Is Running Bad for Your Joints? What the Research Says

If you’ve spent any time running on trails or pavement, you’ve probably heard someone ask, “Isn’t that bad for your joints?” It’s a common question heard by both new and seasoned runners.  

But is it actually true? Should you be concerned about arthritis during your neighborhood jogs? Here’s what you need to know.  

The risks of running too much or not enough

The short answer? Recent research says that average runners don’t have anything to worry about.  

“For most people, when done in moderation, running is not a risk to the joints,” says Mark Harrast, MD, a sports medicine physician and medical director of the Sports Medicine Center at Husky Stadium. “It’s about the relationship between how much running you are doing, who you are and if you have been injured before.”

In fact, running may actually protect against osteoarthritis. According to Harrast, who is also the medical director of the UW Medicine Seattle Marathon, research suggests that the repetitive, rhythmic stress that running places on joints — called cyclic loading — may keep cartilage healthy.

However, both too little loading, if you’re too sedentary, and too much loading, if you’re running more extreme distances, may cause problems for your joints. A 2017 meta-analysis showed that recreational runners had a lower prevalence of lower-extremity osteoarthritis than sedentary non-runners, while elite or competitive runners had a higher prevalence.

“It’s well known that the percentage of arthritis in the general population is 10% to 12%,” says Harrast. “In this study, the control group of non-runners was 10%. Recreational runners had arthritis at a rate of 3.5%. Higher dose runners were at 13%.”

In this study, researchers were looking at association, not causation, so they can’t say that more extreme running caused the arthritis, but the information is still compelling.

What is a “moderate” amount of running?

What can get a little murky is defining “moderate” running. Doctors think of running in terms of your “dose.” This can be defined as weekly minutes, weekly mileage, pace, intensity, years of exposure, race history, recovery time and the cumulative load over time. In essence, there’s a difference between jogging a few days per week versus training for long races like ultramarathons over many years. In that same 2017 meta-analysis, a moderate dose was considered 225 minutes of running per week, or about 30 minutes per day, while a high running dose was more than 250 minutes per week.  

“A reasonable amount of running is protective, and then you may cross the threshold into causing damage,” says Harrast. “Some people are genetically gifted and can push things further. We don’t know why specifically.”

Running and obesity

If moderate running is good for your joints, it also has an added joint-protective feature: reducing obesity.

“The biggest risk factor for osteoarthritis is obesity, since carrying around more weight puts more stress on joints,” says Harrast. “So, while some people worry about impact loading from running, they may overlook the fact that remaining inactive and gaining weight can be more harmful to joint health over time.”  

How to keep running  

Besides body weight, other risk factors for osteoarthritis include age, being postmenopausal, having a family history, and having a genetic or biomechanical predisposition. Some of these can be changed or avoided, but most of them cannot.

Here’s what you can do to ensure running doesn’t increase your risk for joint problems.

Make sure your gait is balanced

If you’ve never been coached on it before, it could be worth taking a look at your running gait.  

“Ensure that you aren’t overloading one joint or one limb more than another,” says Harrast. “If this is challenging to figure out, then seeing a physical therapist or sports medicine physician could be reasonable.”

Address injuries  

Prior injuries can also contribute to higher loads on the joints. Pain during activity, pain that increases or persists at the same level 24 hours after cessation of activity, and night pain are all signs of possible injury and should be evaluated before resuming a running program.

“It’s important to take care of injuries and pain so they don’t become a bigger problem or more chronic,” says Harrast. “That means taking the rest needed to allow a running injury to heal up. Respect the process of recovery and don’t push too quickly to get back to running if you aren’t truly ready.”  

If you’re not certain if an injury has healed, it might be another good time to get a professional opinion and see a sports medicine physician or physical therapist.

Put some thought into training and recovery  

As you age, your risk for osteoarthritis increases. What can you do to keep running as you age?  

“As an older runner or someone prone to injury, you have to be more thoughtful about your training,” says Harrast. “It’s not about not being able to run anymore, but instead placing a focus on recovery. You may have to take more breaks, place a larger focus on nutrition and sleep, and understand your risk of injury is higher.”

If you’re used to being able to run no matter how prepared you are, it might be a different way of thinking about your training. But if your knee feels weird after a run and you’re over 50, that might be a good time to take a break.

It can also be helpful to get regular massages or other myofascial work that apply gentle pressure and improve blood flow to help your muscles recover and withstand the stresses you are putting on them.  

Don’t skip strength training

“To prevent joint injury in general, a strength program can help the joint withstand more forces and stresses,” says Harrast.

The standard guidelines are to get in two days of strength training per week, which can also strengthen your bones and prevent osteoporosis if you’re going through menopause.

Don’t stop running; run smarter

What’s the takeaway? The vast majority of people don’t need to stop running to prevent joint issues, but as you age, you might need to make some changes to your running routine.  

“My job isn’t to tell people to stop moving, it’s to help people move in a way that works for them,” says Harrast. “Running is individualized. You can’t ignore problems over a certain age.”