How Running on the Treadmill affects Knee Health?

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Whether on a treadmill or outdoors, running is a high-impact exercise that can be tough on the knees. 

Running on a treadmill is an excellent alternative to road or cross-country running. One does not have to deal with harsh weather conditions such as the wind, rain, snow, etc., while conditions underfoot are much better.

Of course, the treadmill’s running surface often is more forgiving than that of the road.

One may also find it easy to track speed, energy spent, and the distance covered. The fact still remains that treadmill running affects knee health.

Do consult a sports orthopedic specialist if one experiences discomfort and pain in the knees without further delay.

How does running on a treadmill affect the knees?

Running is a high-impact exercise that definitely adds a great deal of stress on the knees. Please bear in mind that knees are the joint’s complex system prone to injury due to the weight they are required to carry. 

The repetitive motion of running adds extra strain on the knees, even when using a treadmill for running. Though the ankles are the first contact point, the knees get more damaged. Since the knees are positioned between the ankles and hips, they are at a high risk of being injured.

Similarly, the knees are at stake of being injured even if one runs on their toes on the treadmill as they bend at a larger degree when the foot hits the treadmill. The knees have to absorb more force with every step taken.

Unlike running outside, the treadmill’s constant pace is unnatural. It leads to prolonged stress on the knee, which is detrimental to a person’s knee health. In the long run, heavy use of treadmill raises the risk of stress injuries to an individual’s knees. 

What are the most common knee injuries caused by treadmill running?

Running on a treadmill can cause several knee injuries such as :

Stress fracture of the tibia

A stress fracture of the tibia is a small crack in the shin bone. Overuse of treadmill can result in a stress reaction. If one starts to feel shin pain, they must ease off on the treadmill routine. Treadmill running leads to continuous pressure on the bone. The bone begins to crack, resulting in a stress fracture.

Cartilage defects of the knee

Cartilage is the smooth surface covering the end of the bones. Its function is to assist in a smooth gliding surface and cushion the bone’s ends with weight-bearing. Cartilage defects of the knee may result from repetitive wear and tear due to treadmill running.

Chondromalacia patella (CMP)

Chondromalacia patella is damage to the articular cartilage. It is a chronic condition that causes the kneecap cartilage to soften and break down, resulting in pain and inflammation. It is caused by overuse of the knee while running on a treadmill.

Ligament injuries

Ligaments are bands of tough, elastic connective tissue surrounding a joint to support and limit the joint’s movement. When ligaments are damaged, the knee joint can become unstable. Ligament damage usually happens from the overuse of treadmills. A torn ligament can limit knee movement resulting in the inability to turn, pivot, or twist the leg. 

Treatment options for knee injuries caused by treadmill running


Rehabilitation of a knee injury caused due to treadmill running is done in a criterion-based progression. It is based on individual progress from one stage to another and not on a prespecified period. Most rehabilitation program’s include muscle strengthening regimens.

Kinesiology tape 

Kinesiology tape is a practice that is used to relieve knee pain. It is also used to improve knee support, which can treat and prevent various injuries. The practiceinvolves applying a special tape around the knee in specific locations. It is said to manage pain by controlling joints and muscles.

Platelet-Rich Plasma (PRP)

Platelet-rich plasma (PRP) is a treatment for managing pain related to osteoarthritis (OA) of the knee. The platelets in the blood have growth factors. Injecting PRP growth factors from a person’s blood into their injured area will allow the tissues to repair themselves by encouraging new cell formation. In this way, PRP can help reverse existing tissue damage.

Stem cell therapy – Stem cell therapy utilizes the body’s healing mechanisms. It helps repair and slow the deterioration of body tissues, such as cartilage.

Stem cell therapy for knees aims to:

  • Slow and repair damaged cartilage
  • Decrease inflammation and reduce pain


A person may require surgery to treat a knee injury. Conditions such as major cartilage defects and erosions may require surgery. One must consult their doctor to find out if surgery is the right option.

 How to preserve knee health while using a treadmill?

Do check the treadmill for the following features before running on it 

  • Shock absorbing capacity of the belt padding of the treadmill
  • Sufficiently long and wide running surface for natural running stride

Both these features significantly reduce the risk of injury to the knees. 

Remember – Always run in the middle of the treadmill for natural strides.

Duration of run on the treadmill

A single running session of 30 minutes on the treadmill is adequate. Running longer than 30 minutes causes stress to the knees.

Warm-up before running 

It is necessary to have a short 5 minute warm up session of jogging or jumping jacks. This warm-up session ensures the muscles are stretched well for a run on the treadmill. Also, repeat the warm-up session after the run to retain the flexibility of the knees. 

Pay attention to running posture.

Develop and have a more natural, forward-leaning posture when running on a treadmill. 

Set run targets sensibly. 

Focus on having longer but slower runs on the treadmill rather than for one’s best pace. A natural stride will cause fewer knee issues rather than a speedier stride. 

Pay extra attention to footwear.

Shop for shoes that promise a stress-free run on the treadmill. Try them out and on the treadmill too. Seek help from the sales staff to wear them and make adjustments for the best and comfortable fitting experience with adequate support. 

Suitable footwear, especially running shoes, goes a long way in easing the pressure on the knees and the body.

Try to go for slow speed walking on a higher incline rather than sprinting on a treadmill. One can also opt alternative options like cross trainer and cycling.

It is safe to run on the treadmill, provided it is done attentively and in a well-phased manner. For a pain-free run on the treadmill –

  • Develop a less impactful running style.
  • Pay attention to the shape, posture of the body
  • Observe the after-effects on the knee and the rest of the body after running on the treadmill.

Dr. Ratnav Ratan
Dr. Ratnav Ratan
Pediatric Orthopedist and Sports Medicine specialist

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