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Given that knee pain is the most common injury among runners, I thought it would be worthwhile to dive in. In previous newsletters we looked at Runner's Knee, but today let's talk about knee osteoarthritis, degeneration, or "wear and tear" on the knee.

Does Running Really Cause Knee Problems? Debunking One of the Biggest Myths

One of the most common concerns I hear from runners and non-runners alike is: “Isn’t running bad for your knees?”

In fact, I am on the receiving end of this statement quite frequently from my patients all the time (especially my non-running patients): “You won’t be happy you did all this running when you are in your 50-60’s.”

If you’ve ever been told that running will “ruin your knees” or inevitably leads to arthritis, you’re not alone. But the truth is, running doesn’t cause knee problems. If anything, it may actually protect your joints. Let’s break down what the research really says!

Myth: Running Causes Knee Osteoarthritis (OA)

Many people believe that the repetitive impact of running wears down the knee joint, leading to osteoarthritis (OA). But research consistently shows that runners do not have a higher risk of developing knee OA compared to non-runners. In fact, some studies suggest that runners may actually have lower rates of OA than sedentary individuals.

✅ A large study published in 2017 examined nearly 2,700 participants and found that recreational runners had lower rates of knee OA (3.5%) compared to non-runners (10.2%).

✅ A review in 2018 concluded that long-term running is not associated with a higher risk of developing symptomatic knee OA. Instead, other factors—such as previous knee injuries, BMI, and occupational heavy labor—are stronger predictors of OA risk.

✅ A 2019 study using MRI imaging found that marathon training improved cartilage quality in middle-aged runners, suggesting that running may have a protective effect on joint health.

What Actually Increases Your Risk of Knee Problems?

While running itself isn’t inherently bad for your knees, certain modifiable and non-modifiable risk factors can contribute to knee pain or OA development:

• Previous Knee Injuries – A history of ACL tears, meniscus damage, or other trauma significantly increases OA risk.
• Excess Body Weight – Higher BMI at a younger age is linked to greater OA risk later in life.
• Heavy Occupational Load – Jobs involving repeated heavy lifting or kneeling place more long-term stress on the knees.
• Training Errors – Running injuries are more often related to sudden spikes in mileage, poor mechanics, or lack of strength training, rather than the act of running itself.

How Running May Protect Your Knees- Motion is Lotion!

Research suggests that running may actually promote cartilage health by stimulating the production of synovial fluid (which lubricates the joints) and maintaining the strength of surrounding muscles that support knee function.

• Stronger Leg Muscles = Better Knee Support – Running builds quadriceps, hamstrings, and calf strength, which help stabilize the knee joint.
• Synovial Fluid Production – Movement keeps cartilage hydrated and nourished, preventing stiffness and breakdown.
• Bone Density Benefits – Running increases bone density, reducing the risk of osteoporosis and fractures.

So, Should You Run If You Have Knee Pain?

While running doesn’t cause knee problems, it’s important to pay attention to your body. If you’re experiencing knee pain, the solution isn’t to stop running altogether, it’s to figure out why.

🔹 Assess Your Running Form – Poor mechanics (excessive knee valgus (knee caving in), overstriding, hip drop, etc.) can lead to unnecessary stress on the knee.
🔹 Strengthen Supporting Muscles – Weak hips, glutes, and quads can shift extra load to the knee joint.
🔹 Modify Training Volume – Gradual progression (a good rule of thumb is the 10% rule) helps avoid overuse injuries. Remember to think about applying this to not only milage but intensity increases as well.
🔹 Consider Footwear & Surface – Certain shoes and softer running surfaces can help manage impact forces.

The Bottom Line? Running Is NOT Bad for Your Knees

If running truly caused knee problems, we’d see a massive number of lifelong runners developing severe arthritis. But the research doesn’t support that claim. Instead, running, when done smartly, can actually strengthen and protect your knees over time.

It is about how you are training and the supplemental work that you do alongside running that is the key.

So, the next time someone warns you that running will ruin your knees, you can confidently tell them: “Actually, science says otherwise.” 😉

Have questions or dealing with knee pain? Let’s chat, I’d love to help you run stronger and pain-free!

Want to meet in person to chat about this? Don’t forget our New Clinic Open House is next Thursday, March 20th, from 5-7 pm.

- Adria