6 Must-Follow Tips for Running With Osteoarthritis

If you have osteoarthritis — arthritis that happens when the cartilage in your joints starts to wear away — in your hips and/or knees, you may find running difficult. As the cartilage thins, it can no longer absorb the friction, causing pain, stiffness, swelling and decreased range of motion.

However, that doesn't mean you have to end your running routine.

"The latest, best evidence supports that running does not cause osteoarthritis and that folks who exercise tolerate osteoarthritis better than those that are inactive," says Steven J Collina, MD, medical director at Sports Medicine of Central Pennsylvania-UPMC. "If you have osteoarthritis, you want to be consistent in your running program."

In fact, runners with osteoarthritis are less likely than those in the general population with osteoarthritis to require surgery, such as a knee replacement, per a November 2017 study in the ​Journal of Arthritis​.

As long as your doctor gives you the thumbs up, you can run with osteoarthritis. Here are some tips to help you find some pain relief and stay comfortable.

Whether you're running with arthritis in your feet, knees or hips, "when the foot is out of alignment, certain joints take up excess stress to help accommodate the force during our gait cycle," says Amanda Borrelli, DPM, a foot and ankle surgeon with Summit Health.

This is why she sometimes suggests that people work with a podiatrist to get fitted for orthotics.

"Orthotics help your foot function in a more anatomically correct position. When the lower extremity is properly aligned, it prevents strain and stress on those overworked joints, lessening the load," she says.

In addition, you can ask your doctor or physical therapist if you might benefit from using a joint brace or Kinesio tape for a more comfortable run. According to the Cleveland Clinic, using Kinesio tape limits your range of motion just enough to help relieve pain.

Running with arthritis in your feet, knees or hips can place a lot of strain on your joints, but strengthening the muscles around these joints may help you run with less pain.

Exercises, such as squats, lunges, side leg lifts, leg presses and hamstring curls can all boost strength and stabilization around your lower body. Dr. Collina also recommends doing core exercises, because strong abdominal and back muscles can help improve stability and support proper gait.

Stretching the muscles that surround your joints is just as important as strengthening them to help you manage your osteoarthritis while you run. When your muscles are tight, they can pull on the joints and cause more pain. In addition, having osteoarthritis can make your joints feel stiff.

Perform a dynamic warm-up before your run, then do some cooldown stretches, being sure to target your hamstrings, quadriceps, piriformis (deep butt muscle) and calf muscles.

According to the Arthritis Foundation, some surfaces are better than others for running with osteoarthritis. Softer terrain, such as grass, dirt and sand, treadmills, as well as water running in a pool can all reduce the impact on your joints.

To do water running in a pool, find a lane, slip on a special flotation device that keeps you upright and your feet off the bottom of the pool (such as this AQUA Fitness Deluxe Flotation Swim Belt). Then mimic the motions of running with your arms and legs. You'll score a workout similar to running but in a "weightless" format.

If you have pain that's prohibiting you from running, consider swapping in other cardio options like cycling, swimming or using the elliptical, Drs. Borrelli says.

"Low-impact activities like this allow you to maintain your endurance and help prevent overuse injuries," Dr. Borrelli says. "Even with the onset of osteoarthritis, maintaining an active lifestyle without pain is much more beneficial both physically and mentally for the running enthusiast than succumbing to a sedentary lifestyle."

Balancing your workout routine with running, strength training and low-impact cardio can also help runners with osteoarthritis stay on their feet longer, Dr. Borrelli says.

According to a January 2020 review in ​Archives of Rheumatology and Arthritis Research​, weight gain can play a role in the development of osteoarthritis, but endurance running can help manage your weight and prevent osteoarthritis.

Whether you're running with arthritis in your feet or hips, discuss with your doctor if losing weight might help alleviate symptoms of osteoarthritis.

No matter what your weight, adopting an anti-inflammatory diet, such as the Mediterranean diet, and limiting ultra-processed foods might also help you find relief from your osteoarthritis symptoms by reducing inflammation.

While you might imagine knee osteoarthritis and running have a direct connection, running doesn't cause osteoarthritis. Joints are actually bolstered by activity and weakened by inactivity, which is partly why osteoarthritis is correlated with advancing age.

If you've been diagnosed with a mild or moderate case of osteoarthritis, running with arthritis in your feet, knees or hips can be helpful in certain cases.

"The current research suggests that running, within reason, does not worsen osteoarthritis symptoms," Dr. Borrelli says. "The benefits to maintaining your cardiovascular health and muscle strength that come with endurance training or running outweigh ceasing activity altogether."

But just because running — even long distances — doesn't trigger osteoarthritis, it doesn't mean it's always the best idea to combine the two. Running with bone-on-bone contact isn't recommended, so be sure to talk to your doctor before exercising again after you've been diagnosed with osteoarthritis, as well as before making any changes to your fitness routine.

"When the arthritis has progressed to the point that there is little or no cartilage in the joints, running or high-impact activity may be painful," Dr. Borrelli says. "If it is painful, running accommodations may have to be made, such as decreasing the length of run, cross-training or a change in shoe."

Early diagnosis is key to receiving a treatment plan that can alleviate pain and slow the progression of osteoarthritis. You may need an X-ray or MRI in order to fully assess your health status. And if your osteoarthritis is severe enough, you may need to take a break from running for a bit. In some cases, your doctor may recommend physical therapy or joint surgery first to relieve your symptoms.

All that said, it might not be arthritis at all. Many of the signs and symptoms of osteoarthritis can overlap with other issues, which is why seeking expert input is crucial.

"I see a lot of patients who assume it's arthritis, but there are other causes of pain. Among runners, stress fractures are particularly common," Dr. Collina says. "I suggest finding a sports medicine physician who is a runner or other type of endurance athlete who understands your unique needs."