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  • Bryan Hill PT, FAFS, CFL1, CEO

Is Running Bad for Your Knees (Fact or Fiction)? The Age-Old Question Addressed.

Updated: Aug 14, 2023

You may have heard the phrase “running can be bad for your knees” at some point in your running journey, whether it was from a friend, magazine, media outlet, or even a seasoned healthcare provider. Running essentially puts loads of stress on your ankle, knee, and hip joints. It would naturally make sense to think that the sport could lead to higher incidences of degenerative and arthritic conditions.

I have treated several patients who are over the age of 50 and are recovering from all sorts of orthopedic conditions including knee, hip, and ankle surgeries. Unfortunately, most of them begin the physical therapy journey with the already preconceived notion that they will forever have to forego some of the recreational activities that they used to enjoy, such as running, hiking, skiing, or even CrossFit. I will be the first to admit, a post-surgical hip or knee maybe never be back to 100% of the “good” leg, BUT this does not mean that you have to completely eliminate high-intensity activity from your life or that you cannot return to what you LOVE.

This last month, one of my patients “Jim” who has been on the road to recovery from surgical repair of his knee and meniscus, just returned to attending CrossFit classes without pain! Important to share, Jim is over the age of 50 and has had a chronic history of knee arthritis, pain, and weakness. How did he do it?? Jim was diligent in completing his daily mobility and strengthening, and following our detailed plan that outlined a gradual progression of return-to-sport activities while increasing the resilience of his knee joint. This type of success story is not just an outlier, but is actually backed by the literature in the research world as well!

A recent study in 2017 (by Lo et. al) of almost 3000 runners concluded that there is no increased risk associated with OA (osteoarthritis) when compared to non-runners in the community. In fact, some research articles have even proven that running has a protective effect on the knees, with fewer rates of arthritis compared to the general population. Another interesting study followed a cohort of runners over age 50 with already existing knee osteoarthritis, with check-in visits and X-rays at 48 and 96 months. The researchers concluded that a “self-selected running pace” was actually correlated with no worsening of knee pain or worsening of joint damage seen by X-rays. In conclusion, pace wasn't associated with pain, and form and function are more likely the cause for such limitations.

In short, running can be very healthy for you and your knees as long as you are increasing your total mileage and volume in a progressive fashion to avoid overuse-type injuries. As stated above, a “self-selected pace” could mean that you are running walk/jog type intervals or limiting hill or trail runs for the time being as you work on improving leg strength and endurance. As well, if for any reason running does cause pain, don't just wait for it to go away, we recommend you to come and see a specialist (a Physical Therapist) who can figure out the root cause of the problem and get you back to your fitness activities. The standard rule of thumb in the sports rehab and running world is to follow the “10% rule” when beginning a new program or ramping up training, or not increasing your mileage by more than 10% per week as you increase your volume.

Our team here at Rehab United San Diego and Seattle has decades of experience working with all types of runners and evaluating the body systems as an entire chain, instead of just looking to the knee as a source of pain. If you are currently dealing with nagging aches, pains, or tightness or are just looking to have your movement quality assessed, consider scheduling a visit with a PT or rehab professional. Addressing body asymmetries and mobility restrictions now will pay dividends toward pain-free running for the rest of the summer.

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Christopher Cheek PT, DPT Staff Physical Therapist - Rehab United Seattle

Additions by Bryan Hill PT, FAFS, CFL1, CEO - Rehab United


Bryan Hill, PT, FAFS, CF-L1, BFRC, is the Chief Executive Officer and co-owner of Rehab United Sports Medicine and Physical Therapy. Bryan received his bachelor’s degree in Physical Therapy and Health Sciences from the University of New England and has been a physical therapist in the San Diego community since 1998. Through a close professional and personal relationship with renowned therapist Gary Gray, and as a member of the inaugural class of The Gray Institute for Functional Transformation (GIFT) fellowship, Bryan has been a strong advocate, pioneer, and expert in the principles of Applied Functional Science. Throughout his experience as both a clinician and an educator in the field, Bryan has not only treated a wide range of patient/athlete demographics and diagnoses, but has helped inspire and lead San Diego’s aspiring clinicians to become the future of medicine.

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