Running After Knee Replacement: How To Do It Right

Running After Knee Replacement: How To Do It Right

A part of you knows that running after knee replacement isn’t necessarily wise. But another part of you tells you that you have to run, whether that be for fun, for weight loss, or for love of the sport.

You’re in a quagmire.

We’ll try to get you out.

Joint replacement itself is never an easy process. And this goes double for weight-bearing joints. These include the hips, ankles, and knees. Conflicting advice makes recovery even harder. Most doctors advise their patients to avoid high-impact sports. Other doctors encourage their patients to get up and moving.

Both suggestions are valid. On the one hand, doctors believed high-impact sports were dangerous to replacement joints. Doctors worried that high-stress activities would damage the replacement or loosen its connection to the bone. On the other hand, sedentary lifestyles lead to higher body weights. High body weight will put more strain on a body’s joints.

And while both points are valid, they can leave patients confused. Luckily, one piece of advice might not apply anymore. The materials and procedures used for knee replacement surgery have evolved in the last few years. And this evolution has changed a few things. One such change is the durability of knee replacements. They can handle more stress than they used to. In addition, knee replacement patients are getting younger and younger.

The procedure was once reserved for older people with severe arthritic pain. Doctors advised their patients to wait until their pain was unbearable. Only then would the doctor recommend surgery. But that’s no longer the case. Sports injuries, site-specific trauma, and early-stage arthritis are all treated with joint replacement. And improved surgical techniques mean that patients recover faster

Younger patients and easier recoveries have had an effect on medical advice. Doctors are still wary of high-impact sports. But physical therapists report more and more patients asking to run after recovery. Whether the patient was a runner before their surgery doesn’t seem to matter. The question is, how to safely run on an artificial knee.

The Risks of Running After Knee Replacement

It is important to note that running on a replaced joint does carry some risk. Experts can’t agree on how risky it is, exactly. But this article would not be complete without this disclaimer.

If an artificial knee becomes damaged or comes loose, it will have to be replaced. And secondary surgeries are often more complicated than the first surgery. They also have a lower success rate.

Knee replacement surgery always starts with a long conversation between patient and provider. The choice to run on an artificial knee is no different. Patients should always let their doctors know if they intend to run on a replaced knee. And the sooner, the better. This will set the tone for all future exchanges and ensure everyone is on the same page.

The doctor can also outline any risks specific to the patient. The patient should carefully consider these risks when making the decision to run.

Actually Running After Knee Replacement

There are few studies on the impact of high-stress sports on artificial knees. And many of those studies no longer apply due to advances in materials and surgical techniques. This, unfortunately, means that there are also few studies on exercise after knee replacement. Most of the available advice comes from runners who underwent the procedure themselves.

Athletes must consider this lack of evidence when deciding whether or not to run. The suggestions outlined below may help reduce the risk of injury. But running on an artificial knee will always carry risk. Only the athlete can decide if the benefits are more important.

Start Slowly

Recovery from knee replacement surgery takes time. It may be months before a patient is ready to walk. Once they can walk without pain, athletes can slowly move toward running. This may mean jogging a few steps one day a week. Or it could mean power walking until they reach a steady jog. Whichever route they take, the key is to start slowly. This will let the joint adjust to its new stress load. It will also help the surrounding muscles grow stronger which will protect the joint.

Focus on Full-Body Strength

Strong muscles protect the joints that they surround. This is why trainers always urge runners to hit the weight room. And it is even more important for runners who have had joint replacement surgery. Weight lifting also does more than strengthen muscles. It can help runners keep their body weight at an ideal level. This, in turn, reduces stress on the joints of the lower body.

Add in Resistance Training

The old advice states that high-impact sports may cause knee replacement implants to come loose. Some doctors are now challenging that idea. They think that implants come loose as the bone around it becomes weaker. But there is a solution! Resistance training helps to increase bone density. And the best part is that athletes can start even before they’re ready to run. Athletes can focus on their arms, core, or uninjured leg using machines. It’s a good idea to stick a trainer at first, especially during recovery. They can help athletes avoid injury

Focus on Form

Bad form can injure even the healthiest of runners. But when the runner has an artificial knee, bad form can ground them for good. Runners with artificial knees should have a trainer critique their form. Physical therapists can also do this if they work in sports medicine. It is important to note that this goes for power waking as well as running. Walking a mile and running a mile puts the same amount of stress on a joint. While walking is slower, the athlete ends up taking more steps. This means that form is important no matter what speed the athlete is moving.

Check Your Equipment

Runners with artificial knees may find that old running equipment is no longer comfortable. This is more likely if the runner preferred toe shoes, minimalist shoes, or barefoot running. Runners can blame their increased discomfort on the lack of shock absorption. Whether the runner’s shoes are worn out or never had much padding to start with is irrelevant. The less shock a shoe absorbs, the more stress goes into the joint. This, in turn, will put more wear and tear on the joint. It can also increase damage to the surrounding tissue or bone. Over time, this damage can permanently take a runner off their feet. Once the athlete is ready to run again, they should make sure they’re doing it with supportive shoes and appropriate knee braces.

Choose the Softer Side

There’s more than one way to reduce stress on a joint. Supportive shoes are only the first step. The second step is avoiding super hard surfaces such as asphalt or concrete. Runners should opt for padded tracks or dirt trails instead. These options are much softer which means the ground will absorb stress with each foot-fall. And, as with supportive shoes, this will lead to less strain on the runner’s knees.

The Bottom Line About Running After Knee Replacement

Athletes should not rush into running after knee replacement–or really, after any kind of surgery. They should weigh all the pros and cons to determine if it’s the right sport for them. Some athletes may find that running and elliptical machines are enough to keep them active. Both of these options put less strain on the joints. On the other hand, some athletes may find that nothing compares to the freedom of running. Ultimately they have to listen to their doctor and their body. Then choose the path that’s right for them.


  1. Runners World
  2. Stone Clinic