Are bad knees inevitable?

Hey, Marsh, I have a question. Recently, I was disappointed to learn what has happened to a friend of mine, since we’ve swapped great stories about  running marathons, ultras, etc. through the years. He’s 70 years old, and he explained to me that he has simply worn out the cartilage in his knees from the thousands and thousands of miles he  has run. Now, he can’t run at all.

Is this what you and I can expect later on if we keep on running?

–Bill P.

Bill, unfortunately for your friend, much of his problems are how he is  genetically predisposed. I would strongly suggest, for you, getting  a pair of well cushioned shoes, such as many models available from Altra. I also have a friend who is about 60 years old and had to stop running and  started biking. He put on a pair of good, cushioned shoes, and he is back on the  trails.

It’s a complex question that you asked, but let me share a story  with you: when I was about 40 years old I went into the doctor for a  meniscus trim (that was not necessarily caused by running). He took  a MRI of my knee … fast forward 15 years and about 50,000 miles of  running. I was running trails hard and doing some down jumps when my  knee started hurting again, so I went into the same doctor. He took  another MRI and found that one of my knee bones had been bruised.  Now here is the funny thing about it all: He had kept the old MRI and  compared it to the new one. He asked and wondered if I had stopped  running (though he knew better), as the cartilage looked exactly the  same 15 years and 50 K miles later.

So the answer is this. Take care of yourself and buy some great  shoes that will help you maintain your joints (barefoot/forefoot  running will not help unless that is YOUR natural style of running).  Glucosamine/chondroitin supplements are a good thing and also will help you maintain healthy joints. Don’t overdo, and take rest periods. I traditionally take a couple of months off during the  winter and don’t run, but might bike, or you can swim, too. The rest  is out of our hands, but I say we owe it to ourselves if we want to  run, it’s about quality of life. I am of the opinion that  we should use our God-given talents to the fullest extent that we can, no matter in what field we choose.

Hope this helps!

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10 Responses to Are bad knees inevitable?

  1. Bob Shaw says:

    Hi Marshall,

    Long time no see/talk to….I like you can easily relate to this issue. Since I have been running for 54 years and doing ultras and marathons for the past 37 years, I feel that if you take the time to get the proper shoes for your foot and abandon any shoe that causes pain, the knees will not “wear out”. I just has x-rays of my knees this year as part of my physical and they show no signs of wear and tear. This is after 110+ ultras and marathons. My brothers who run have had no problems with their knees either. However, my bike riding brother has had multiple knee problems. FWIW.
    btw: trying my first pair of HOKAs. Did a 50k with them a couple weeks ago and they made the trails feel good.

    • Hi Bob,

      Great to hear your knees are holding up well. I agree that if a shoe is causing problems to get rid of them, right away. The Hoka theory of more cushioning is good — I believe it will be the new logical approach to making a great shoe for any manufacturer. In all fairness, some of the midsole materials have just now become available, and Hoka was smart to “get with the program.”

  2. Rob M says:

    Alright! I’m convinced its time to pick up some Hoka’s. Lots of reading on their design, talking with friends that have made the purchase and now the coffin nail. Okay, bad metaphor, but I’d like to run indefinitely. Great piece Marsh.

  3. dee says:

    Interesting – but i think i need a stock response to people as i am ALWAYS told when people learn about my running ‘you’ll blow out your knees’. It’s really frustrating to hear that so much – particularly from older people who have never moved and have a host of health problems that i’ve never had!

    • Being inactive will kill you faster than being active, no matter what you choose to do. There are risks involved in doing just about anything we love, so the key is to DO them and not limit ourselves by paying attention to what others say and think.

  4. Bret says:

    I am a heal striker and usually wear stability shoes. I bought a pair of Hoka Stinson Trails and wore them on a 9 Mile trail run. My back, quads and calves were SOOO sore, especially my back. Is this normal? Will I get used to them over time? I am worried, I have not been this sore in a very long time. Any help is appreciated.

  5. Dianne says:

    I just found this blog by Googling the exact title! So glad you used that. I have not found a decent doctor, unfortunately I am in the Kaiser network. I am 56 I have been running for 30 years. I have never had knee problems until last year. I am not sure but I believe the problem started when I started wearing…Hokas! I noticed knee pain quickly but loved the ride so I backed off and did a very slow build up. I walked around in my Hokas and went for some shorter 3 or 4 milers a couple times a week and built up to full time wear over months. No knee pain, success! Following a 20 mile trail run with a lot of serious downhill the pain returned so I iced and stretched etc. Then after two days of back to back 13 milers the right knee became exceptionally bad. I went to a physical therapist and did everything we could think of to get me through an upcoming 50K which I ran slower but successfully. Then I went to a Dr. who basically said, “Yep you’re over 50 running is the worst thing you can do, stop running.” I stopped running for a couple months, walked and strength trained and then went back to running. Pain returned, No weakness, no swelling but pain and now that’s where I am today 10 months later. Two physicians at Kaiser have told me not to have an MRI! I am going to get one but I first need to find a doctor to trust to address my injury not my age and sport! I continue to look for information and that led me to your article. I am back in my Brooks Cascadias and Altras for short runs. I am terrified of my Hokas! 🙂

    • marsh says:

      Hi Dianne,
      Sorry for the late reply, but it has given you some time to settle back into Cascadias and Altras…did you find any improvement? That is likely the best test for you, is to go back to what DID work for you. Having said this, bad knees are mostly genetic, this is in my view and I’m not a doctor. I’ve seen some runners abuse their knees by running in badly cushioned shoes and they are fine, then others get killed by ANY shoe. I would look toward your form, do you pronate or over pronate? Do your feet track straight? Orthodics may be the answer and maybe the extra cushioning afforded by the Hoka’s allow your foot to flex too much. Strengthen your ankles and that may help too. Let me know how it is going as I suspect there is more to your problem than brands of shoes you are wearing. Case in point, I have a couple of friends who had to give up running because of their knees and have returned after wearing Hoka’s…they are very happy with them.

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