A Guide to Running and Knee Health
Runners and those who workout regularly are often told by ill informed clinicians that squats or running is bad for their knees. That couldn't be farther from the truth! It drives me nuts!
My goal is to get people back to doing the things they love and dispel these myths. I've put together a quick guide for PTs to help inform their runners and give them hope!
Modern Manual Therapy's Guide to
Running & Knee Health
The Myth
"Running inevitably wears down your knee cartilage, leading to arthritis."
The Fact
Recreational running is associated with a LOWER prevalence of knee osteoarthritis compared to being sedentary.
Recreational runners have a knee OA prevalence of just
3.5%
compared to 10.2% in sedentary individuals.
Source: Alentorn-Geli et al., JOSPT, 2017
How Running Builds Resilient Knees
Nourishes Cartilage
Cyclical loading promotes nutrient exchange and may enhance cartilage health.
Improves Lubrication
Stimulates synovial fluid circulation for a healthier joint environment.
Strengthens Bone
Mechanical stress stimulates bone remodeling, leading to increased density.
Manages Weight
Reduces overall load on the knees, a primary risk factor for OA.
Run Smarter: Key Strategies for Clinicians
-
Optimize Cadence
A 5-10% increase in step rate can significantly reduce impact forces and patellofemoral joint stress. (Heiderscheit et al., 2011)
-
Manage Load
Educate on progressive overload. Advise against sudden increases in volume, intensity, or frequency. The "10% Rule" is a great starting point.
-
Prescribe Strength Training
Focus on hip abductors, extensors, and quadriceps to improve shock absorption and control frontal plane mechanics.
Vary Your Load by Rotating Shoes
Research suggests that the parallel use of more than one pair of running shoes is associated with a 39% lower risk of running-related injury. The study's authors theorize that alternating shoes varies the physical loads applied to the body, reducing repetitive strain on any single tissue.
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Get Unlimited AccessKey References
- Overall Risk & Prevalence: Alentorn-Geli, E., Samuelsson, K., Musahl, V., Green, C. L., Bhandari, M., & Karlsson, J. (2017). The association of recreational and competitive running with hip and knee osteoarthritis: a systematic review and meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 47(6), 373–390.
- Cadence Manipulation: Heiderscheit, B. C., Chumanov, E. S., Michalski, M. P., Wille, C. M., & Ryan, M. B. (2011). Effects of step rate manipulation on joint mechanics during running. Medicine & Science in Sports & Exercise, 43(2), 296–302.
- Load Management: Gabbett, T. J. (2016). The training—injury prevention paradox: should athletes be training smarter and harder? British Journal of Sports Medicine, 50(5), 273-280.
- Shoe Rotation: Malisoux, L., Ramesh, J., Mann, R., Seil, R., Urhausen, A., & Theisen, D. (2015). Can parallel use of different running shoes decrease running-related injury risk?. Scandinavian Journal of Medicine & Science in Sports, 25(1), 110-115.
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