Is running actually good for your knees?

Someone who regularly runs is often told (mainly by non-runners) that running is ‘bad for your knees’.

It is undeniable that there are a number of running-related injuries that require some treatment. However, when you consider the positive benefits of running that include improved cardiovascular health, mental health, bone mineral density, as well as reduced weight, and diabetes management - most runners are seldom put off by these comments.

There is evidence to suggest that in fact non-runners are more at risk of knee problems. So here we are going to turn the claim on its head - and propose that running might actually be good for your knees.

So, why is running good for your knees?

When people say that running is ‘bad for your knees’, they are generally referring to its role in the development of OA (osteoarthritis). However, there are many causes of OA, and none of these have anything to do with running - one of the main ones being obesity. There is good evidence, especially in the case of knee osteoarthritis, that exercise is actually beneficial in terms of pain management and disease progression.

Although you couldn’t be blamed for thinking that the repetitive loading from running might be too much, in fact, running can improve aspects of the joint including soft tissue extensibility, blood flow, and synovial fluid mobility. Running also improves joint proprioception and the strength of supportive hip and knee muscles.

Recent research published in the British Medical Journal even found that marathon running can improve knee damage in middle-aged adults. It found that long distance running is not harmful for healthy knees, and that existing cartilage damage within the knee was reversible following training and running a marathon.

Naomi, our specialist knee and lower limb injuries physio says:

“There is a general consensus, which is often reinforced by those in the medical profession unfortunately, that running ‘wears down’ the joint. On the whole this is untrue. I like to reassure my clients that running is actually good for the knees even in those with OA changes.“

However, the research also found that the patellofemoral joint in the knee is most susceptible to damage so any runner training for a long distance race is advised to focus on injury prevention exercises that include this area.

Why might running cause knee pain?

The repetitive nature of the running movement can put excessive strain on parts of the body - more so than any other sport.

A recent review which covered injury data in runners that included. 36 studies, found that the predominant injury in female runners is to the knee. Male runners have a more even distribution of injury between the knee, shank and ankle-foot complex. In fact, women are 2 to 8 times more likely than men to suffer from knee pain, and from knee injuries, in particular.

So why do female runners have more knee injuries? Although there is no definitive answer to this, there are several reasons why women may suffer more. Causes may include their biomechanics, quad dominance and hormonal (mainly oestrogen) fluctuations.

Like most running injuries - the knee pain is not because of the running itself, but usually because of poor training methods and techniques, muscle weaknesses or incorrect equipment (footwear).

Physio Naomi comments:

“It is really important to look at the person as a whole, to get a really good history. Load management is an important factor to look at. In a lot of the runners I treat, overload is a frequent cause of injury.”

Patellofemoral Pain Syndrome, or ‘Runner’s Knee’ is a common running injury that refers to pain at the front of the knee which can be exacerbated by hip weakness.

IT Band (Iliotibial Band) Syndrome (sometimes confused with ‘Runner’s Knee’) can be another cause of knee pain. This band of soft-tissue running from hip to the lateral tibia can become inflamed and cause soreness when it rubs on the outside of the knee. Causes include postural imbalances, poor core strength, and gluteal muscle weakness - and can be exacerbated by occupations with prolonged sitting, poor stretching routines and unsupportive footwear.

Treatment Options for Knee Pain

At Physio Remedies, we look at the total picture when a patient presents with an injury. Our physiotherapists will look at your total movement pattern. On assessment we will identify any areas of muscle weakness or joint stiffness and will formulate a specific rehab programme just for you. We can also offer sports massage therapy to help with soft tissue injuries.

“Often the clients I see are lacking a strength and conditioning element in their training programme. This is something I address in rehab and although the evidence is lacking on whether a strengthening programme prevents injury I still feel it has an important part to play,“ says Physio Naomi.

In summary, the causes of knee pain can be dealt with and managed so that you can enjoy your sport. But if you are going to take your running up a level from just for fitness or recreation up to a marathon or long-distance run, we strongly advise that you speak to a physio to get a personalised injury prevention programme.

Call us for an appointment on 02030 12 12 22.