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Knee OA and Running

Knee OA and Running

We are often asked whether running causes knee osteoarthritis (OA). This is a common misconception after experiencing knee pain following activity.

What is osteoarthritis?

Osteoarthritis (OA) is a condition that affects the whole joint including bone, cartilage, ligaments and muscles. Xray imaging comonly reveals age related changes in these areas of your knee, but these changes don’t always correlate directly with pain or loss of function.

Running knee OA

OA and Running

Interestingly, recreational runners are shown to have less OA changes in their knees than sedentary people1. Recent research by Millerconfirms that joint loading in runners does not initiate knee osteoarthritis.

Benefits of Running

So why could running be good for our knees? The main findings from Miller’s studywas that runners do not have high risk of developing knee OA despite placing high loads on their knees on a frequent basis. Possible reasons for this include:

  1. Cumulative load, which is surprisingly low in running, is more important for OA risk than peak load.
  2. Running conditions knee cartilage to withstand more stress without joint deterioration.

Knee OA Running My Physio

OA and Pain

But what if you have knee pain and an XRay shows osteoarthritis? First of all, it’s important to look at the many factors that cause pain.  Your physiotherapist is highly experienced in undertaking thorough questioning and a comprehensive assessment of strength and movement around your knee. Rest may be required for a short period of time to let things settle down, but is not useful in the long term. Your physio can help plan a tailored return to activity program for you.

OA and Surgery

Already spoken to a GP or Surgeon that says surgery is inevitable? Even if surgery like a total knee replacement is required, appropriate strengthening can delay surgery at least two years, or result in twice the improvement in pain and function following surgery3.

Book an appointment with Ruth today and formulate a plan to return to running. 

1(J Orthop Sports Phys Ther., Vol 47, No 6 pp373-390 2017).

2(Exerc. Sport Sci Rev., Vol 45, No 2 pp 87-95 2017)

3(Osteoarthritis and Cartilage., Vol 26 pp1170-1180 2018).


  1. Alistair Bartlett on December 31, 2021 at 12:29 am

    I have been a keen runner nearly all my life, competing in various competitions and races at various distances from 5k to half marathon. I first got diagnosed with osteoarthritis on the inside of my left knee 12 years ago, and a slight tear on the inside of my right one after an MRI scan. I have been able to manage it ok in the years since, while still training and competing. In the last week or so however, both my knees have hurt while running to start with, but slightly got better as I have carried on my run, this being in training. But this Boxing Day just gone, I took part in a 5k race, and both knees hurt while I was warming up beforehand. Then come the start of th race, they still both hurt, restricting my speed, and it was only at about 3k into the race that the pain subsided a bit. I use heat rub creams and Voltarol cream on my knees before running and I also use other pain relief devices and patches as well as knee supports in the past. I am thinking of purchasing the “Revite med” electronic device. Do you have suggestions that could help me please? Many thanks,, Alistair Bartlett.

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