Good News: Running Actually *Isn't* Bad For Your Knees

Find out why experts support running and 6 ways to keep your pace while protecting your joints.

<p>Getty</p>

Getty

Amongst those who lace-up, the only thing more common than a post-workout runner’s high is being told that your running is bad for your knees. The rampancy of this reprimand might have runners worried they need to dial back their mileage or hang up their sneakers in favor of a cap and goggles or helmet and bike. But there’s not actually any trust in this widespread warning. Phew.

“Running is not bad for your knees, period,” says certified running coach and personal trainer Alysha Flynn ISST, founder of What Runs You, a company dedicated to helping women run. To the contrary, the exercise is associated with reduced risk of certain knee injuries, as well as overall knee health and longevity, she says. Good running habits, however, are key for keeping this the case. “Wearing high quality, properly fitting shoes, prioritizing recovery, and cross-training are among some of the most important ways to keep your knees and whole body healthy while you run,” says Flynn.

Read on to learn what the research says about running and knee health. Plus, 6 habits experts recommend implementing into your run routine to keep your knees (and whole body) healthy for many years and miles to come.

No, Running Isn't Bad For Your Knees

Despite how prevalent the myth that pounding the pavement is bad for your knees has become, it’s just that: a myth, according to chiropractor and physical therapist Julia Morgan DC, PT, an expert with Hyperice, a company dedicated to improved movement and recovery. “Running is not bad for your knees,” she says. On the contrary, it’s actually beneficial for your knees—as well as your body in general.

The rumor is rooted in the fact that running is a high-impact activity, according to licensed physical therapist and certified breathwork practitioner Kate Crawford PT, CEO of Korē Breathwork, a company committed to helping individuals manage their pain through a combination of breath and movement. Each and every time you re-plant your foot while you stride, the force from the ground travels through your shoe to your feet and then up to your knees and hips, she explains. Research published in the Journal of Engineering in Medicine reports that your knees (each) absorb 3.6 pounds per pound of body weight while jogging. (For a frame of reference, they absorb 2.8 pounds of force per pound while walking).

But the thing is, it isn’t necessarily bad for the knees to absorb force. Doing so can lead to stronger bones, says Crawford. The impact causes the lower-body muscles to push and pull against our bones in a way that increases the activity of bone-building cells called osteoblasts, she says. The jolting also tells the body it is time to increase the production of bone-building hormones (like calcitonin and parathyroid hormone), she explains. The result is that your bones—in particular, those in and around the knees and feet—get stronger and thus become more resilient against fracture.

Morgan also says running doesn’t increase an individual's risk for knee osteoarthritis, another fear underpinning claims that lacing up puts too much ‘wear and tear’ on the knees. Osteoarthritis, if you don’t know, is a degenerative joint disease that causes the protective tissues surrounding the joint to break down over time. In fact, runners are significantly less likely to get osteoarthritis than non-runners.

One study published in The Journal of Orthopaedic & Sports Physical Therapy found that 3.5 percent of recreational runners had osteoarthritis of the knee or hip joints, compared to 10.3 percent of sedentary people. Meanwhile, another study published in the American Journal of Preventive Medicine followed a group of runners and non-runners for 20 years. Researchers found that 32 percent of the non-runners developed arthritis compared with only 20 percent of the runners.

One possible explanation is that “regularly running has been found to reduce systemic inflammation, which could contribute to maintaining healthy, arthritis-free knees,” says certified health coach Victoria Repa, CEO and founder of BetterMe. Another is that being overweight or obese is one of the factors thought to contribute to osteoarthritis risk.

6 Ways to Protect Your Knees While Running

Running may not be bad for your knees, “but running badly for a long time can be,” says running coach Kathrine Switzer, the first woman to run the Boston Marathon as a numbered entry in 1967. More specifically, running in improper footwear, exclusively on hard surfaces, and too long, too soon may be detrimental. Thankfully, all this can be avoided with the expert-backed tips below.

1) Get the Greenlight

If you have previously had bouts of knee pain or undergone knee surgery, be sure to get the go-ahead from a physical therapist or orthopedic specialist before running, suggests ACE-certified Personal Trainer and registered dietitian Hollee Mohni. These experts may have specific suggestions for how to incorporate running into your routine in a way that protects your new and/or injury-prone knees.

“It’s also wise to chat with your doctor before starting running if you have any underlying heart or breathing problems,” says Mohni, such as lung cancer, asthma, arrhythmia, high blood pressure, or cardiomyopathy. Ditto goes if you already have osteoarthritis, though you'll likely get an A-OK, as research has found that running when you have osteoarthritis improves knee pain without worsening the arthritis.

2) Veer Off Road

At least one day per week, Flynn recommends getting off the sidewalk and running on grass or dirt.

Running on hard surfaces results in a greater impact on the connective tissues in the knee with each and every stride, she explains. Over time, this increases your risk for injuries such as patellar tendonitis (Jumper’s knee), patellofemoral pain (runner’s knee), or stress fractures. Running on softer surfaces is more gentle on these delicate connective tissues, she says, while still allowing you to strengthen your lower-body muscles, tendons, and ligaments and reap the other benefits of running, too.

Oh, just don’t be surprised if you're a smidge more sore the first few times you hit the grass or dirt trail. “Softer surfaces also tend to be more uneven, so your body has to work a little harder to stabilize,” says Flynn. This is an effective way to strengthen the tiny supportive muscles in your knees and ankles, as well as your core, therefore reducing injuries long term, she says. But it also means you’ll be working muscles you likely haven’t had to develop before.

If you live in an urban space with limited greenery and don’t have access to wooded trails, another option is to run on the roads rather than sidewalks, says Switzer. Cement is ten times denser than asphalt, which has greater give, she explains.

3) Consider Cross-Training

As much as you may love running, it doesn't have to be all or nothing. Running experts recommend against limiting your physical activity to running and instead suggest incorporating cross-training.

Cross-training, which is sports speak for doing a variety of fitness modalities, allows you to strengthen your connective tissues through a greater range of motion than running alone does, explains Crawford. Assuming that you’re exercising multiple days per week, cross-training also ensures that you’re giving your ‘running muscles’ sufficient time to repair and recover after use, she says, which helps prevent overtraining injuries and improves overall performance.

According to Crawford, cross-training is an especially good option for individuals primarily running on the treadmill. “Soft tissue and joint injuries, including those of the knee, are more common in individuals whose only form of exercising is running on the treadmill,” she says. Likely, that’s because most treadmills are hard surfaces and thus unforgiving on your connective tissues. For these folks, spending one or two days less on the treadmill and instead training in other ways can be incredibly beneficial, she says.

In practice, there is great freedom in what cross-training entails. “You could switch out a run for a bike, long walk, or swim,” says Crawford. “Or, if the weather prevents you from exercising outside and you’re gym-bound, it could mean hopping on a stationary bike or an elliptical,” she says. Subbing a run (or two) each week for a yoga, CrossFit, or bootcamp class, or simply heading to the weight room qualifies, too, she says.

4) Invest In Proper Footwear

There is no hard-and-fast (or slow!) rule as to what the best running shoes are for you, as the shape of your arch, width and length of your foot, running speed and distance, and more all impact which shoe is best.

However, “as a general rule, you want your running shoes to be well-fitted to your foot, and you don’t want them to be too old,” says Crawford. A specialty running store will have foot-scanning and measuring technology, as well as trained specialists, that can help you find your perfect fit, she says. Meanwhile, she suggests replacing your running shoes every 300 to 500 miles, as that’s how long the midsole generally lasts before acquiring wear-and-tear that can alter your running gait and increase your risk for injury.

If running is your primary form of exercise and you can afford it, Flynn actually recommends investing in multiple types of running shoes. “When you wear the same pair of running shoes day in and day out, there is little variation in your gait as well as the muscles being activated,” she explains. This can lead to the over-development of some running muscles and under-development of others, which can lead to muscle imbalances within the foot and lower-body muscles, which is no good.

For this reason, “a shoe rotation, where you use different pairs of trainers for different run workouts, is associated with lower rates of injury,” she says. You might, for example, have a pair of trainers for easy effort long runs and something more responsive and lightweight for speed sessions and racing, she says.

5) Start Slow

From marathoners to couch-to-5K-ers and weekend joggers to track stars, runners are as different as the length of various running races. As such, it should come as no surprise that, as Flynn puts it, “there is no one-size-fits-all running plan.” Still, following a training program is important.

“Running training programs usually adhere to the 10 percent rule, which means that they help you build up your endurance by increasing mileage no more than 10 percent, week over week,” says Flynn. They also usually incorporate a deload every 3 to 4 weeks, which allows your brain and body to recover mentally and physically from the volume you’ve been hitting, she says. Too much mileage can shock your knees, causing undue stress, she says, so both of these features allow you to continue to run pain- and injury-free, she says.

Working with a running coach or fitness trainer who has the skill set to write you a running program tailored to your individual fitness level, training age, running experience, and unique fitness goals is ideal. In particular, if you try to incorporate running with other forms of physical activity. But if that isn’t financially feasible, another option is to find a downloadable training program from a reputable source designed for people with your experience level and running goals. This is a great 5k training plan for beginners, for example, while this plan is perfect for intermediate runners training for a marathon.

6) Prioritize Recovery

Whether you just got back from a loop around the block or a marathon training run, what you do after you untie your laces is just as important as, say, the pace and distance you hit moments prior.

When you run, tiny microscopic tears get shorn into the muscle fibers that get worked during every leg stride and arm pump, explains Flynn. These micro-tears need to be repaired—primarily through a combination of time, nutrition, and sleep—for your body to make gains from the run you did, as well as to help prevent injury, she says.

To support post-run recovery, runners should aim to consume about 15 to 30 grams of protein and some carbs within 45 minutes to one hour after finishing a workout, Pamela M. Nisevich Bede, R.D., author of Sweat. Eat. Repeat previously told SHAPE. A 3:1 carb-to-protein ratio is optimal for replenishing glycogen stores (AKA muscle fuel), notes Flynn. Mathematically, that means that you should pair 15 grams of protein with 45 grams of carbohydrates.

Nutrition aside, getting adequate sleep (7+ hours per night), staying hydrated, and foam rolling your legs can also support your recovery and, therefore overall training, she says.

Experiencing Knee (or Other) Pain? Don't Ignore It

If you want to run for the rest of your life (*raises hand*), you need to tend to aches and pains as soon as they pop up, says Crawford. That applies whether the sensation is located in the knee or elsewhere in the body, like the hip, ankle, or feet.

“Waiting to see a professional in hopes the issue is going away on its own can cause the pain to intensify or to lead the underlying cause to get worse,” she says, “which is an especially big bummer if running is feeling really good and you're loving it.” True.

Your move: If you start to question whether the sensation you’re experiencing is more than just your usual post-run muscle soreness, consult a professional. Knee, hip, and IT band issues are usually best addressed by a physical therapist, while a podiatrist should be your first stop for foot and ankle pains.

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Read the original article on Shape.