Running is one of the best ways to keep fit. It also is a great way to relieve stress at the end of the day. But, if you’re an avid runner, you’ve probably come across comments that running is bad for your knees. Usually, the comments come from non-runners, and while this might be discouraging, plenty of reports document the benefits of running, and these outweigh the risks.
Running is easy, inexpensive, and is one of the most popular forms of exercise. You only need good running shoes and appropriate clothing to start your running routine. But it’s still not for everyone. If you speak to any avid runner, their sentiments are usually that running makes their world go round.
Given its numerous benefits and impacts on lives, it’s not easy to understand when people say running is bad for your knees. This is usually in reference to its potential role in osteoarthritis (OA) development.
Running is often considered one of the causes of OA by the public, and some healthcare practitioners have also intimated this. The noise might be too much for the keen runner to block out, and you might start getting concerned. However, it would help if you weren’t surprised that OA cases are more common in non-runners than runners.
What is Osteoarthritis (OA), and What Causes It?
Before concluding that running could be bad for your knees and cause you to develop OA, it’s imperative to understand the condition and what could cause it.
Osteoarthritis refers to the breaking down of the cartilage on either side of the joint breaking down. This cartilage provides soft cushioning and prevents the bones in the joint from grinding into each other. Osteoarthritis is the degeneration or wear and tear of the joint surface.
Although its cause is unknown, several factors are believed to contribute to the development of OA. Some of these factors are beyond your control, but others are within your control.
Most of these risk factors have nothing to do with running, but somehow, running takes most of the blame for causing OA. These factors include:
Non- Modifiable Risk Factors
These are risk factors that you can’t do anything about:
- Age: Age is one of the leading risk factors for causing osteoarthritis. Your risk of suffering from OA increases with age.
- Sex: Generally, females are more likely to develop lower limb OA, especially in the knees.
- Genetics: Some people are more at risk of getting OA than others. Genetics account for up to 40% of Knee OA.
- Previous injuries are one of the most significant risk factors for the subsequent development of OA in runners, particularly Anterior Cruciate Ligament (ACL) and meniscal injuries.
Modifiable Risk Factors
These are factors within your control and the ones you can do something about:
- Weight: Obesity is also considered a primary driving factor for developing OA. The heavier you are, the higher your risk of OA.
- Poor biomechanics: Various biomechanical factors, like how you walk, are suspected to contribute to the development of OA.
- Sports participation: If you participate in sports, there will naturally be greater loads on the knee and a higher risk of injury.
- Heavy occupational load: If your job requires you to carry heavy loads or is physically demanding, such as farming, military, or construction, you might have an increased risk of developing OA.
- Weakness: Strong muscles are necessary to control and absorb forces passing through the knee joint. Weak muscles could mean that more of these forces pass through the joint, increasing your risk of developing OA.
What Does Research Say About Running and OA Knee?
The notion that running is bad for your knees or you will wear out your knees if you don’t stop running isn’t just by non-runners. You may also come across some publications that suggest as much.
It has been suggested that repetitive joint loading may lead to cartilage swelling and disruption of the collagen structure, which is indicative of early OA changes.
However, recent publications have described many potential beneficial effects on cartilage from joint loading, including suppression and reduction in degenerative changes within the tissue and improved cartilage structure, which is critical to secondary joint remodelling due to the cyclic loading while running.
Another positive aspect of running is that it can improve other aspects of the joint, such as soft tissue extensibility, blood flow, and synovial fluid mobility. In the proper doses, running can also improve joint proprioception and strengthen the supportive hip and knee muscles, which help protect the joint by dispersing the forces more effectively.
Research also shows that excessive loads, such as high-volume running and insufficient loads, can adversely affect joint cartilage compared to moderate running levels.
Other research also suggests that different outcomes depend on the frequency and intensity of running. A review that included 25 studies involving over 120,000 people concluded that only 3.5% of recreational runners had hip or knee arthritis, while sedentary non-runners had about 10.2%, and elite or ex-elite runners had 13.3% higher rates of knee and hip arthritis.
The question then remains: does running cause knee osteoarthritis? Research and literature indicate there is no increased risk when running simply for fitness or recreational purposes, and this activity level provides a wide range of long-term health benefits.
However, there is a small risk for OA in high-volume, high-intensity runners. However, more research is required to separate previously knee-injured subjects from non-knee-injured subjects. The research should also consider the role of genetics in runners and non-runners developing knee OA and the chemical environment of the knee joint before and after running at various intensities.
Should I Continue or Start Running?
That is a decision that you have to make on your own. Here are some details that could make the decision easier for you:
- Recreational runners had a lower chance of developing knee OA than sedentary individuals and competitive runners.
- Running recreationally for many years can be safely recommended as a general health exercise and could benefit knee joint health.
- The rate of OA increases if you are sedentary or are a high-volume, high-intensity runner compared to regular recreational running.
- The beneficial effects of running on general health are well established and include improved cardiovascular health, mental health, diabetic control, bone mineral density, reduced weight potential, and increases in pain threshold and balance.
Running has numerous benefits, and most research and evidence suggest that recreational running is safe and will not harm you. It may even improve your knee joint health. We recommend getting a knee scan to review everything.
What Measures Can I Take to Protect My Knees?
Besides making your running more moderate, there are other measures you can take that can protect and reduce the risk of OA development, such as:
- Wearing appropriate, good quality running shoes
- Increasing distance gradually, especially when you’re new to running
- Ensure you have sufficient recovery time between runs and avoid running on consecutive days.
- Include focused strength training and flexibility in your exercise schedule
- Cross-training to include some cycling and pilates in your running routine
- Maintaining good general health, good nutrition and sufficient sleep. You should also maintain a BMI of 18.5 to 24.9 and reduce overall stress.
Should I Consider Professional Help?
It’s worth considering professional help from a physiotherapist if you’re concerned about the risk of OA. The physiotherapist can assess you for factors that may increase your risk and help you determine whether running is beneficial for you as an individual.
They can also help you develop a specific plan and strategies to prevent injuries. These can include strength and conditioning programmes or loosening stiff joints and muscles, and they can help rehabilitate injuries when they occur appropriately.
The evidence might be scanty, but what is available suggests that moderate running could be more beneficial than destructive for your knees when all factors are kept constant. Running can also help with other health factors, such as weight and cardiovascular health.
