Knee Osteoarthritis in Runners

Knee Osteoarthritis in Runners

In June this year, a prominent arthritis researcher from the UK wrote an article in the prestigious British Journal of Sports Medicine, asking the question: Does running cause knee arthritis? It turns out there’s good news and bad news.

The Good News

Overall it appears that ‘recreational’ running is not a risk factor for knee osteoarthritis (OA). Now, before we get carried away, this needs to be defined a little better.


Figure – Knee osteoarthritis is a multi-tissue disorder of the joint.

Firstly, when they refer to ‘recreational’ runners the authors are referring to anyone who doesn’t receive a payment to run. Roughly speaking, this refers to those who are slower than a 2hr 45min marathon pace. This represents probably 95% of the running population! However, this is conditional that you haven’t had a significant knee injury, such as previous cartilage or ACL injury.

Now we should also clarify this is referring to the risk of developing OA in someone who currently does not have the condition; it is not referring to the risk of furthering the progression of someone already affected.

The Bad News

Due to limitations in OA research, the good news part of this story isn’t definitive. Very few of the studies followed a big group of people (including runners) over a period of time to determine who did or didn’t get OA; instead, they looked at patterns in the people with and without OA to determine whether running presented a risk. In other words, we can make an educated guess that running isn’t bad for your knee, but we’re not certain.

Bottom line: There’s nothing to suggest that running causes OA! At least for the majority of us with healthy knees at the recreational level.

Michael Ryan
BHK, CPed(C), MSc, PhD

  • Richard Hoover

    April 16, 2020 at 11:30 am Reply

    How many km a week is it safe to run?

    • Michael Ryan

      April 16, 2020 at 1:46 pm Reply

      Hi Richard, The question of safe weekly running mileage depends A LOT on how consistent your running mileage has been. As a general rule that errs on the conservative side, it is often recommended to increase your running mileage (or time) by no more than 10% of the previous week. So if you ran 20km in total over last week, you should plan to run only 22km this week. Arguably, it is safe for some people to run as much as 80-100km per week provided they have spent the necessary time to adapt their body to that high amount of loading. The next question is then, for how MANY WEEKS, can I safely sustain that mileage? I’d suggest to hold that weekly volume progression for 3 weeks before dropping down for a reduced amount in the 4th week.

  • Alma Martin

    June 29, 2020 at 10:03 am Reply

    Running helped with my arthritis knees!

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