For ease, accessibility and effectiveness, few workouts beat lacing up and heading out for a run. But what if your knees start to hurt? Explore the evidence, runner’s knee symptoms and practical ways to look after your joints.
🕒 5 min read
Is running bad for your knees?
Recreational running is not automatically bad for your knees. Research does not support the idea that it inevitably wears joints out, although injury history, training demands and individual health matter. Knee pain during running is a reason to adjust and assess your routine, rather than proof of permanent damage.
A Stanford University study followed 45 long-distance runners and 53 non-runners with knee X-rays from 1984 to 2002. Running was not associated with faster progression of knee osteoarthritis. Severe osteoarthritis was recorded in 2.2% of runners and 9.4% of controls, but that difference was not statistically significant. Most participants had little or no X-ray evidence of osteoarthritis at the start, so this was not a trial showing that running treats arthritic knees.1
A 2017 systematic review also found a lower occurrence of hip or knee osteoarthritis among recreational runners than competitive runners or controls. The authors could not establish whether running itself explained the differences, or whether factors such as previous injury played a part.2
The useful message is reassuring but measured: enjoying running does not mean you are destroying your knees. Walking is a valuable activity too, and should not be described as causing knees to wear down.
What is runner’s knee and what does it feel like?
Runner’s knee commonly refers to patellofemoral pain: discomfort at the front of the knee, around or behind the kneecap. Despite the name, it can affect people who do not run. It is not a label for every knee problem.3
Symptoms can include:
- An ache around or behind the kneecap during activity.
- Discomfort on stairs, when squatting or when running.
- Pain after sitting for a long time with the knee bent.
- Tenderness around the kneecap, sometimes with clicking or grinding.
These features overlap with other conditions. Pain on the inside or outside of the knee, swelling after an injury, or a knee that locks or gives way may need a different explanation. A GP or physiotherapist can assess the pattern rather than relying on the name “runner’s knee”.3, 7
Taking care when your knee hurts
That is not to say all runners can pound the pavement to their heart’s content without adverse effects. A pre-existing injury, a sudden change in training or how you move can influence what your knee tolerates.
If running causes knee pain, stop the run rather than trying to push through. A wrapped cold pack may help with discomfort; never put ice directly on your skin. For pain that is not severe, NHS advice is to get it checked by a GP or physiotherapist if it has not settled after a week off running. Your return depends on the cause and severity.5
A physiotherapist can assess your symptoms, strength and movement, then help you build an appropriate recovery plan. A running-shop shoe fitting can help you choose comfortable footwear, but it does not replace a clinical assessment of persistent pain or guarantee injury prevention.
How can you reduce the risk of knee pain when running?
The aim is to prepare your body for the running you want to do, rather than find one perfect technique. These habits are useful starting points:
- Build up gradually. Avoid suddenly doing much more running than usual. Changes in distance, pace or hills all change the demands on your knees.
- Warm up before you run. Start with easy movement and build towards your planned effort, rather than going straight into a hard session.
- Choose suitable shoes. Look for a comfortable fit appropriate to your activity. There is no single shoe that prevents every runner’s knee problem.
- Include recovery. Give yourself time between harder sessions and adjust your plans if soreness is building instead of settling.
- Train more than running alone. Strength and flexibility work can complement your runs. Cycling or swimming may offer variety if comfortable for your knees.
- Respond to recurring symptoms. If the same pain keeps returning, seek advice rather than repeatedly changing shoes or relying on painkillers to finish a run.
Overuse and how force is managed through the leg can contribute to patellofemoral pain. An individual plan is more useful than assuming that everyone needs to change the way their foot lands.4
Strength exercises: support the whole movement
Protecting knee health is not all about how you run, or how often you do it. Your hips, thighs and other supporting muscles also contribute to movement. Limiting exercise to running alone can leave gaps in your wider training routine.
Try alternating runs with activities that develop strength, balance and flexibility. Yoga or Pilates may complement a routine, while appropriate resistance exercises can help build strength. A physiotherapist can select and progress exercises for your hips and knees if you have symptoms.4
NHS knee exercises for runners provide a starting point for people without an existing knee injury. They are not a personalised rehabilitation programme: stop if an exercise causes pain, and check suitability with a health professional if you are unsure.6
For more ideas, explore our guides to exercise for healthy joints and swimming for healthy joints.
Nutrition alongside your running routine
Regular meals, adequate energy and a varied diet support an active lifestyle. If you want to compare nutritional products, browse our glucosamine supplements and joint-health supplements range.
Check what each formula provides and how it fits your diet. Some joint products include vitamin C, which contributes to normal collagen formation for the normal function of cartilage. This nutritional role is different from treating runner’s knee. Our joint-care supplements guide explains the options.
When should you get knee pain checked urgently?
Seek urgent GP advice or help from NHS 111 if your knee is very painful, badly swollen or has changed shape; you cannot move it or put weight on it; it locks or gives way; or you have a fever with a hot, red knee. These are reasons to get assessed rather than assume you have a routine running injury.7
