Running and Aging Knees

Is running Harmful for Your Joints?

Mature woman jogging on beach
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Running may help you live longer and avoid disability in general as you age, but will the sport do your knees and hips harm? One of the most common worries among would-be runners and long-time runners alike is that they will injure their knees by hitting the track, treadmill or trail. If you run for your health and lifespan, will your aging joints enjoy the same longevity?

Runners and Osteoarthritis

There have been a few different studies examining the effect of running on knees to determine whether the sport causes osteoarthritis (a painful chronic condition involving swelling and deterioration) in aging joints.

For example, a team of Stanford University School of Medicine researchers followed a group of older runners (with an average age of 59) for more than two decades to track their general health, rates of disability and longevity in general. Among their studies: A look at running and arthritis, published in 2008 in the American Journal of Preventive Medicine, which involved repeated x-rays on 45 senior runners and 53 controls conducted between 1984 and 2002.

How Much Were They Running?

Running subjects were clocking an average of 213 minutes a week, at the beginning of the study. That works out to about 30 minutes a day, though their runs were not necessarily daily. By the time of their last x-ray assessment, runners were logging about half of that (94 minutes a week).

After 18 years of investigation, the runners — now in their 70s — did not have more arthritis than the non-running control subjects, nor were the existing cases of arthritis any more serious in the runners when compared to adults who didn't run.

James Fries, now Professor Emeritus at Stanford and one of the study's authors, says that the results came as a surprise to his team.

"Our hypothesis to begin with was that exercise is good for you, and that those who exercise the most benefit the most," he says. "But we also expected that the runners would suffer more joint disability, and would need more knee and hip replacements than the general population.

We were very surprised to discover the opposite!"

Fries quotes follow-up data on knee replacements in the study group showing that fewer of the runners needed to have a knee replaced, relative to the non-runners.

"Among the non-runners, 12 knees were replaced, but only 4 in the runners," he says. "I was sure there would be some downside, some price to pay for all those years of running, but there really isn't."

What Other Research Has Been Done?

A review of studies investigating running and arthritis was conducted by researchers from the University of Utah Orthopedic Center. Published in 2012 in the journal Physical Medicine and Rehabilitation (PM & R), the paper cites research showing no significant differences in x-ray results between former competitive runners and sedentary control subjects. While most subjects suffered some joint deterioration, the problems were no worse among runners. In some cases, the runners maintained a greater bone mineral density, a finding that supports James Fries' conclusions about running being protective for knees.

Which Sports do Lead to Knee Arthritis?

A number of activities are linked to worse knees in later life, such as sports that require unnatural sideways action, load or impact like tennis, soccer, weightlifting, and ballet. In addition, obesity, a prior knee injury, and cumulative damage from years of heavy physical labor are all implicated in premature osteoarthritis of the knees.

Bottom Line

Can you run later in life, free of the worry that you're ruining your knees for the future? The general consensus from the research so far is that running "straight ahead without pain" as Fries describes it, does not lead to a greater incidence of osteoarthritis in your joints. If you've had a prior knee injury, or your BMI is above the healthy range (that is, BMI >25), consult your doctor or other health-care provider for advice on the best exercise for you.


Eliza F. Chakravarty; Helen B. Hubert; Vijaya B. Lingala; James F. Fries. "Reduced Disability and Mortality Among Aging Runners: A 21-Year Longitudinal Study." Arch Intern Med. 2008;168(15):1638-1646.

Eliza F. Chakravarty , Helen B. Hubert, Vijaya B. Lingala, Ernesto Zatarain, James F. Fries. "Long Distance Running and Knee Osteoarthritis: A Prospective Study." American Journal of Preventive Medicine, Volume 35, Issue 2, August 2008, Pages 133–138.

Interview with James Fries, MD. Professor of Medicine Emeritus, Stanford University Medical School. Conducted August 23, 2013.

Pamela Hansen, Michael English, Stuart E. Willick. "Does Running Cause Osteoarthritis in the Hip or Knee?" American Academy of Physical Medicine and Rehabilitation 1934-1482/12/$36.00 Vol. 4, S117-S121, May 2012.

Stuart E. Willick and Pamela A. Hansen. "Running and Osteoarthritis." Clin Sports Med 29 (2010) 417–428.

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