Eight tips for running with arthritis in your knees

Someone recently asked on Facebook “Osteoarthritis in the knees and running on the treadmill... any hope of the discomfort and occasional pain to go away as I lose more weight and get stronger?” In this article I’ll answer this question and give you some tips that may help your knees.

In this article:

• Is it OK to run with arthritis in your knees?

• Tip 1: Start slow

• Tip 2: Do strength training

• Tip 3: Manage your volume

• Tip 4: Recovery, Recovery, Recovery

• Tip 5: Cross train

• Tip 6: Shoes are important

• Tip 7: Experiment with different running terrains

• Tip 8: Get to know your knees!

Here's the video of a previous livestream that I did about this:

It is OK to run with arthritis in your knees?

Yes, absolutely. It’s a common misconception that running is bad for your knees. A recent study that followed participants with arthritis in their knees over a 4 year period found that running did not make their arthritis symptoms worse and it also didn’t increase the signs of arthritis seen on x-ray. In fact, the participants in the study found that running helped their knee pain.

Another study that followed runners and non runners over an 18 year period also found that the runners did not show more signs of arthritis in their knees compared to the control group of non runners.

This does not mean that everyone with arthritis will be able to run. All of us are built differently and our bodies react to exercise and running in very different ways, but take a look at the 8 tips below before you hang up your running shoes.

Tip 1: Start slow

If you’re new to running, you have to give your body enough time to adapt to the new load that goes through your joints, muscles and ligaments. This takes time, but every time you do a session it stimulates your cartilage and bones and muscles to grow stronger. The older you are, the longer this adaptation can take.

Osteoarthritis is part of the normal aging process in the body. It’s very similar to getting wrinkles. How well our joints age are to a large extent affected by our genetics, diet and previous injuries that we may have sustained in the past.

If you have a bit of arthritis in your knees, you will just have to take it much easier when you first start running because your joints may take longer to adapt. Following a run / walk programme can be a good idea.

Tip 2: Do strength training

The stronger the muscles in your legs are, the less force goes through your joints when you run, walk, climb stairs etc. Strength training has also been shown to prevent running injuries in runners of all ages. Make sure that you include exercises for your glutes, hamstrings, quads and calves.

Tip 3: Manage your volume

Yes, there is no arguing that osteoarthritis affects the structure of your knee joints. This may mean that they can’t quite handle the same volumes of running as they did when you were younger. If you try and pile too many miles on them, you may overwork them and make them hurt.

So if you have arthritis in your knees, you have to pay close attention to what your knees are telling you. How much running will your knees allow you to do without making them hurt more? How much is too much?

Tip 4: Recovery, Recovery, Recovery

All runners need to have recovery days to allow their bodies to repair and adapt to the exercise they’ve done. The younger and fitter you are, the shorter the recovery period needed. As you get older the body naturally takes longer to repair itself.

Check if you need to maybe give your knees more recovery days between your run days. Do your knees feel better if you just run twice a week, rather than 3 times?

Tip 5: Cross train

I know this is an article about running and arthritis, but doing other activities like swimming or cycling in between your running sessions can actually help your knees recover better which will help your running.

Tip 6: Shoes are important

There are no specific guidelines for what running shoes you should use, but in general I would suggest that you

• throw out old trainers,

• get cushioned but supportive trainers,

• stay away from minimalist shoes.

What the research has shown is that the best way to select a running shoe is by testing it and feeling that it’s comfortable, so try to find a running store that will allow you to test them on a treadmill or pavement.

Tip 7: Experiment with different running terrains

Again, there’s no specific terrain that has been shown to be better for runners with osteoarthritis in their knees. My patients usually have to test it for themselves. Some find that they are better when running on the flat, others prefer off road and some has to stick to running on a treadmill.

Running down hills are usually harder work for knees and I tend to advise my patients with sensitive knees to limit the amount of downhill running they do. Running up hills doesn’t seem to be such a big problem.

Experiment with this for yourself. See what your knees feel like when you run the same distance at the same speed on a variety of surfaces.

Tip 8: Get to know your knees!

To recap: running does not cause osteoarthritis in knees and it doesn’t make it worse. Because your joint’s ability to adapt and recover from exercise is affected by arthritis you may not be able to run at the volumes or intensities that you’d done previously.

If you would like to continue running or start running, you will have to pay close attention to what your knees are telling you and choose your running intensity, volume and frequency accordingly.

In that study that I mentioned earlier that showed that running doesn't cause arthritis and can help knee pain, the participants all adapted their running according to what they felt was right for them. I’m pretty sure that the study would have had a very different outcome if they’d forced the participants to run according to a programme set by someone else.

Make sure that you experiment with all the things listed above and observe how it affect your knees!

Let me know if you have any questions. Need more help with an injury? You can consult me online via video call for an assessment of your injury and a tailored treatment plan.

Best wishes

Maryke

About the Author

Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn, ResearchGate, Facebook, Twitter or Instagram.

References:

1. Chakravarty EF, Hubert HB, Lingala VB, et al. Long distance running and knee osteoarthritis: a prospective study. American journal of preventive medicine 2008;35(2):133-38.

2. Lo GH, Musa SM, Driban JB, et al. Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative. Clinical rheumatology:1-8.