeley, M. K. (2016). Running decreases knee intra-articular cytokine and cartilage oligomeric matrix concentrations: a pilot study. European journal of applied physiology, 116(11-12), 2305-2314.
- Lo, G. H., Driban, J. B., Kriska, A., Storti, K., Mcalindon, T. E., Souza, R., ... & Suarez-Almazor, M. E. (2014). Habitual Running Any Time in Life Is Not Detrimental and May be Protective of Symptomatic Knee Osteoarthritis: Data from the Osteoarthritis Initiative. Arthritis & Rheumatology, 66, S1265-S1266.
- 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, (0), 1-36.
