Is running bad for your knees? | Peter Attia and Adam Cohen

This clip is from episode #264 ‒ Hip, knee, ankle, and foot: common injuries, prevention, and treatment options with Adam Cohen, MD.

In this clip, they discuss:

- Does running and walking amplify forces at the knee?
- Is running good or bad for your knees?
- What is the inverted U-shaped curve of injury risk?
- And more

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About:

The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 90 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.

Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.

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[kevinandlisa]

1. Run on a variety of surfaces, not just hard surfaces.
2. Don’t skimp on shoes. Buy new ones every 300-500 miles.
3. Make stretching and mobility training a priority.
4. Take rest days.
5. And yes, have good running mechanics.

[EliteSimba]

Ive worked with hundreds of sedentary individuals with bad knees (never ran or really exercised). I also work with a ton of runners who are older and never had knee issues. Training smart, adequate strength, appropriate volume, form, lifestyle....all these matter. A lot of times people get hurt from running because they dont know how to train smart

[cherlgolja]

I’ve been a runner for over 40 years, body alignment is critical! Motion is lotion!

[cimarronMC]

It's important to make sure you have good strength throughout all those little muscles throught your leg for running, anytime a runner comes into our PT clinic with knee pain it's usually do to lack of muscular strength in the hips. Most patients that come in with total knee replacement, are out of shape and have been inactive for most there life, when an athletic person comes in with an ACL they recover so quickly

[Wavygravvy]

Foot strike is so, so important and commonly left out of this conversation. Solid 3 minute breakdown.

[boydrc]

Yep.. 2 meniscus repairs and now a TKR (Total Knee replacement) means my marathon days and running in general are over. After 19 Marathons and lots of half marathons along a 30 year journey means at 60 years of age, we are forced to slow down. We now walk a lot, bicycle riding and Gym exercises to keep the fitness going.. Thanks for the report as people kept telling me my knee issue was caused from the running...

[flynnoflenniken]

My dad has bad knees, and he firmly believes it's from years of long distance running on pavement, so I generally avoid that since I have half his genes. I still exercise, but I mostly do lower impact stuff like lifting or swimming or rucking. Yeah, I'm sure it's fine if you have good form or run on grass, but running's not the only exercise out there, so I don't think it's worth the risk for me personally. If you really love running though, by all means go for it. Don't let fear hold you back from doing what you enjoy. It's fantastic exercise, and I'm sure it's fine as long as you're careful and smart about how you do it.

[opusdei]

I've started running on a bad knee (lateral bulging disc) 12 months ago and while it aggrevated the knee especially on longer runs, I'm now mostly pain free.

My approach is to limit length and intensity so my knee is slightly challenged but not hammered eg. keep my runs below 45 mins.

Also I switched my gait to land on the front/mid foot rather than herl striking. This dramatically reduces impact force into your bones from the foot to your neck but your calves will be very sore, so start with gentle short runs.

I run mostly on the beach or grass for a softer surface.

I'd also recommend eating plenty protein (meat/eggs) and have been taking Glucosamine+msm daily but efficacy has not been not proven.

[danmcarthur]

I had a hip replacement at 37 and am now running sub 30 minute 5kms again pain free. Not sure if this will be bad for me but man does it feel amazing to be active again. I do some road running but mostly stick to the treadmill and have big fat ON running shoes which I feel are helpful

[derekjolly]

I used to run regularly when I was younger, from 22 (Outside of forced exercise before that.) to 47 when I dropped it. It was a mistake as I lost a lot, most of my fitness and gained weight. I got back to bikes after a few years of being off running and stopped the slide and corrected for ten pounds from merely light riding almost entirely. Last year at 59 I picked up road biking again, ramped up cycling massively, got myself adjusted back to a very lean frame, 154 pounds, good endurance and stronger. At that point a few months back, running again seemed reasonable. Even though I had my wind and was back to proper condition, there's always that adjustment back to having the legs right for running. The point is, now that I'm back at that, alternating with cycling, I feel at least slightly better than just months ago, especially with back and legs, the added conditioning from running making the difference. The only thing I have to watch is my weight, which is down to 150 pounds and under, the last few pounds being attributed to the running. I eat big meals, big breakfasts, lots of fats, lots of meat, and that's not optional either. At sixty now, and re-naturalized to distance running, it's nothing but an improvement with everything, joints and knees included. If anything it's made me more together and back to my younger self entirely.

[AlexBlack]

I’ve had four knee surgeries in four years and battled chronic pain for seven years. I ruptured ACLs, MCLs, and both meniscus during an AFL game at age 16, leaving professionals doubting I’d ever run again. Today, I’m an exercise physiologist and have completed a 21 km run followed by a 90 km ride for charity, and I’m training for my first marathon in October.

Is running bad for your knees? It doesn’t have to be. Here’s what worked for me:
• Mobility to reduce inflammation and reduce joint strain.
• Strength training, especially around the knees, was crucial.
• Listening to my body—knowing when to push and when to rest.
• Gradual progression, not rushing the process.

Running has strengthened my knees and improved my joint health. With the right approach, it can be a powerful tool for recovery and growth, even after serious knee injuries.

[EvaSawicka]

I'm the only one in my family that has run more than a 5K.
In fact, I've run more than 40 marathons, countless 1/2 marathons, 10Ks, etc.
I've hiked 500 miles across Spain with a backpack.
And I'm also the only person in the family that has never had back pain.

[virtualathlete]

Good form matters for injury prevention.
Why I love Chi Running … we focus on good posture & alignment.

[notagain]

I gave up running before many on here were born which was 1980. There weren't that many shoes available back then and we used Goo to build back the heels which was a big mistake. Now, I cycle for exercise and being clipped in on a bike keeps your form aligned so pronation is eliminated.

[cesarzoghbi]

I have been running since I was 14 years old. I am currently 52 years old and I run between 50/100 km a week, I have done hundreds of races and I have not suffered a knee injury since I was 20 years old!!

[gzfashions]

Ground contact time and quick twitch fibers are key.

The longer the foot strikes the ground even by milliseconds the more shock is sent through the skeletal system. Which will then challenge the integrity of the fluid in between joints over time. I have been running 1000+ miles since 2016 each year. The only time I noticed I get injured is when I don’t cross train and I skip weight training.

Also, I noticed my joints get a little sore and tight when I avoid doing stretching, proper warm-ups, cool downs, and also Avoiding yoga can definitely cause injuries in the world of running.

[DBASSDAN]

Destroyed my knees, extreme difficult to come to terms with giving up something you love doing so much, yet it was the very thing that ended it all.

[joesph]

I love running, it is my favorite exercise. I believe that for most of us it will cause issues with age. Most people, myself included don’t have perfect form and the perfect form is what is needed to avoid the hip, leg and foot issues that occur over time. I seem to recall Peter Attia knows this which is a reason why he doesn’t run anymore. I will continue to run to complete a few final Ironmans and then move to walking. I would love to be wrong about my opinion on this subject.

[richardbennett]

The only thing I would add is that you must have the right nutrition for repair.

[cesarzoghbi]

I have noticed that with years of training my knees are much stronger! And I am not light, I weigh between 155/165 lbs depending on the season! I have good running technique and good general health.