How running affects your knees

running knee injury

For those running the London Marathon on 21 April, you’ll now be entering the tapering stage, reducing your weekly mileage and allowing your joints to recover, muscles to repair, and body to recharge for that final test of your endurance.

Could running actually be good for knees?

For years, it has been perceived that running is incredibly damaging to your knees, yet several studies published recently have debunked that myth.

In a study published last year, researchers at Northwestern University in the US explored the relationship between long-distance running and knee arthritis. They established that a running history was not significantly associated with an osteoarthritis diagnosis.

The researchers surveyed almost 4,000 participants in the 2019 and 2021 Chicago Marathon for a detailed history of their running activity alongside a record of their knee pain and other arthritis symptoms.

The critical factors in developing knee arthritis were age, BMI, family history, and a previous knee injury or surgery.

This research follows a 2019 study published in the British Medical Journal for Sports & Exercise Medicine. This studied beginner, middle-aged runners and found that distance running did not result in the progression of meniscal tears and rebuilt some damaged cartilage. However, it did find damage to the cartilage and other tissues around the kneecap or patellofemoral compartment.

Common running knee injury conditions

Whether running long distances, doing couch to 5K or regularly attending your local Parkrun, it is essential to be aware of the effect running has on your joints. For each pound of body weight, your knee absorbs one and a half pounds of stress when you walk, which jumps to nearly four pounds when running.

Patellofemoral pain syndrome (PFPS)

This is the most common type of running knee injury. Pain is usually felt above, under, or just below the kneecap, and it typically worsens when you run or walk up the stairs. Often, the cause is biomechanical, which means the kneecap’s position is causing excessive friction or there is a muscle imbalance. It is treated with non-invasive measures such as rest and exercises aimed at improving strength and flexibility.

Iliotibial band syndrome (ITBS)

This thick band of tissue that runs all along the outside of your knee and thigh is the leading cause of pain on the outer part of the knee as it can rub against the lower part of your femur or thigh bone, which forms part of the knee joint. Treatment typically involves rest, anti-inflammatory medication and knee strengthening and stretching exercises.


The bursae are fluid-filled sacs that act as cushions in your joint. When inflamed, they can cause pain and tenderness and often occur due to overuse from running. Treatment includes rest, leg elevation, cold therapy and over-the-counter painkillers and anti-inflammatories. Surgery is not usually required, but a steroid injection might be recommended.

Prevention rather than cure

Many factors can affect your knees as you run, and steps you can take to prevent knee injury include:

  • Work on your core strength and mobility, as it can affect your running posture
  • Incorporate strength training into your routine, as the surrounding muscles play an essential role in protecting your knee
  • Be aware of any hip injuries or weaknesses, as these make you more susceptible to a knee injury
  • Try to maintain a healthy body weight, as a high BMI places more strain on your knee joints
  • Invest in a pair of running shoes that provide proper support
  • Stretch the muscles around your knees before a run, focusing on the quadriceps, hamstrings and calves
  • If your knees are sore after your run, use cold therapy
  • Ensure you have regular rest days to allow your muscles and joints to repair and recover
  • If you are developing pain with running, vary your exercise routine with lower-impact exercise, for example, cycling which puts less stress on the joints and can help to strengthen the muscles around the knee
  • Softer running surfaces such as a running track or a flat, smooth dirt trail can lessen the impact on the joints
  • Seek medical advice if your pain is persistent and not improved by conservative methods such as rest, ice and stretching

If you’re concerned about a running knee injury, you can arrange a consultation with Mr Neil Hunt for further investigations or treatment by making an appointment at one of his clinics or by calling Charissa Sullivan on 07724 909 414.