The runner’s high might be contagious. In 2024, fitness tracking app Strava recorded a 59% increase in users attending social running events and run clubs globally. Applications for London’s marathon have increased 40% since 2024, while New York City’s received about 20% more applicants this year. Overall, an estimated 56 million Americans regularly run on a treadmill and 51 million jog, according to a report from the Sports and Fitness Industry Association.
But running has a reputation for being rough on our joints. There is some good news for those chasing the high: one 2023 study found little relationship between recreational running and arthritis of the hip or knee, and another suggests that the impact of running causes cartilage to adapt, fortify and thicken over time.
However, for those with existing joint issues, other cardio activities may be better alternatives. Here’s what experts say about running, joint health and good alternatives.
How does running affect lower-body joints?
Running is a full body activity, but some areas are more affected by it than others.
“Most people come in with knee issues,” said Lauren Borowski, a primary care sports medicine specialist at NYU Langone’s Sports Medicine Center. Pain in the hips, ankles, feet and low back are also common.
“When running, you’re essentially landing in a single leg squat, and it’s a lot of repetitive pressure. It’s three to four times your body weight in every step,” Borowski said. “When the muscles are not ready to receive the extra weight, [the impact goes] more directly to the bones and the cartilage.”
What can make a joint unhealthy or painful?
“Unhealthy” joints can show up as a variety of things. Injuries such as a torn meniscus in the knee, hamstring strains, ankle sprains, Achilles tendinitis, shin splints, plantar fasciitis and stress fractures can make running painful. So can “osteoporosis or osteoarthritis, where the bone tissue is starting to break down”, said Dr M Claire Coopes-Meske at Good Reps Physical Therapy.
With conditions such as rheumatoid arthritis or arthritis related to inflammatory bowel disease, there is “a lot of known inflammation that’s attacking [the] cartilage”, Borowski said. Broken down cartilage further exposes the bone to stress.
Some pains are legitimate cause for concern and need attention from a healthcare provider. Alexis Colvin, orthopedic surgeon at Mount Sinai hospital and the chief medical officer of the US Open, recommends seeing a doctor sooner rather than later “if the knee is swollen or the pain is really persistent even after a day or two and it’s affecting their regular activity” – or if you are constantly taking painkillers to try to mitigate the pain.
Which cardio options are easier on the joints?
Motion is healing and essential for healthy joints, said Coopes-Meske. “Any time we’re moving a joint, [synovial] fluids are released into the joint space that provide nutrition and lubricate the joint.”
Additionally, diversifying your exercise is essential for general health. Borowski recommends focusing on four categories: strength training, for the muscles; cardio respiratory exercise, which strengthens the heart and lungs; balance work; and mobility and flexibility training.
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If the impact of running is inhibitive for you, experts recommend the alternatives below to help you dodge physical stress on your bones and cartilage:
Cycling: If the knee cannot withstand the impact of running, biking is an option. “It’s a really great tool for range of motion,” Borowski said. Cycling stimulates the production of synovial fluids and allows for a range of leg extension. Coopes-Meske pointed out that people can adjust the resistance, speed and distance to vary workload. Increasing these measures requires more from muscles without the additional stress of impact on the joints.
Rowing: Rowing is also great for those who are looking to avoid joint impact but may not be ready for weight bearing exercises. It offers a greater range of motion than cycling, depending on how much your knee can bend. If your range is limited, modifications are available. For instance, on a rowing machine, you can adjust how much your knees are bent in the starting position and how much you straighten them when driving your seat back, making for a shorter stroke.
“The intensity, resistance and speed can also be adjusted based on their capabilities as well,” Coopes-Meske said. Rowing requires a lot of work from the hips, core and upper body, so its benefits go beyond the legs.
Swimming: For those with bone or cartilage issues that experience a lot of swelling, swimming is a great cardio option, said Coopes-Meske. It’s a full body workout and puts minimal stress on the joints. It’s excellent for building lung capacity and heart strength, and there’s an added bonus for swollen joints: “The hydrostatic pressure from the water can help push the swelling out of that area,” she said.
It doesn’t do much for bones or muscles, or from a strength standpoint, because water doesn’t provide much resistance, said Borowski: “But it’s great for mobility and range of motion of those joints.”
Incline walking: Incline walking reduces load on the joints while increasing heart rate. Unlike swimming, cycling and using the rowing machine, walking is a load-bearing exercise because you’re supporting your bodyweight against gravity while on your feet. “We still want to load those bone tissues, because the body starts to rebuild those areas and help build up the bone as well,” Coopes-Meske said.
Load-bearing exercises are important because the physical stress stimulates bone-forming cells to produce new bone tissue. This increases their density, which can slow age-related bone density loss and help with osteoporosis. “We still want to load those bone tissues, because the body starts to rebuild those areas and help build up the bone as well,” Coopes-Meske said.
Walking, however, avoids the harsh impact of running, and doing it at an incline gets your heart rate up quicker. Depending on whether you are using a treadmill or walking outdoors, you can also adjust the speed and incline depending on your symptoms, capabilities and the terrain.
Rollerblading, ice skating or cross-country skiing: Booted activities such as rollerblading, ice skating and cross-country skiing can be good alternatives for those with injured or weak ankles. “The boots come up much higher on your ankle, providing extra support,” said Coopes-Meske. Running and walking both involve heel strikes – the initial contact your heel makes with the ground. These activities eliminate the impact from heel strikes and focus on continuous gliding motion. They are great for strengthening the glute muscles, hamstrings and quadriceps, and deliver a full body workout with minimal stress on the knees and ankles.
Other options: As long as you are diversifying your movement and covering the four buckets Borowski referenced, many cardio alternatives are suitable. For instance, Latin, hip hop, house or ballroom dance classes and Zumba. (Skip ballet, which can involve high-impact leaping.) Be mindful of how much jumping is involved in any of these options, but there are typically lower-impact modifications for these movements. They are a great way to get your cardio in, mix it up and have fun.
