Worried that running will wear out your knees? Neurologist reveals 7 evidence-based ways to protect them

Neurologist Dr Kumar highlights the importance of exercise for knee health and addresses common misconceptions about how running affects the joints.

Running is one of the most low-effort and high-impact exercises one can incorporate into their daily life to stay fit and healthy. However, many don't take up running because they fear it will impact their knees.

On August 12, Dr Sudhir Kumar, a neurologist at Apollo Hospitals, listed 7 evidence-based ways to protect your knees and hips in an X (formerly Twitter) post. According to him, if you are worried that running will ‘wear out’ your knees, you should know that ‘this is one of the most persistent myths about osteoarthritis (OA)’.

Here are 7 evidence-based ways he recommended to protect your knees and hips:

1. Keep moving

According to the neurologist, walking, cycling, swimming, and other aerobic activities are good for your joints. He stressed, “Exercise does not 'wear out' healthy joints.” In fact, he noted that regular exercise is one of the best-supported strategies for maintaining joint function and reducing OA-related pain and disability.

2. Running is NOT necessarily bad for your knees

“Recreational runners do not appear to have a higher risk of knee or hip OA than sedentary people. Some studies find lower OA occurrence among recreational runners. The concern is more relevant to very high-volume or high-intensity running, previous major joint injury, and certain individual risk factors,” Dr Kumar underlined.

He also stated that ‘running destroys your knees’ is a myth, and sensible, progressive running is generally fine for healthy joints.

3. Strength training may be your knee’s best friend

Dr Kumar highlighted that strength training may be your knee’s best friend; in fact, building muscle around the quadriceps, hamstrings, glutes, calves, and hips, and strengthening these muscles, improves joint function and load tolerance. “And you don't need a gym; squats, step-ups, lunges, resistance bands and other progressive exercises can work,” he added.

4. Maintain a healthy weight

This is particularly important if you are overweight or obese, according to the neurologist. “Excess body weight increases mechanical loading on the knee and hip and is an important modifiable risk factor for OA,” he explained. Therefore, if you are overweight, weight loss and exercise are a powerful combination.

5. High-impact vs low-impact exercise: which is better?

There is no single ‘best’ exercise for everyone, according to the neurologist. “Walking, strengthening, neuromuscular exercises, and aquatic exercises can all be useful. Current guidelines do not establish a hierarchy in which one type is universally superior. The best exercise is often the one you can do consistently and progressively,” he explained.

6. What about calcium, vitamin D and protein?

Adequate protein, calcium, and vitamin D are important for overall muscle and bone health. However, the neurologist stressed that ‘important for bones or muscles’ does not mean ‘prevents osteoarthritis.’ “There is no good evidence that routinely taking calcium or vitamin D supplements prevents knee or hip OA in people who are not deficient,” he added.

“Supplement when there is a genuine indication; not simply because you have reached a certain age. Similarly, adequate protein supports muscle maintenance, but protein supplements are not proven to be OA-preventing drugs,” the neurologist stated.

7. What if you already have knee pain?

If you already have knee pain, the neurologist advised that one shouldn't automatically stop exercising. “For most people with knee OA, exercise is part of the treatment, not something to fear. Walking, cycling, swimming and strength training can often be modified according to symptoms,” he explained.

The neurologist added that even people with OA can often continue running, provided the condition is appropriately assessed and running is introduced/continued progressively. However, if pain is persistent, swelling is significant, the knee locks/gives way, or symptoms are worsening, you should get assessed.

5 myths to remember

The neurologist also underlined five myths one should remember:

• Running causes knee arthritis.
• You should rest if you have knee OA.
• Only low-impact exercise is safe.
• Calcium and vitamin D supplements prevent arthritis.
• Once you have OA, exercise will further damage the joint.

Lastly, he stressed that the truth is your joints are designed to move: “The goal is not to avoid loading your knees and hips. It is to load them appropriately, build strength, maintain a healthy weight and avoid preventable injuries.”

Dr Sudhir Kumar is a veteran neurologist at Apollo Hospitals, Jubilee Hills, Hyderabad. With over 26 years of experience and qualifications including MBBS, MD (internal medicine), and DM (neurology), he treats a wide range of conditions such as dementia, ALS, cerebral palsy, back pain, Canavan disease, and more.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

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