Running is the cardio of choice for many, but does the toll on your joints – the knees in particular – do more harm than good?

While every contact on pavement or grass jostle the knees as they support the body, Clifford Rios, MD, an orthopedic specialist with the Hartford HealthCare Bone & Joint Institute, said the benefits of running likely outweigh the risks.

“Running is a good means of improving and maintaining physical and mental fitness. That said, before initiating a running routine, it’s helpful to ensure that the body is ready,” Dr. Rios said.

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Run ready

That means checking in with your primary care provider on your overall health, and ensuring there is adequate flexibility and strength in the legs to reduce the risk of overuse injuries like tendonitis, he said.

“In addition, if there has been a prior injury or surgery to the knee, or possible wear of cartilage due to early arthritis, the higher impact nature of running could lead to pain and even progression of arthritis,” Dr. Rios explained.

Choosing your location doesn’t necessarily alter the impact of running on your knees, although he said uneven terrain on wooded trails and even grass can require more strength and balance. Novice runners, he urged, should start on a track or predictable surface.

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Sneaker choice

The sneakers you tie up before your run – and the socks worn underneath – are more of a personal choice than something to help or hurt your body, Dr. Rios added.

“People’s feet come in different sizes and shapes, and different brands may accommodate one foot type better than another,” he said. “If you have a question about which better fits your foot, there are numerous shops where they can do an anatomic assessment and provide shoe or insert recommendations.”

Equally important, he said, is using your running shoes only when you’re out for a run.

This protects the tread and cushion for when it is needed,” he said, adding that sneakers should be replaced if used frequently to maintain adequate protection.

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Signs of trouble

Pain, especially if it is increasing, is the first sign that something may be wrong in the knee, Dr. Rios said.

“This is especially true if it seems to be increasing, or takes a while to resolve. That could signal a developing problem,” he said.

Other potential signs of trouble are numbness or tingling in the leg or foot and swelling in the knee.

Run or rest?

“Pain around the knee or leg should not be ignored. Most runners can recognize the difference between muscle soreness that may follow a good workout and the pain that may occur around the knee or lower leg,” Dr. Rios explained.

If pain is transient and doesn’t seem to affect your ability to run, he said it is okay to continue your routine. However, if there is activity-related swelling, or the pain is escalating after similar levels of running, he suggested getting it evaluated.

“In addition, anyone with a known history of arthritis of the knee, or who had prior surgery to the knee where cartilage or meniscus tissue was removed, should seek medical advice about whether or not to continue running,” he said.

Medical advice

He also noted these other reasons to consider seeing a doctor:

  • If you have never been a runner or haven’t run in several years and you want to make sure there are no concerns with the health of your knee. You can do this before or while initiating a running program.
  • If there is pain, swelling or other symptoms that are affecting your ability to run.

“It’s much easier to address the problem early, when symptoms start, rather than waiting several months,” Dr. Rios said. “Often, earlier attention can prevent the problem from becoming more chronic and can lead to an earlier return to activity.”