Facts and Myths About Runner’s Knee

If I had a dollar for every time someone told me that running would ruin my knees, I’d be rich enough to retire at 30. And I’d spend that early retirement with my knees feeling great. Despite the worry about the impact running has on knees, there’s no evidence that regular running damages them.

That’s not to say runners don’t deal with knee pain. So-called “runners’ knee” makes up 20% of running injuries. But unless you slipped on the sidewalk and smacked your knee cap on the pavement, knee problems in runners are usually a symptom of issues going on elsewhere in the body, and most can be overcome with some simple changes.

Here are a few things you need to know about your knees

Runner’s Knee is Just a Symptom

The most common knee injury among runners is runner’s knee. Runner’s knee is a catch-all term used to describe discomfort felt in the knee. Known clinically as chondromalacia patella or patellofemoral pain syndrome, it’s an inflammation of the cartilage under your kneecap. There’s increasing consensus among sports medicine professionals that runner’s knee is caused by a few common biomechanical problems, including weak hips and glutes, which introduce instability further down the legs; weak or overactive quadriceps, which can make it difficult for the kneecap to track correctly; and tight hamstrings, which shift some of running’s impact to the knees.

The instinct when something hurts is to back off. However, when weaknesses or imbalances are causing the pain, increasing the load can actually be the best remedy. In the case of runner’s knee, incorporating strength training can be the fix you need to run pain-free.

Runners Are Not at an Increased Risk of Arthritis in Their Knees

Studies have found that runners have less incidence of arthritis in the knees. A long-term study that followed runners and non-runners for 18 years found that while 20% of the runners developed arthritis during that time, 32% of non-runners did. A large study that looked at runners and walkers found that regular runners had roughly half the rate of arthritis as regular walkers. In that second study, the runners with the highest consistent mileage had the lowest rate of arthritis.

The results of those studies apply to all runners, regardless of age. Some medical experts have said that loss of cartilage, including in the knees, is a natural part of aging. But there’s no evidence that running accelerates that loss as you age.

Keep it Simple to Keep your Knees Happy

As noted above, weakness or tightness elsewhere in your legs can mean trouble for your knees. So get stronger.

Quad-dominant running form is the most frequent source of pain in the front of the knee, as it commonly causes athletes to over-stride. In this case, stability exercises for the core, foot and hip can help teach the foot to land closer to the body.

Extra weight places extra strain on your knees. According to studies, each additional pound of body mass puts several more pounds of stress on the knee. Running’s long-term effect on keeping weight lower is thought to be a key reason why runners might have less knee arthritis.

If you have a history of knee pain consider switching to more of a forefoot strike. One study found that more impact force affects the knees in rearfoot strikers, while forefoot strikers have more impact forces in their ankles.