Is Running Bad For Your Knees?

As a rheumatologist, I often come across patients concerned about the effects running will have on their knees long-term and question if it will accelerate knee arthritis and need for a knee transplant. A recent study in the Orthopedic Journal of Sports Medicine looked to answer those very questions.

Researchers conducted a systemic literature review of the PubMed, Emboss and Cochrane Library databases up through October of 2021- to evaluate for studies that looked at knee OA formation and accumulation of chondral damage. Outcomes of interest included patient reported outcomes and radiographic outcomes. In total 17 studies were included, representing 7,194 runners and 6,947 non-runners in their analysis.

The findings showed there was an overall "significantly higher prevalence" of knee pain in the non-runner group. Further multiple studies showed no real difference in the presence of radiographic knee OA based on MRI and one study showed an increased risk for requiring total knee replacement compared with runners.

This review further supports our growing literature showing that there is no evidence for a higher incidence of knee pain, knee OA or a need for knee replacement among runners when compared to non-runners. Further exercise therapy has been shown to be as effective as NSAID’s (such as ibuprofen) and two to three times more effective than Tylenol in reducing pain in knee OA. This has been supported in translational studies showing exercise results in an increase in beneficial cytokines (such as IL-10, collagen type I and II) and a decrease in harmful or inflammatory cytokines (such as IL-1, IL-6, TNF-a, and MMP-13). Not to mention the additional health related benefits of running such as improvement in BMI and on overall health.

I hope these studies can help ease the concerns of my runners and soon to be runners. It is always important to discuss with your Physician on the correct “dose” for any form of exercise, and to listen to your body and adjust or report any injuries should they arise.

Reference: Dhillon J. et al. Orthopedic Journal of Sports Med. 2023