Does marathon running damage bones and joints?

AI-generated illustration. Based on a photograph of Prof. Dr. Gürkan Özkoç; it does not depict an actual event or patient consultation.

There is no single answer to “Will running wear out my knees?” Recreational running and intensive competitive training are not equivalent. Previous injuries, muscle strength, recovery and the way training load increases all matter.

What does research show?

A systematic review of running and hip and knee osteoarthritis found a lower prevalence of osteoarthritis among recreational runners. Most of the evidence was observational, however. It does not prove that running protects everyone from arthritis, or that every distance is safe for every person.

How should pain be interpreted?

MRI findings should be interpreted alongside symptoms and a physical examination. Conversely, recurring pain at a specific point on a bone, pain that increases with loading, or pain that persists at rest should not simply be dismissed as “normal for athletes.” A bone stress injury may need to be investigated.

Increasing distance and pace gradually, including strength work and allowing recovery are sensible principles. Rather than continuing to run through pain, reducing the load and seeking assessment can help you keep exercising in the longer term.

Sources

• Alentorn-Geli et al.: Running and osteoarthritis (2017)
• AAOS: Nonunions

This article provides general information. Individual diagnosis and treatment require a clinical assessment.