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Can you keep running with knee osteoarthritis?

  • Writer: Emma Glynn
    Emma Glynn
  • Nov 3
  • 4 min read

Updated: 6 days ago

By Emma Glynn - The Hip & Knee Physio

General information only; not personal medical advice



women with knee osteoarthritis running

Short answer: for many people with knee osteoarthritis (OA), yes, with the right loading and progression. Major guidelines back regular exercise as first-line care, and modern evidence doesn’t show recreational running “wearing out” knees. The key is how much, how often, and how you build over time [1,2].


What the evidence says

  • Exercise is a core treatment for knee OA; done consistently, it helps pain and function. Guidelines emphasise that exercise isn’t harmful to OA joints [1, 3, 4].

  • Recreational running isn’t linked to accelerated OA and may even be protective versus not running, especially compared with sedentary peers. (We’re not talking elite distances!) [2, 5, 6]

  • Good programs pair strength & activity and adjust exercise loads, footwear, and terrain as needed [1, 4].


A 4-week “run with OA” plan

Rule of thumb: if you have a mild ache (≤3/10) during or after activity that settles within 24–48h, that is acceptable. If pain lingers >48h, reduce the load on your next run by ~20%.


Week 1 - Prove tolerance

  • Swap runs for walk-run intervals (e.g., 1 min run / 2 min walk × 8–10).

  • Flat surfaces, shorter strides.

  • Strength 2×/wk: sit-to-stand (slow 3s down), step-ups (low box), calf raises (2–3×8–10 each).

  • Aim every other day, not daily. (Recovery matters) [1,4].


Week 2 - Nudge up

  • 90-120 sec run / 90 sec walk × 8–10.

  • Keep terrain flat; add one gentle incline walk (no hard downhills).

  • Strength as above + mini-squat to chair (comfortable depth) [1,4].


Week 3 - Consolidate

  • 3-4 min run / 1 min walk × 6–8.

  • Re-test a short, gentle downhill, shorten stride and slow the descent pace [1,4].


Week 4 - Continuous block

  • 12–20 min continuous easy run (chatting pace), or keep intervals if that’s comfier.

  • Weekly volume up by ~10–15% only [1,4].


Abort/adjust if: swelling that doesn’t settle, night pain that worsens, locking/giving-way, or ache >48h post run - that’s your cue to dial down or get reviewed [1].


Technique & setup that help

  • Shorten stride → less joint load per step downhill  [1].

  • Footwear: stable, comfortably cushioned pair that passes a 10–15-min test  [1]. Replace flattened soles  [1].

  • Surface: flat paths first; avoid cambered edges until you're stronger  [1].

  • Strength stays in even when the running time grows  [1,4].



Ready to run smarter with knee OA?




Prefer to talk? Call (03) 9978 9833



👉 Take my Knee Quiz if you’re unsure whether your symptoms need attention.




FAQs

Do I need a scan first?

Usually no. Use imaging when results would change the plan or if there are red flags (locking, hot/red swelling with fever, trauma).


Meds/injections?

Short-term analgesia can help you keep moving; talk to your GP about fit and risks. Injections can blunt irritability for some, but they’re not a stand-alone fix without load/strength changes.


What does a first session look like here?

History → movement/tolerance check → personalised plan → clear progressions.



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References

  1. National Institute for Health and Care Excellence (NICE). Osteoarthritis in over 16s: diagnosis and management (NG226). 2022. (Core treatments: exercise; imaging usually not required; safety/appropriateness of activity.)

  2. Lo GH, et al. Running does not increase symptoms or structural progression in people with knee osteoarthritis. Arthritis Care & Research. 2018. (Self-selected running not linked to worse pain or radiographic progression.)

  3. Fransen M, et al. Exercise for osteoarthritis of the knee (Cochrane Review). 2015; updated evidence page 2024. (Exercise improves pain and function; appropriate for OA.)

  4. Mo L, et al. Exercise Therapy for Knee Osteoarthritis: Systematic Review & Meta-analysis. 2023. (Multiple exercise types effective; supports pairing strength + activity.)

  5. Alentorn-Geli E, et al. Association of Recreational and Competitive Running With Hip and Knee OA. JOSPT.2017. (Recreational running associated with lower OA occurrence vs sedentary/competitive groups.)

  6. Alexander JLN, et al. Does recreational running cause knee osteoarthritis? Br J Sports Med. 2022. (Narrative overview: recreational running likely protective; elite exposure different.

  7. Bensa A, et al. Corticosteroid injections for knee OA: systematic review/meta-analysis. EFORT Open Rev.2024. (Clinically meaningful pain/functional benefit is short-term, waning by ~6 weeks.)

  8. Hawley S, et al. Effect of intra-articular corticosteroid injections for knee OA: instrumental variable analysis.2025. (Short-term pain reduction; contextualises expectations.)



Disclaimer

The content provided on this website is for general information and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.

While The Hip and Knee Physio strives to present accurate and up-to-date information, we do not guarantee results or outcomes based on the information provided. Any exercises, strategies, or recommendations featured on this site should not be considered a personalised treatment plan.

Always seek the advice of a qualified healthcare provider before starting any exercise program, particularly if you are experiencing pain, injury, or a pre-existing medical condition.

Use of this website does not create a physiotherapist–patient relationship. The Hip and Knee Physio accepts no responsibility for any injury or loss arising from reliance on or use of this information.

By using this website, you agree to these terms.




 
 
 

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