Running is Bad for my Knees...NOPE!!
Running is the exercise most of us love to hate. We were born to run but often the rumor has been spread that it is eventually bad for us or at least our knees. Running is good for you & your joints
Arthritis. Plenty of people have heard about it and know FOR SURE that certain things make arthritis worse. How do they know? Well, they heard it on social media, from a well-meaning doctor, a friend, or maybe even from your mom. Perhaps you even heard it from a Physical Therapist (which crushes my soul since they should know better). Regardless of who told you, if you don’t understand how arthritis happens, then you won’t know what makes it worse and what won’t. So I am here to set the record straight. Running is good for your knees, and here are the reasons why.
What is Arthritis?
To understand why running is good for your knees, we must understand our pal Authur-ist🤓. Arthritis (specifically osteoarthritis) is the breakdown of the cartilage between two bones. The cartilage is what keeps the bones from rubbing on each other. Cartilage is the padding between the bones, like styrofoam is padding in a box of glass. The difference is that your bones are not glass, and your cartilage is not styrofoam BECAUSE THEY ARE SO MUCH MORE AMAZING. Your hip, knee, and ankle cartilage stays healthier when you run. How do we know it is better to run? Magnetic Resonance Imaging, or MRI, as most people call it.
There is not just one study using MRIs to look at the inside of the knees with running. There are LOTS of them. When you are a nerd researching to support your statement that running is good for you, you really look for research papers called a meta-analysis. Why? Because a meta-analysis is a paper that looks at the results of many research papers in areas all over the world instead of just one done in Utah or Finland, for example. When you look at lots of papers about a specific topic, it allows you to see if something is true across a wide variety of people and ages.
Here is what a meta-analysis in 2022 said about recreational running and cartilage. “Results suggest that cartilage recovers well from a single running bout and adapts to repeated exposure.” This is nerd talk that says your cartilage does not break down but gets better with repeat exposure to running. Recreational runners are people who run for a workout a couple of times a week or more. These runners actually have thicker cartilage than people who don’t run. However, this research is unlikely to convince the dogmatic ex-football star uncle who swears his bum knee was caused by running sprints on the field.
He is 100% entitled to his opinion. He is also completely wrong, according to many people who went to college for 12 years, so they could be the epitome of a fantastic nerd and help humanity (or at least our knees). Since nearly half of Americans are expected to develop painful knee osteoarthritis at some point, how do you ensure you are not counted in that number?
Healthy Cartilage= Decreased Arthritis
If the root of osteoarthritis is a lack of healthy cartilage, then it is in our best interest to figure out how to get the best cartilage possible. It was commonly believed that cartilage can't adapt or repair itself because it doesn't have a blood or nerve supply. BUT cartilage is a living tissue that adapts and thrives with regular use. Cartilage is not just shock-absorbing styrofoam doomed to get brittle and eventually fail with age.
Cartilage does better with lots of use, like when you walk long-distance or run for short bouts. This is because putting weight through the joint squeezes the cartilage like a sponge, expelling waste and then drawing in a fresh supply of nutrient and oxygen-rich fluid with EVERY SINGLE STEP—remember there is no blood supply so this is the only way they get nutrition. Changes in cartilage can be seen relatively quickly. A small research study with non-runners who followed a running program saw improvement in cartilage strength in 10 weeks.
Often I get asked what exercises to substitute for running because of “bad knees.” The truth is that swapping one form of exercise for another at the first sign of knee pain or the fear of knee pain may be the opposite of what we should do. People with knee pain often switch to swimming, biking, or cycling because they think it is better for their joints. But if we get healthy cartilage by putting weight through the joint, then we might be getting fewer nutrients to our cartilage by decreasing the weight we are putting through them.
Pain Does NOT Mean Damage
Many people think running is bad for the knees because their knees hurt when they run. Just because something hurts does not mean that damage is happening. Everything in the body changes and adapts based on the stress that you put it under. Whenever you start with a new activity or get back into an activity, parts of your body will be cranky.
They are cranky because you need to build up some tissue tolerance. Most people take something like 160-180 steps per minute while running. If you can’t do 30 squats or lunges because your muscles are weak, then running will probably feel a bit cranky because your muscles can’t provide as much support as needed. When muscles are weak, your other tissues, like cartilage and ligaments, will take more load until your muscles are stronger.
The load with running doesn’t all go into the tissues when your muscles are weaker than needed. The unique joint fluid, called synovial fluid, puffs up with impact. This puffing-up effect literally gives you little airbags that cushion that protect the inside of the joint as you run and go for long walks.
Soreness is still expected when starting a running program or increasing mileage and does not mean you are doing damage. BUT, there's a limit to how quickly the joint can adapt to unfamiliar stresses. If knee pain persists for more than an hour after exercise, that is a sign the joint was probably overloaded—not damaged but overloaded. You should adjust what you're doing or seek the help of a super cool, funny, and brilliant Physical Therapist near you who can help you with exercises or running adjustments.
What is Bad for your Cartilage
Traumatic knee injuries like a torn ligament lead to uncomfortable osteoarthritis in about 50% of individuals. Sure, there is potentially lingering damage, but individuals with knee injuries are also very likely to be less active as they age. The former athletes I have seen in my practice have decreased their activity because they fear flaring up old issues. The problem is that their eating habits and patterns don’t adjust to their reduced activity level, so they put on weight and keep it on for years.
Arthritis is typically worse when you have put on more weight than is good for your frame. When we have excess weight on our frame, we won’t be able to bend and move our joints like they should be moved. Being unable to move them through their normal patterns means that the joints aren’t getting nutrients where movement is limited.
The Crux
Running is low-hanging fruit on the exercise tree. It is easy for most people to start because there is a low entry cost. Good shoes and a safe area to run are all you need—no monthly membership. Fear and loathing of running are the biggest hurdles to overcome. You don’t need to overcome them alone. Meet with a friend or get your neighbors to train with you for a 5k. Find a group to help keep you accountable and encourage you. Get everyone to keep someone else’s right running shoe so you all have to show up so everyone can head out for the jog with their own two shoes.
The benefit of running far outweighs the risk of being overweight. Often I have patients and clients that blame their joint discomfort on the only time in their lives when they were active. If you have had an injury in the past, there is no time like the present to start working on the muscle support for the joint, which can help make up for limited cartilage. If you have less cartilage because some of it was cut out, running helps to give you tougher, thicker cartilage. Stop buying into the fear and lies that running is bad for you.
The best is yet to come…for your cartilage😁
Dig Deep Action Steps
Get Deliberate: Call up a friend and ask them to join you for a walk, a walk-jog, or maybe even a hike. It is just starting to get nice outside in most places, so lace up those sneakers or hiking shoes, make a plan, and get at it.
Get Inspired:
Running is when I am most aware of my physical body. I embrace the racing heart in my chest and the discomfort in my legs. I am here pushing myself to be better.
Running allows me to experience nature. I spend most of my time inside or driving. Getting outside is a balm to my mental outlook on my day.
Running makes me feel empowered and resilient. Some runs are fast, and others I walk often, but I am still making time for myself again and again.
Running is the only time that I disconnect. I have my phone set to focus mode when I run. I don’t get notifications. I don’t check my email. It is the one time of the day I am conscious but not chained by my phone or to-do list.
Get Going: What gets scheduled gets done. If running or walking is something you are going to make happen, schedule it. Write it down. Discuss how to make it happen with your significant other so work and home tasks don’t get in the way.