Research Study: Can Marathon Running Improve Knee Health in Adults?

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Is long distance running good for your knees, or bad for your knees?

A recent research study[1] posted in the BMJ Open found some surprising results.

The general thoughts on running and knee health, especially for older adults tends to go back and forth with some studies saying that repetitive movements are too jarring and cause too much impact to knees, ankles and other joints while other studies have concluded that the damage is minimal and that running can be safe if done correctly.

In this long term, cohort study researchers attempted to prove that longer term running (i.e. marathon running) did not cause excessive damage to the knees and that it could, in fact, improve knee health.

The technique of breaking up exercise into short "snacks" instead of long workouts is known as Exercise snacks. It has been shown to lead to measurable increases in cardio fitness - even when done infrequently.
Is running good for your knees?

What is a Cohort Study?

A cohort study is one that uses a group of people (the cohorts) with one or more common factors in a preset time frame to see if the study’s theory is proven or not proven. In this case, the theory was that marathon running could actually improve the damage to the knees of the participants.

Who Were the Participants of This Study?

For the study, a total of 82 adults were used. All were determined to be healthy before the training and the actual marathon. MRI images were taken of the knees of each person 6 months before the training period started and then shortly after the end of the marathon for comparison.

The ages of the participating adults ranged from early twenties to early seventies. All had additional testing including cardiac workups to ensure their health. Each also had to be a new runner who had previously never ran a marathon with most declaring themselves as mostly sedentary when they began. The study’s participants were given a training program to get ready for the marathon as well.

What Were the Conclusions of This Study?

Instead of being conclusive, this study created additional questions on whether or not running is “safe” or recommended for overall health and fitness. While it did show that some types of damage was actually helped by running the marathon it showed that the race caused other types of damage to occur at a higher rate in these participants. The study’s authors did acknowledge the limitations to the study including whether the new areas of damage would have happened in an established runner or not.

Another question that arose during the study was whether or not the improvement could be considered long term or not.

Practical Applications For This Information

Whether the improvement is caused by the basic improvement of fitness and strength simply be ending the sedentary lifestyle could not be determined but getting some type of exercise is better than nothing for most people.

Getting off of the couch and running a first marathon in 4 months time might be too much to expect for most so a smaller change is in order. Trying to go for a slow paced, longer distance run once or twice a week and gradually adding in more time, more speed or more sessions is more sustainable for most people and may allow them to monitor changes in their fitness as well as the overall health of their joints from day to day.

Running and Knee Health – In Summary

Even if you never plan to run a marathon, you can incorporate running into an overall balanced fitness routine using slower paced, longer distance runs to start with and then increasing. You may be improving your joint health while also improving your cardio fitness and overall outlook on life.


1. “Can marathon running improve knee damage of middle-aged adults? A prospective cohort study”

Running on a treadmill in the gym
Running on a treadmill