Does Running Damage Your Knees?
Dr. Rahman Kandil

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It is easy to understand why many people believe the high impact of running must be damaging to the knees. In fact, several studies now contradict that belief and some researchers believe that regular, recreational jogging actually decreases the likelihood of developing debilitating osteoarthritis. Primarily, running helps you to stay at a healthy weight and strengthens the muscles and ligaments that support the knee. Keeping proper form and not overdoing it are the keys to success. Done correctly, running is a great way to stay fit, relieve stress, and spend time outdoors.

Healthy Habits to Avoid Injury

Many runners manage to avoid injury by following these guidelines for healthy running habits:

  • Begin your run with a warm-up. Start slowly and stay at a slow pace for the first 10 to 15 minutes of your run. In addition, some fitness experts recommend stretching. When you stretch, make sure you learn the correct form. A fitness trainer can teach you how to properly stretch your muscles.
  • Do not run every day. Alternate hard days and easy days. Plan 1 to 2 days a week for rest or cross training.
  • Do not try to run too fast. Build your ability to run distances before you try to run those distances fast.
  • Do not run too much before you are ready. Give your body time to adjust to running and its demands. Experts recommend increasing your total weekly mileage by no more than 10% per week.
  • Rest. It is okay to take days off, especially if you have an injury, or if you just completed a marathon or other long distance race. Taking a few days off to recover can help you avoid injury down the road.
  • Vary your running surfaces. Try running on different, softer surfaces for some of your runs. Just make sure that they are level.
  • Strength training. Consider working with weights on your off days to strengthen and support the muscles needed for stability when running. A strong core helps runners maintain good posture and balance, and avoid injury from the slight but repetitive rotation of the spine that occurs with every stride.

When knee injuries do happen, it usually is from overtraining, increasing mileage or pace too quickly, or improper stretching. Listen to your body—if you feel pain, stop. If pain continues when you run, rest the affected area for up to 3 days.

Choosing the Right Athletic Shoes

Many experts suggest that running injuries often result from wearing the wrong athletic shoes. While lacing up the right pair of shoes will not turn you into a superstar, it may save you pain and suffering down the road.

The goal is to find a shoe that gives you a neutral foot strike to protect your knees when you are pounding the pavement. If you tend to overpronate or oversupinate, you want a shoe that helps you get back to a neutral position. Go to a store that specializes in running shoes. They will look at how you run and analyze the wear on your old running shoes. From there, they can suggest a running shoe that is right for you. If you are an active runner, remember to change your athletic shoes every 300 to 400 miles. Finally, buy shoes in the evening when your feet are at their biggest. Shoes that are too tight can be painful.

Treating Running-Related Knee Injuries

No matter how careful you are, running-related knee injuries sometimes happen, usually the result of overuse. Most runners experience either lateral pain or patellar pain. Typically, knee injuries are caused by:

  • Improper running form
  • Wearing the wrong athletic shoes
  • Running too much when your body is not ready

You can help prevent knee injuries by doing stretching and strengthening exercises for the hip and thigh areas, slowly building up your running time, and using proper form.

Most minor knee injuries can be treated with rest and ice. Do not start running again until your knee pain is gone and you get clearance to start again from your doctor. Avoid activities that include jumping, twisting, pivoting, or climbing. If your knee pain does not improve with rest and ice, you could have a more serious injury. Your doctor will determine if it requires further testing, treatment, or physical therapy.

Generally, running injuries are divided into 4 grades:

  • Grade 1—Minor pain noticed after running.
  • Grade 2—Discomfort or tightness noticed while running, but does not limit activity.
  • Grade 3—Pain felt while running that begins to limit activity.
  • Grade 4—Severe pain while running that forces you to stop.

In most instances, running-related knee injuries begin as a Grade 1 or 2 injury and progress to Grade 3 or 4 if not treated. It is crucial to treat the injury quickly and properly.

Immediately ice any area that is painful or tight from running. Apply ice wrapped in a towel for 15 to 20 minutes. Ice as many times as possible each day until the symptoms improve. It is important to rest a low-level injury or you can make it worse. In general:

  • Grade 1—May require 1-2 days rest.
  • Grade 2—Requires 4-7 days rest.
  • Grade 3—Requires 2-4 weeks rest.
  • Grade 4—May need 6 weeks or more of rest.

Use anti-inflammatory medications to control inflammation, not pain. Masking pain so that you can continue to exercise after a knee injury will lead to a more severe injury. If a Grade 3 injury does not improve after a week of proper treatment, consult your orthopedist. Grade 4 injuries require immediate medical attention.

Come back slowly from an injury. Recognize that it will take at least as long as the time you took off due to the injury to work back to the training level you had achieved prior to the injury.


What researchers know is that any exercise helps reduce weight and lowers the overall risk of osteoarthritis. Done correctly, running is a great way to achieve a healthy lifestyle. Whether you are a beginner or a seasoned strider, following safe running guidelines will help keep you keep your knees and other joints healthy for many miles to come.

If you would like to make an appointment with Dr. Rahman Kandil to discuss staying healthy while running or think you may have an injury from running or another endurance sport that may need to be addressed, go to Dr. Kandil's physician page or call (703) 665-2720 and we will be happy to assist you.

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