Is Running Bad For Your Knees? Maybe Not - It Could Be Good For Them!

By Rick Morris

You've almost certainly heard it over and over again from your non-running friends and associates. "I don't run because it's hard on my knees." Or they might say "You run marathons? Your knees must be shot!. For some reason many non runners and even some new runners or former runners associate running with knee damage and osteoarthritis (OA) of the knee. Some even think that running, which is a moderate impact activity, is more of a knee damaging event than high impact sports such as basketball, football, soccer and weightlifting.

Is there any truth to those vicious rumors about running and knee damage? Is running really bad for your knees. I have had more years of running experience that I like to admit and I am convinced that not only is running with proper mechanics not bad for you knees, it may even be good for them. If you talk to most lifelong runners they will tell you the same thing. Their knees are stronger than ever. Both my experience and those of other long time runners suggest anecdotally that running does not cause knee damage but what does science say? There have been several recent studies that support the belief that running does not cause knee damage or OA of the knee.

A 2008 investigation from Austria looked at the knee health of 7 recreational long distance runners and 1 former runner who had given up the sport, over a 10 year period. The researchers found that 6 of the 7 long distance runners showed no adverse long term knee problems. One of the runners had arthrotic changes that were progressive in nature. Interestingly, the 1 study group member that gave up running presented after 10 years with severe deterioration of the internal knee structures. The scientists concluded that long distance running does not cause permanent damage to the knee joint and they even discussed a possible protective mechanism of long distance running suggesting that the athlete that quit running could have prevented their severe knee problems if they had continued running.

While the Austria study was interesting, the small study group reduced the confidence of their results. Another study from Stanford University looked at a larger group of 113 volunteers composed of 45 distance runners and a control group of 53 non-runners, over a longer two decade period. The researchers went into the study hypothesizing that long distance running may be associated with increased incidence and severity of OA but found that just the opposite was true. They concluded that "...long distance running was not associated with accelerated incidence or severity of OA." They went on to add "...there were some suggestions that runners may have less OA than (non-running) controls...".

These studies all back up the anecdotal data that says long term, long distance running is not bad for your knees and may actually improve the health of your knee joint. How about a single long distance race such as the marathon? Many non runners are convinced that running even a single marathon can damage your knees. Are they correct? I don't think so and neither does science. An investigation from 2006 in Austria asked the question; Does marathon running cause acute lesions of the knee? They evaluated the knees of 22 non professional marathon runners using an MRI both before and after a marathon. They concluded that "The evaluation of lesions of the knee with MRI shows that marathon running does not cause severe, acute lesions of cartilage, ligaments or bone marrow of the knee in well -trained runners.

A similar study from Germany looked at the knee health of 20 former elite level long distance runners and found that "Osteoarthritis of the knee joint is rare in former elite marathon runners".

Both science and anecdotal data agree that long distance running is not bad for your knees and may even play a role in protecting and strengthening your knees. Does that mean that running cannot have an adverse effect on your knee health? I wouldn't go that far. Any type of physical activity can wreak havoc on your joints if you don't use the proper mechanics and take the necessary precautions. While the risks of running to your knees are low here are some tips to reduce them even further.

• Run with proper mechanics. Always run with a foot strike directly under your center of gravity and land either flat footed or slightly on the ball of your foot first. Avoid over striding and heel striking.

• Run softly, fluidly and lightly with very little vertical movement

• Run with a quick cadence of around 90 full strides or 180 steps per minute

• Try to run on softer trails, dirt or gravel surfaces and avoid concrete as much as possible

• Strengthen your lower leg muscles to reduce excessive pronation and increase your foot and ankle stability

• Strength train to improve your joint stability and support

References:

Long Distance Running and Knee Osteoarthritis A Prospective Study, Am J Prev Med. 2008 August;35(2):133-138

Changes on magnetic resonance tomography in the knee joints of marathon runners: A 10 year longitudinal study. Sleketal Radiol. 2008 Jul; 37(7):619-26

Does marathon running cause acute lesions of the knee? Eur Radiol. 2006 Oct 16(10):2179-85

Is competitive running associated with osteoarthritis of the hip or knee? Orthopade, 2006 Oct:35(10): 1087-92

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