Is running bad for your knees? No, and physical therapists explain why

The question ‘Is running bad for your knees?’ has been around for years, but it’s time to finally put this myth to rest. “Running is NOT bad for your knees. It’s good for them,” says Alec Martinez, PT, DPT, a physical therapist at Hinge Health. “In fact, runners tend to have healthier knees than people who are less active.”

It’s understandable why this myth persists, especially if you’ve ever experienced knee pain while running. Misconceptions about the impact of running on knee health have been around for decades.

“For a long time, even medical professionals believed running was harmful to the knees,” says Dr. Martinez. “But recent research has shown that it’s not the activity itself that’s the problem — it’s often how we approach it. Guidance on proper training, preparation, and recovery plays a crucial role in avoiding issues.”

Read on to discover what science really says about running and knee health, along with tips and exercises recommended by Hinge Health physical therapists to keep your knees feeling strong and supported.

How does running affect your knees? 

While it’s true that running is a high-impact activity that puts more stress on your knees than lower-impact activities, not all stress is harmful. Stress on the body is essential for building strength and resilience.

“Stress is the term we use in physiology to describe any load on the body,” explains Dr. Martinez. “For example, picking up a glass of water stresses your tendons, albeit at a very low level. There’s a spectrum: Too little stress doesn’t stimulate your body enough to adapt, but too much can overwhelm your body and lead to pain. The right amount helps you get stronger.”

Without regular stress or load, your body becomes weaker, making everyday tasks harder. “If you don’t use it, you lose it,” says Dr. Martinez. “But when you use it — through activities like running — you build strength and resilience. Running challenges your knees, which helps maintain joint health as long as it doesn’t push your body beyond its ability to recover.” Pairing running with cross-training, strength exercises, and stretching can further support knee health and enhance your overall fitness.

A sedentary lifestyle, on the other hand, poses a much greater risk to your knees, leading to muscle weakness, reduced mobility, and an increased likelihood of joint problems. Movement is medicine, and running is a powerful way to keep your knees strong and healthy.

Why running is good for your knees 

Still wondering, ‘Is running bad for your knees?’ Here are some benefits of running that might just convince you to hit the pavement.

• Less stiffness. Movement increases the production of synovial fluid, a liquid that lubricates your joints. This helps reduce stiffness, friction, and inflammation, making movement feel smoother.

• Reduced pain. A study published in the Journal of Clinical Rheumatology found that adults aged 50 and older with knee osteoarthritis who ran experienced reduced knee pain without worsening their arthritis.

• No added wear and tear. Running doesn’t harm your joints. A 2023 review in the Orthopaedic Journal of Sports Medicine that involved about 14,000 participants found that running didn’t increase the risk of osteoarthritis. In fact, runners reported less knee pain compared to non-runners.

• Improved mobility and power. “Regular runners tend to have healthier joints than those who don’t run,” says Dr. Martinez. “By consistently bending, extending, and putting positive stress on your knees, running promotes better joint mobility and greater strength.” 

• Stronger bones. High-impact activities like running stimulate bone growth and strength. As you age, bone density naturally declines, increasing the risk of osteoporosis and fractures. Running not only supports bone health but may also strengthen cartilage in your joints, potentially helping to stave off osteoarthritis, according to preliminary research.

Causes of knee pain while running

If you’ve ever experienced knee pain while running, it’s natural to assume that running itself is the problem. But that’s not necessarily the case. Pain is often your body’s way of signaling that it needs a change — whether that’s more rest, a gradual increase in activity, or an adjustment to your routine. Running isn’t inherently bad for your knees, but certain factors can make them feel sore or uncomfortable. Here are some common reasons why knee pain might occur when you run. 

• Too much, too soon. Overuse, like running a longer distance than your body is ready for, is a common reason your knees may hurt when you’re running.

• Abrupt changes in your routine. Switching up your running surfaces, shoes, or even running in colder weather can affect how your knees feel. For example, moving from a soft trail to concrete, or from supportive shoes to minimalist ones, may contribute to knee pain. Easing into these changes gradually can help your body adapt and reduce discomfort.

• Not enough rest. Running on consecutive days without allowing time for recovery can lead to knee pain. “The pain is your body’s way of saying, ‘Hey, I need a rest. This is more than I’m ready for,’” explains Dr. Martinez.

• Overuse injuries. Conditions like patellofemoral pain syndrome or iliotibial (IT) band syndrome are common among runners and can make your knees more sensitive. However, these injuries don’t mean you need to stop running. Movement is medicine, and a physical therapist can help you modify your running routine to manage pain and recover effectively.

Is running on concrete bad for your knees?

The surface you run on matters less than how your body adapts to it. While softer paths like dirt or wood chips are often recommended over asphalt or concrete, knee pain is usually linked to doing too much too soon rather than the surface itself.

“Knee pain is less about the surface and more about what your body is used to,” says Dr. Martinez. Switching surfaces, like moving from trails to concrete, can cause discomfort if you don’t ease into it. Gradual progression and training can help your body adapt to different surfaces and reduce impact-related strain. A physical therapist can also guide you in preparing for new running conditions.

Strength and flexibility are key to reducing or preventing knee pain while running. These exercises recommended by Hinge Health physical therapists target the muscles that support your knees, hips, and core, helping to stabilize and protect your joints during repetitive, high-impact movements like running. Stretching reduces muscle tension that could pull on your knees, while strength training improves the resilience of muscles and tissues, allowing them to absorb impact and support your joints more effectively. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

How to prevent knee pain while running

Follow these physical therapist-recommended strategies to reduce your chances of experiencing knee pain while running. 

1. Strength train. Building strength in muscles that support your knees — like your glutes, quadriceps, hamstrings, and calves — helps you move more efficiently and comfortably while running. It also enhances shock absorption and supports joint health. Studies show that strength training can cut injury risk in half for activities like running. Incorporate exercises such as the ones mentioned above into your routine to keep your knees strong and stable.

2. Ramp up slowly. Whether you’re new to running or increasing mileage, gradual progression is key. A conservative approach is to increase by 2.5% per week. For example, if you usually run 10 miles a week, add just a quarter-mile the next week. If you’re running 90 minutes a week, add two to three minutes the next week. “If you notice an unacceptable increase in pain, back off to give your body time to build tolerance,” advises Dr. Martinez.

3. Change one thing at a time. When making adjustments to your running routine — like changing shoes, terrain, or running conditions — focus on altering only one factor at a time. This allows your body to adapt gradually and reduces the risk of overloading your joints. For example, if you’re transitioning to new shoes, stick to your usual running surface until you’ve adjusted. If you’re adding hills to your route, don’t increase your mileage at the same time. 

4. Adjust your running stride. There’s no right or wrong way to run — the best stride is the one that feels most natural and comfortable for your body. That said, taking shorter steps, where your foot lands closer to your body, can help reduce impact and strain on your knees. “Your heel strike should occur as your hips pass over your heel,” says Dr. Martinez. If shorter steps feel helpful, you can also increase your cadence — the number of steps you take per minute. Listening to fast-tempo music can help you find a comfortable, lighter stride that works for you.

5. Cross-train. Alternate running with activities like cycling, swimming, or strength training to reduce overuse injuries, prevent muscle imbalances, and keep your workouts engaging. Cross-training strengthens supporting muscles and gives running-specific ones a chance to recover.

6. Build in time for rest and recovery. Allow your body time to recuperate by spacing out your runs. Running every other day, combined with cross-training or rest days, helps prevent overuse injuries. “This is one of the best ways to stop pain from cropping up over time,” says Dr. Martinez.

PT tip: Shoe comfort is key

There’s a wide variety of running shoes available, from lightweight minimalist styles to highly supportive stability shoes — and plenty of opinions that are supposed to be “best” for knee pain. However, research shows there’s no “perfect” shoe for every foot type. “The right shoe is the one that feels comfortable and works for you,” says Dr. Martinez. Shoes that don’t fit well or feel uncomfortable can change how you run, potentially leading to knee pain. 

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Miller, R. H., & Krupenevich, R. L. (2020). Medial knee cartilage is unlikely to withstand a lifetime of running without positive adaptation: a theoretical biomechanical model of failure phenomena. PeerJ, 8, e9676. doi:10.7717/peerj.9676

2. Lo, G. H., Musa, S. M., Driban, J. B., Kriska, A. M., McAlindon, T. E., Souza, R. B., Petersen, N. J., Storti, K. L., Eaton, C. B., Hochberg, M. C., Jackson, R. D., Kwoh, C. K., Nevitt, M. C., & Suarez-Almazor, M. E. (2018). Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative. Clinical Rheumatology, 37(9), 2497–2504. doi:10.1007/s10067-018-4121-3

3. Dhillon, J., Kraeutler, M. J., Belk, J. W., Scillia, A. J., McCarty, E. C., Ansah-Twum, J., & McCulloch, P. C. (2023). Effects of Running on the Development of Knee Osteoarthritis: An Updated Systematic Review at Short-Term Follow-up. Orthopaedic Journal of Sports Medicine, 11(3), 232596712311529-232596712311529. doi:10.1177/23259671231152900

4. Lauersen, J. B., Bertelsen, D. M., & Andersen, L. B. (2014). The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 48(11), 871–877. doi:10.1136/bjsports-2013-092538