Is Running Bad for your Knees?
“Running is bad for your knees”
“Running will give you arthritis”
Boooooooooo.
In healthcare, words matter because people tend to believe their doctor. If your doctor, PT, chiropractor, nurse, etc. tells you to stop running, you are probably going to stop running.
To be clear- there are reasons not to run. For example you would never want to keep running with a lower extremity fracture. But not running because you are worried about arthritis? Hell naw.
I am here to tell you that running is not bad for your knees, and running does not cause arthritis.
Says who?
I’m glad you asked!
A recent study looked at 125,810 people and compared rates of hip and knee OA between non runners, recreational runners, and competitive runners. Below I listed the rates of each respective group that was followed over a 15 year period.
Non-runners: 10.2%
Recreational runners: 3.5%
Competitive runners: 13.3%
Non-runners were more than 3x more likely to develop arthritis than recreational runners.
Now, you are probably wondering about the competitive runners. Here are my thoughts.
Competitive runners can put in 100 mile weeks. I would never recommend that if you are trying to optimize knee health, but if you are trying to qualify for the olympics, you have to! Every activity has diminishing returns, but sometimes pushing the envelope is awesome.
Nutrition, sleep, and hydration status all affect injury risk, especially at the higher levels of an activity. Perhaps the rate would be lower if these things were controlled for.
13.3% developed arthritis, which means 86.7% did not
The competitive runner will live longer than the sedentary person, despite their arthritis (which may or may not be symptomatic). They will have lower blood pressure, better metabolic health, and more muscle mass.
What is Arthritis?
Osteoarthritis (OA) is the term for the degeneration of the cartilage in the joints. Cartilage surrounds the ends of the bones and acts as a buffer zone in which the joints glide on each other.
“Bone on bone” or “wear and tear” are two phrases people will be told about their knees.
Again, words matter. If I said your knees were “bone on bone,” you automatically think of worn-down, fragile bones. If wear and tear caused arthritis, why wouldn’t everybody have arthritis when they reached a certain age?
Arthritis doesn’t develop over time from “wear and tear.” It’s a complex, inflammatory condition that has more in common with being inactive than “overuse1.” In fact, recent studies have linked sedentary behaviors, diabetes, and high blood glucose to the development of osteoarthritis in joints. Back in the day, people chopped it up to pounding pavement.
How do you prevent arthritis and promote joint health?
Because of recent evidence suggesting arthritis is more of a result of inflammation and sedentary behavior, this is what should be addressed to prevent arthritis.
Limiting inflammatory foods
Sleeping 7-8+ hours per night
Weight bearing exercise (walking counts!)
Joint Anatomy and Nutrition
How does the anatomy of our joints affect their health? Let us use the knee as an example.
Joints have poor blood supply.
In most parts of our body, blood carries nutrients to repair damaged tissue and clears out the junk. Think about getting a cut. You bleed, then have redness and swelling. This is the healing process.
If joints have poor blood supply, how do they heal?
Enter synovial (joint) fluid. Synovial fluid is found in joints and provides lubricant to the area. Interestingly, scientists have never found a more slippery substance than fluid from a human joint. People have attempted to recreate this in a lab, but have not come close to recreating the small amount of friction that synovial fluid provides.2
When we flex and extend our knee, this fluid coats the surfaces of the joint. Weight bearing exercise, transmits a force through the knee. When we land on the ground, some of this fluid is jettisoned from the joint capsule. When we pick our leg up, fluid rushes back into the joint. Think of a sponge: when you squeeze the sponge, fluid exits, then allowing the sponge to expand allows water to enter the sponge again.
Weight bearing exercise is critical to capitalize on the nourishing, fluid-coating action of the joint.
Think that’s gonna happen sitting on the couch all day?
No!!!!!!
So get out there and run folks, run like your life depends on it. It kind of does.
Until next time friends.
Bonus Content!
Me and my friend Eddie at a Post Malone concert. Someone bought us beers (15 dollars a pop) because they enjoyed our costumes so much. Moral of the story: wear your stume to the show.
Another word I don’t like. I prefer “underprepared”
In fact, people used to harvest synovial fluid from whales to use as lubricant in watches!