Is Running Actually Bad For Your Knees and Joints? 3 Experts Weigh In

Whether you're a long-time runner, working out consistently, or just getting into the sport, one thing can't be denied: it's a high-impact exercise. And as a result, it's gotten a reputation for being hard on one's joints. But is running really bad for your knees and other joints? The short answer is no - but that doesn't really tell the whole story. The relationship between running and your knees - and, more broadly, your joints - is complex. While research shows that running can actually improve the health of your joints, it also has the potential to injure your knees, hips, and other joints, especially with overuse, which is an easier trap to fall into than you might think. To find out more about exactly how running affects your body, we consulted three experts. Here's what they had to say about whether running is bad for your knees and other joints, plus the training mistakes that can lead to issues down the road.Experts Featured in This ArticleJean-François Esculier, PT, PhD, leads the research and development division at The Running Clinic. He is also a physiotherapist with MoveMed Physiotherapy and a clinical assistant professor in the department of physical therapy at the University of British Columbia.Scott C. Greenberg, PT, DPT, is a physical therapist for the Florida Gators, the manager of clinical operations for UF Health's department of rehabilitation, the director of UF Health's physical therapy residency programs, and an NSCA-certified strength and conditioning specialist.Bryan Heiderscheit, PT, PhD, is the Frederick Gaenslen Professor in Orthopedics and the vice-chair for research in the University of Wisconsin's orthopedics and rehabilitation department. He is the director of UW Badger Athletic Performance and provides care for athletes of all ages with running-related injuries at UW Health Sports Rehabilitation.How Running Benefits Your JointsAfter asking three experts, the responses were unanimous: no, running is not bad for your knees or other joints - as long as you stick to some simple training practices. "Studies show that in most cases, the joints can tolerate and recover from a single bout of running and from a running program up to [the] marathon [distance] without any issues," says Jean-François Esculier, PT, PhD. In fact, he notes that "running can help joints stay healthy and even improve joint health if done the right way." Just like how your muscles adapt by getting stronger, "joints can adapt to running. Cartilage adapts with repeated compressions and makes joints more tolerant to impact. That's why runners can start by running for [only] five minutes, [but go on to] complete a half- or full marathon months or years later," Dr. Esculier says. "The process is much slower than for muscles and bones, however."Research shows that running often and for short durations seems to benefit joints the most. Regardless of the type of running surface, people who run four times during the week (e.g., two times for 30 minutes and two times for 15 minutes) seem less at risk of injury than those who run once or twice per week for an hour each time, Dr. Esculier says.Scott C. Greenberg, PT, DPT, agrees that running itself isn't bad for your knees or joints. "There are studies that have shown a greater incidence of knee osteoarthritis in the sedentary population when compared to recreational runners," Dr. Greenberg says. "When you look at running joint injuries, cartilage damage, and osteoarthritis, the best data would suggest that running in general is not a causative factor - unless you're at extreme high volume," Bryan Heiderscheit, PT, PhD, tells PS. And he means really high volume: people who are running "multiple marathons and upwards of 100-plus miles per week for a sustained number of weeks and years," he says. Even in those cases of super-high-mileage individuals, more research is needed before experts can say for sure there's an increase in the risk of knee and joint pain, cartilage damage, or osteoarthritis. But "there's been a little bit of link," Dr. Heiderscheit says.All that said, there are certain missteps runners commonly make that can put their knees and their joint health at risk.When Is Running Bad For Your Knees?So, running isn't necessarily bad for your knees or joints, and can even benefit them when done correctly. But if that's the case, why is it that so many runners seem to experience runner's knee or similar issues?It's true that the joint that's most at risk of being injured or irritated by running is the knee joint, per Dr. Heiderscheit. "Because of the motion and loads that pass through, the knee is exposed to a fair amount of forces during running. If those forces get too high or become too common and too frequent, it creates a fatigue effect on the tissues," he says.But while the knee joint can become injured from running, it's also typically the first joint to begin to feel pain when a runner is beginning to experience a general breakdown of their body from not-ideal running habits. So it's not so much that running is bad for your knees as it is that "too much of anything is bad and running is no different," Dr. Greenberg says. When it comes to knee and joint issues from running, the biggest misstep people make is doing "too much, too fast, too soon," per Dr. Greenberg - i.e., when they increase their speed or volume before their body is properly trained. "If your body's tissue capacity cannot tolerate the imposed loads, then the joints and tissues are at risk," Dr. Greenberg says. Two types of runners are especially at risk of pushing their bodies past what their joints are capable of: the "elite" runners who sustain very high training loads over many years, and recreational runners who keep running despite joint pain, Dr. Esculier says.Knee and hip joint injuries - the first and second most common running injuries, respectively - typically can be treated with "training modifications, strengthening exercises, and potential changes in running technique and footwear," Dr. Esculier says.But an even better strategy is working to reduce the risk of such injuries in the first place. And the best way to do that is by taking it slow. "Both speed and volume should be increased gradually," Dr. Greenberg says. Also essential to keeping your joints healthy are what he calls "tissue capacity sparing and building activities," such as practicing good running form, wearing supportive shoes, strength training, and resting adequately.What's the Best Surface to Run On?The surfaces you run on can also affect your joint health. There's no one "best" surface for joint health; instead, experts suggest trying to run on a variety of surfaces. "I am a big fan of altering the surfaces you run on," Dr. Greenberg says. Try to run on treadmills, the road, trails with lots of turns, and different terrains such as concrete, turf, or grass. The trouble with running most of your mileage on one surface is that your gait adjusts depending on where you're running. For instance, "Most treadmills have a built-in shock absorber or cushioning that tends to bounce up and down and provide some give," Dr. Heiderscheit says. "The effect that it has on your running form is that you will stiffen up when you run. So it does change your overall running mechanics." Varying the incline also matters. Running uphill adds to Achilles tendon stress, while running downhill puts more stress on the knees, Dr. Greenberg notes.But while running on different surfaces consistently is a good thing for your joints, consider treating each new surface as if you're a beginner or you're returning to running after a break, to minimize your risk of injury. "If training on a new surface, make sure variables such as speed and volume are gradually increased," Dr. Greenberg says.How Runners Can Protect Their Knees and JointsYou've likely already noticed a theme in the advice from the experts: increase mileage and speed slowly, over a long period of time. To elaborate on that, Dr. Esculier gives four main strategies that a beginner runner should take into consideration if they're hoping to reduce their risk of knee and joint issues down the road:Increase running through a run/walk program and alternate slow running with walking.Run often and for shorter periods of time.Aim for a high cadence, which means taking quicker, shorter steps (e.g., around 180 steps per minute, or three per second). Run "soft," trying to land with low impact.Additionally, runners should focus on strength training. "Build up tissue capacity with a well-rounded strength program that incorporates unilateral loading and foot and ankle strengthening," Dr. Greenberg suggests. He cites compound lifts such as the squat and the deadlift to assist in building tissue capacity, but exercises that build the quadricep muscles, glutes (gluteus medius and minimus, in particular), calf muscles, and hip abductors are all important. "Every tissue has a unique 'breaking' point," Dr. Greenberg says. "However, building capacity can help protect tissues better and allow them to better handle load."Running form is the final piece of the puzzle. Although Dr. Greenberg notes that stresses cannot be totally eliminated from running, making sure you're running with good posture and mechanics can help ensure that the stress of running is more evenly spread across the body to the tissues that can best handle it, Dr. Greenberg says."Watching your running form, being smart with how you train, and how you build up your running volume are probably the most important pieces to preventing a lot of these injuries," Dr. Heiderscheit says.Of course, running isn't for everyone, which is why it's so crucial to check in with your healthcare provider before starting to jog or run. Other tips to keep in mind: don't go for a run on a swollen joint, don't run through pain, and if you feel worse after running than before, consult a qualified healthcare professional, Dr. Esculier says. But don't buy the myth that all runners are heading toward knee or joint trouble either. With a few simple considerations, you can continue to run for as long as you love it.Jade Esmeralda, MS, CSCS, is a health and fitness staff writer and a strength and conditioning specialist. A lifelong martial artist and dancer, Jade has a strong passion for strength and conditioning, sports science, and human performance. She graduated with a Master of Science degree in exercise science and strength and conditioning from George Washington University.