Exercise Is Running Bad for Your Knees?


Are you passionate about running but concerned about its impact on knee health? Delve into the comprehensive exploration of running’s effects on knee joint cartilage. This systematic review and meta-analysis dissect key factors such as cartilage oligomeric matrix protein (COMP), cartilage volume and thickness, and T2 relaxation time, shedding light on whether running contributes positively or negatively to knee articular cartilage. Whether you’re a dedicated runner or contemplating taking up this sport, understanding its influence on knee health will provide valuable insights to help you make informed decisions about your running routine. Uncover the science behind the relationship between this sport and knee cartilage.

The information on this page is based on data collected from numerous peer reviewed research articles.

Below is a summary of the research methods, data, and conclusion of the article, The Effect of Running on Knee Joint Cartilage: A Systematic Review and Meta-Analysis and the answer to the question Is Running Bad for Your Knees?

The Answer

No, moderate running may actually promote the integrity of knee cartilage. While running may have some short-term impact on specific cartilage biomarkers, the overall effect on knee cartilage seems to be relatively minor. The results imply that moderate running may promote cartilage health by facilitating nutrient exchange and eliminating metabolic substances. The article acknowledges the complexity of the issue and highlights the importance of further research for a more comprehensive understanding of the relationship between this activity and knee cartilage health.


This study highlights the popularity of this sport as a low-cost, accessible sport with numerous health benefits, including disease prevention. The controversy in existing studies regarding the impact of it on cartilage is noted, prompting the need for a systematic review and meta-analysis. The study aims to clarify the relationship between running and knee cartilage health, examining COMP levels (, cartilage volume and thickness, and T2 relaxation time. The ultimate goal is to provide valuable insights for individuals uncertain about the potential positive or negative effects of this sport on knee articular cartilage.


The study followed the PRISMA guideline for systematic reviews. The search, conducted in November 2020, included four databases using specific terms related to running, knee, and cartilage. Inclusion criteria involved English-language articles, RCTs or cohort studies on healthy humans, with at least one group engaged in running. Outcome measurements included COMP, cartilage volume, thickness, or T2. Exclusion criteria encompassed knee injuries, surgical history, and retrospective studies.

Data extraction covered various study aspects. Meta-analysis, performed using Review Manager 5.3, assessed mean differences with 95% CIs for continuous outcomes. Heterogeneity was evaluated with I2, and fixed- or random-effect models were applied accordingly. Sensitivity or subgroup analyses were conducted for substantial heterogeneity. Outcomes included COMP, cartilage volume and thickness, and T2. Subgroup analyses considered timing after running, running duration, and mean age.

Methodological quality assessment employed the GRADE approach, categorizing evidence into high, moderate, low, or very low quality. Two authors independently assessed study quality, resolving disagreements through discussion. This meticulous methodology provides a robust foundation for the systematic review and meta-analysis, ensuring a comprehensive evaluation of running’s impact on knee cartilage.

COMP and Subgroup Analyses
  • COMP immediately or at 0.5 hours after running significantly increased compared to the control group.
  • No significant differences were noted at 1 or 2 hours after the run.
  • COMP decreased at 3 hours after running according to one study.
  • Subgroup analysis by duration (<30 min and >30 min) showed increased COMP in both subgroups.
  • Subgroup analysis by mean age (<30 years old and ≥30 years old) revealed decreased COMP in the <30 years old subgroup and increased COMP in the ≥30 years old subgroup.

Cartilage Volume and Subgroup Analyses

  • No significant difference in cartilage volume between the running and control groups.
  • Subgroup analyses by running duration (≤30 min and >30 min) and mean age (<30 years old and ≥30 years old) showed no significant differences.
Cartilage Thickness
  • Cartilage thickness significantly decreased after running.
  • No significant difference in T2 between the runners and control groups.
  • Sensitivity analysis, excluding one study, showed lower T2 in the runners compared to the control group.

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