Running and Knees

Publication date

29 Jan 2024

Estimated reading time

2 min read

Ques­tion: I’ve been told not to run because of my knees — is it really that bad, or are there tricks with shoes or sur­faces that pro­tect them?

At this point, there’s no sci­en­tific evi­dence that run­ning harms your knees — or any other joints. On the con­trary, there’s grow­ing evi­dence that a rea­son­able amount of run­ning is actu­ally ben­e­fi­cial for joint health. For exam­ple: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9983113/

When asked, 86% of health­care pro­fes­sion­als agree that run­ning is good for the knees: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9528027/

The pop­u­lar myth that run­ning “destroys your knees” prob­a­bly started during the Amer­i­can run­ning boom, when a wave of pre­vi­ously seden­tary people sud­denly began to run — and inevitably got injured. The prob­lem wasn’t run­ning itself; the prob­lem was the lack of load before it. The “use it or lose it” prin­ci­ple applies here. From a cer­tain age, every system in the body starts degrad­ing if not loaded enough — bone den­sity, muscle mass, joint integrity. Revers­ing or slow­ing that process requires phys­i­cal activ­ity. Bones strengthen under load (see Wolff’s Law). Mus­cles and ten­dons — obvi­ous. Car­ti­lage gets its nutri­tion and strength through com­pres­sion, decom­pres­sion, and glid­ing. That’s exactly what hap­pens during run­ning.

Yes, pre­vi­ous injuries, com­pen­sa­tions, weak mus­cles, poor neu­ro­mus­cu­lar con­trol, run­ning while fatigued, bad sleep, and chronic life stress — all of that can increase injury risk.

But a grad­ual start, vari­a­tion of sur­faces, hill run­ning, and some pre­lim­i­nary strength and sta­bil­ity work can lower that risk sub­stan­tially.

Over­all, at least within the admit­tedly biased envi­ron­ment of run­ners and sports med­i­cine pro­fes­sion­als, the con­sen­sus is clear: if a doctor tells you not to run because of your knees — that’s prob­a­bly a bad doctor (unless there are spe­cific med­ical cir­cum­stances we’re not aware of).

Prac­ti­cal steps: start with some­thing like this rehab rou­tine — https://www.instagram.com/p/CvKMiHeAO10/. Begin with walk-run inter­vals. Aim for reg­u­lar­ity and con­sis­tency. Then phase out walk­ing. After that, train accord­ing to sound train­ing prin­ci­ples tai­lored to your indi­vid­ual goals, needs, and lim­i­ta­tions :)