Impact of Running on the Risk and Progression of Knee Osteoarthritis: A Review of Current Evidence

This review evaluates the safety of recreational running for knee health, defining the “biomechanical window” based on the latest evidence (2020-2024). The available evidence reveals a U-shaped risk curve, indicating that moderate recreational running is highly protective against knee osteoarthritis (KOA) compared with both sedentary lifestyles and elite, high-volume running. In patients over 50 years of age with existing OA, running does not accelerate structural damage and effectively reduces pain when managed through gradual load progression (the “10% rule”). Recreational running is a safe, chondroprotective intervention. Clinical guidelines should favour individualized load titration over the unfounded discouragement of activity.