Myth Busters: Does Arthritis Mean You Should Stop Running?

The Claim

A common belief is that running "wears out" joints, so once arthritis has been identified or seen on a scan, the sensible thing is to stop running altogether to protect what cartilage is left.

What the Research Says About Running and Osteoarthritis

The idea that running grinds cartilage away is not well supported. A meta-analysis of 25 studies found that the overall prevalence of hip and knee osteoarthritis was 3.5% in recreational runners, 10.2% in non-running controls and 13.3% in competitive runners. Recreational running was not associated with a higher occurrence of osteoarthritis, although the authors noted that it was not possible to say whether these associations were causal or influenced by other factors such as previous injury (Alentorn-Geli et al., 2017). Another systematic review concluded that the role of running in the development of knee osteoarthritis could not be determined from the existing evidence, which was mixed and of moderate to low quality (Timmins et al., 2017).

Studies that imaged the knee before and after running add some biological context. A systematic review and meta-analysis of MRI studies found that cartilage thickness and volume reduced slightly immediately after running, but these changes were small and appeared to be transient, which the authors interpreted as indicating that a single run is not detrimental to knee cartilage, albeit with very low certainty of evidence (Coburn et al., 2023). Cartilage appears to behave like a tissue that responds and adapts to load rather than one that simply erodes with use.

An Important Limit to That Evidence

It is worth being clear about what these studies do and do not show. Most of them ask whether running contributes to developing osteoarthritis in people who start without it. They do not directly answer whether a person who already has painful osteoarthritis should run. That question depends on the individual: which joint is affected, how symptomatic it is, how much running the person has been doing, and what other loading options are available. Inflammatory forms of arthritis, such as rheumatoid arthritis, are a different situation again and warrant medical guidance.

Load, Symptoms and Sensible Decisions

Across the broader osteoarthritis literature, the consistent message is that appropriate exercise helps rather than harms. A Cochrane review of land-based therapeutic exercise for knee osteoarthritis found high-quality evidence that exercise reduced pain and moderate-quality evidence that it improved physical function (Fransen et al., 2015). That review concerns exercise in general rather than running specifically, but it reinforces that avoiding load is not automatically protective.

In practice, decisions about running with osteoarthritis are usually made around symptoms and capacity. Gradual changes in distance, pace, frequency and surface, supported by strength work for the muscles around the hip and knee, give a joint time to adapt. Some people continue running comfortably, some modify the amount or switch part of their training to other activities, and some find running remains too provocative for now. A tailored assessment is the way to work out which applies.

The Verdict