How running affects your knees — and how to keep the joints safe

Running affects knees if the right form, posture is not maintained, or there are inadequate warm up or cool down regimes.

Running is always considered to be a well-rounded, full workout of the body. But if it is not done in the right way, it can cause damage. Running affects knees if the right form and posture are not maintained, or muscles are over-strained. So, if you have persistent pain, swelling, and stiffness in your knees and are going for daily runs, the two can be linked together. Therefore, it is very important to understand how to run without hurting your knees. Running can be great for knees too as it can strengthen them, as well as help you maintain a good body weight.

Does running affect knees?

Running is often perceived as bad for the knees, but this is not necessarily true. “Running may be beneficial for knee health by strengthening the muscles around the joint, improving cartilage health, and maintaining a healthy weight,” says physiotherapist and sports medicine expert Dr Ali Irani. A study published by PeerJ states that runners are at a lower risk of developing knee osteoarthritis. However, issues arise when running is done improperly, without proper conditioning, or in the presence of pre-existing conditions.

How is running bad for your knees

Running can negatively impact the knees if certain mistakes are made:

1. Poor running form

Incorrect posture, such as over-striding, heel striking, or improper alignment, increases stress on the knees. A study, published in Medicine & Science in Sports & Exercise (MSSE), recommends that runners and coaches are careful about their stride parameters and lower limb angles so that they can optimise their pelvis movement and performance. Maintain an upright posture with a slight forward lean from the ankles. Avoid over-striding by keeping your steps shorter and landing mid-foot rather than on the heels. Check out how you can increase your stamina for running in the right way.

2. Overtraining

Running excessively without sufficient rest can lead to overuse injuries like patellofemoral pain syndrome (runner’s knee). Runner’s knee is a condition where you have pain around the knee cap. This is often a sign of overuse, states this study, published by StatPearls. Follow a structured training plan that includes rest days and gradually increases mileage and intensity. Avoid sudden increases in distance or speed.

3. Incorrect footwear

Worn-out or inappropriate shoes fail to provide adequate support and shock absorption, leading to knee pain. Invest in high-quality running shoes that match your foot type such as flat feet or high arches, as well as your running style. According to the UK’s NHS, your footwear should reduce the impact of the ground on your feet and help your feet to work properly. It is important to replace shoes every 300-500 miles to ensure they continue to provide proper support.

4. Ignoring strength training

Weak muscles, especially in the hips, glutes, and core, increase the burden on the knees. Incorporate exercises like squats, lunges, and planks into your routine to build strength and stability in the muscles that support your knees. This study, published in Cureus, states that isomeric strengthening exercises can help with pain intensity as well as range of motion. Check out some strength training exercises and how to do them.

5. Running on hard surfaces

The Arthritis Foundation states running on hard or uneven surfaces is one of the reasons for knee pain. Constantly running on hard surfaces like concrete increases the impact forces on the knees. Mix up your running surfaces by including softer trails, grass, or track surfaces in your routine. This reduces repetitive stress on the knees.

A woman running — To avoid running affecting knees it is important to buy high-quality running shoes that match your foot type such as flat feet or high arches, as well as your running style. Image courtesy: Freepik

6. No warm-up and cool-down regime

Skipping these routines can lead to stiffness and higher injury risk. Start your runs with dynamic stretches to prepare your muscles and joints. Finish with static stretches to improve flexibility and promote recovery. The NHS recommends a five to 10-minute brisk walking routine or even gentle jogging before you start to run. Check out how to power walk here.

Running affects knees: Warning signs

Recognising the early warning signs of knee issues can prevent more serious injuries. Here is what to be careful about.

1. Persistent pain

Continuous or sharp pain in the knees during or after running. If pain persists despite rest and proper care, it could indicate conditions like a runner’s knee, IT band syndrome, or tendonitis. Seek medical evaluation if pain is severe or doesn’t improve.

2. Swelling

Visible swelling around the knee joint. Swelling may be due to inflammation, fluid accumulation, or injury to structures like the meniscus. Rest, ice, compression, and elevation (RICE) can help manage swelling, but persistent swelling warrants medical attention.

3. Stiffness

Difficulty bending or straightening the knee. Stiffness can result from overuse, inflammation, or underlying joint issues. Persistent stiffness may require evaluation to rule out conditions like arthritis or ligament injuries.

4. Clicking or popping sounds

Audible sounds from the knee during movement. While some sounds are normal, if accompanied by pain, it could indicate cartilage issues, such as a meniscus tear, or misalignment of the knee structures.

5. Instability

Feeling that the knee is giving way or unable to support weight. Instability can be a sign of ligament damage, such as an ACL or MCL injury, or severe muscle weakness.

How to protect your knees when you run?

Now that we have established that running affects knees, there are various tips and tricks to keep in mind to help avoid this. Here is what you can do:

1. Strengthen supporting muscles

Strong muscles around the knee help distribute the impact forces of running. Focus on exercises that target the quadriceps, hamstrings, glutes, and core. Include squats, lunges, step-ups, and core stabilization exercises in your routine to enhance muscle support and joint stability. Check out this guide to do the dead bug exercise for a strong core.

A woman holding her knees — Persistent pain, stiffness, swelling can be warning signs of running affecting your knees. Image courtesy: Freepik

2. Don’t be overweight

Extra weight increases the stress on your knees with every step. Maintaining a healthy weight reduces the load on your knees, decreasing the risk of degenerative changes and injuries. Combine a balanced diet with regular exercise to manage weight effectively. Use this BMI calculator to understand how healthy you are.

3. Use proper running shoes

Appropriate footwear provides necessary support and cushioning. Choose running shoes that fit well and are designed for your foot type and running style. Visit a speciality running store for a gait analysis and personalized shoe recommendations. Replace shoes regularly to ensure ongoing support.

4. Warm-up and cool-down

Proper warm-up and cool-down routines prepare your muscles and joints for activity and aid in recovery. Start your runs with 5-10 minutes of dynamic stretches (e.g., leg swings, high knees) to increase blood flow and flexibility. After running, spend 5-10 minutes on static stretches (e.g., hamstring stretch, quad stretch) to maintain flexibility and promote muscle recovery. Check out some more warm-up exercises that you can do.

5. Listen to your body

Paying attention to pain and discomfort can prevent serious injuries. If you experience pain or unusual discomfort, take a break and allow time for recovery. Ignoring pain can lead to more severe injuries. Adjust your training intensity and volume based on how your body feels.

6. Consult a doctor or a coach

Getting advice from a professional can help optimise your running technique and prevent injuries. It will be a good idea to consult a physiotherapist or running coach who can give you personalised advice on your running form, strength training, and injury prevention. They can provide specific exercises and modifications tailored to your needs.

Summary

While running can be extremely helpful for your knees, the wrong form, wrong shoes, or over-exertion can lead to running affecting your knees. Therefore, it is very important to run in the right way. Maintaining a good pace, and proper warm-up and cool-down exercises must not be ignored. Besides this, making sure that you are not overweight is also very important.