“I love running, but I’ve been told it’s bad for my knees. I keep thinking I should give it up.”
This is something I hear often from my clients. The idea that running is bad for the joints, and that “low impact activities” are better for you, is a prevalent one. Even medical professionals sometimes still advise people worried about their knees to stick to swimming or cycling.
How much truth is in this, though? Let’s look at the evidence.
Runners don’t have unhealthy knees
A study published recently showed that although plenty of runners did get knee pain and osteoarthritis, non-runners were even more likely to suffer from these problems. If you run and you have knee pain, it’s natural to blame the running (after all, that’s when you might notice it the most); but this study suggests that may not be the cause of the problem after all. People who had run regularly in the past, but not currently, had healthier knees than non-runners but less so than those who are currently running.
So, running is good for your knees…?
Not so fast… there’s a problem here. Remember – just because two things go together, it doesn’t mean one caused the other. Runners happen to have healthier knees, but that doesn’t mean it’s because of the running. After all, it stands to reason that people with knee pain might be less likely to go running. Equally, people who have had knee injuries in the past (which we know is a risk factor for osteoarthritis) might also be less likely to run.
Another factor could be body weight. One survey published in 2013 noted that although runners have less osteoarthritis in the hip, this is at least partly because they tend to have a lower body mass index (BMI). The same could very well be true for knees.
This all sounds a bit vague. Can’t you just give us a “yes” or “no”?
How hard can it be to get a definite answer, without all the “perhaps” and “maybe”? Very hard, as it turns out. Studies that try to figure out whether something causes something else by looking at what people do in the real world have a lot of limitations. If we could randomly assign people to two groups – runners and non-runners – and then follow them for years to see what happens to their knees, we’d get a much better idea; but those kind of experiments are tough to do – for obvious reasons!
What if I already have knee problems? Is it ok to keep running?
The answer to that will depend on exactly what is wrong with your knees; I’d strongly recommend seeing a qualified professional to get a proper diagnosis and individual advice. In general, though, we know that movement and activity is good for many kinds of joint problem. Running should not be automatically discounted if it’s something you want to do.
The advice for osteoarthritis sufferers in particular has changed significantly in recent times. Although many people worry about making things worse, patients are now advised that staying active is likely to be helpful. This is true even if activity is slightly painful; although it’s important that you speak to your doctor or clinician to find the right balance between managing your pain and staying active.
Even for patients who have had a meniscectomy (partial meniscus removal) – a group who are known to be at a higher than average risk of developing osteoarthritis later in life, and who may in the past have been advised to limit the amount of running they do – it isn’t clear that this is always necessary.
The verdict: running is unlikely to be bad for your knees.
The latest research points towards running – at worst – not being bad for your knees in the long term, and it may even be beneficial. It’s also important to remember the numerous benefits regular runners get from it, including improved general health and enjoyment. If you like running, then there’s probably no reason to stop doing it. If you don’t, then there are plenty of other activities to try instead!
If you’re a runner with knee pain, then you can get in touch with us for an individual assessment and advice. We’ve found that in many cases, some simple exercises can go a long way to getting our runners pain-free and back on track.