Have you just had a knee replacement, and you are wondering whether you can go back to running after a total or partial knee replacement.
Will it damage the new knee prosthesis? For this article I had to speak to some of the surgeons at my workplace about the subject and of course relied on research studies that have followed up people with knee replacement who have resumed running.
Happy reading!😀 and feel free to ask questions in the comments or share your own experience.🙏
Last updated: November, 2025. Written by Juliet Semakula, a diagnostic radiographer.
| Take home!Yes, it’s possible to return to activities like running after a knee replacement, though the consensus is that it’s generally discouraged due to the increased stress on the artificial joint.You should resume running very gradually, generally at least 3 months after the operation. |
Knee replacement surgery is designed to help reduce pain, restore mobility, and allow you to resume many of the activities you love.
The subject of running again after a knee replacement is controversial and debated among medical professionals and research studies.
Some believe it is possible to run again after knee replacement if you were able to run before the operation.
Also, other studies and subjective evidence suggest that running is achievable, because the implants being used nowadays are more durable than previously thought though in some cases it should be avoided.
A research study of over 4521 participants both patients and healthcare professionals analysed the issue of running again after knee replacement.
🟠54% patients and 45 % healthcare professionals believed that running long distance frequently increased the risk of developing knee arthritis.
🟠48% patients believed that running after knee replacement increased the risk of knee pain.
🟠38% healthcare professionals believed that running could cause joint replacement due to wear and tear.
Esculier,2022
Indeed, despite the presence of confounding factors, the occurrence of knee and hip osteoarthritis in recreational runners is 3 times less than in sitting nonrunners and 4 times less than in competitive runners
A history of running has also been associated with a 54% lower risk of requiring surgery later in life owing to knee osteoarthritis
Before returning to running, individual factors should be considered.
⚫Every patient’s recovery journey is different. Some may tolerate moderate impact better than others.
⚫ Overall health of an individual.
⚫ Weight.
⚫ The type of knee replacement surgery performed.
Research studies advocating for running after knee surgery.
Despite limited research, running after total knee replacement is gaining acceptance. A systematic review in some PubMed studies regarding running after Total knee replacement had the following observations.
⚫If you do still have pain, you should wait until your knee muscles and range of movement is ok.
⚫You can consider a gradual return to running at 6 to 8 months after surgery.
Faldini,2025
There’s an increasing body of evidence to suggest that running with a knee prosthesis doesn’t damage the prosthesis any faster if you don’t feel pain.
▶️Research studies against running after knee surgery (Faldini,2025)
A few research studies are controversial due to concerns about implant loosening if you go back to running after a knee replacement.
For example, cemented implants used during the implant are known to have durability issues at the bone-cement interface.
A study that analysed 150 younger patients (Kuster,2000) for a period of 5.8 years who returned to running after total knee replacement and hip.
⚫They found no increased loosening of total hip replacements in patients with intense sporting activities and concluded that there was no need to prohibit sport after total hip replacement.
⚫But one patient who participated in a marathon ran after total knee replacement despite being discouraged by the surgeon. The polyethylene piece broke at the 35-km mark due to severe delamination and destruction.
⚫And some patients complained having more difficulty with pain and discomfort during and after running.
Kuster,2000
▶️Speaking to a team of knee surgeons at my place of work about running again after knee replacement.
They had this to say.
The new implant technology being used now has improved and your knee can function normally like before the operation but running can still take a toll on the new joint.
Reasons given?
Running and even light jogging create repeated impact loads on the knee joint over time this can increase the risk of implant loosening or wear.
For that reason, he does not recommend running as a form of exercise after a knee replacement
He believes if you decided to go back to running after a total knee replacement, you should try to alternate activities such as power walking, swimming and cycling (that’s his opinion as a qualified surgeon)
▶️When to start running after knee replacement surgery?
Now you may be wondering when you can resume running after a knee replacement.
The decision to run should be made cautiously. While there are inspiring stories of patients returning to competitive running post-surgery, the general advice remains to proceed with caution.
It is important to consider both the load and knee flexion angle of the peak load you are going to apply to the knee joint before you think of returning to running.
Activities such as hiking or running may pose two main problems for a modern knee design.
1️⃣The loads can reach up to 8 or 9 border width
2️⃣The peak loads occur between 40 and 60° of knee flexion
Regular running or hiking with intense downhill walking produces a large, overloaded area that may endanger the polyethylene inlay of most current total knee prostheses (Kuster,2000).
Before encouraging the progressive resumption of running, check with your physiotherapists to check if you can perform the following without pain and swelling.
♦️You can walk for several days or weeks for more than 30 minutes.
♦️You can perform at least 4 squats on one leg to 90% of knee flexion.
♦️You can run on the spot for 25 minutes.
♦️You can hop on one leg for 15 minutes.
♦️Then try to focus on exercises to build the strength and flexibility of your quadriceps, hamstrings, and calf muscles to support your knee.
If after all these, you do not feel any pain or discomfort then you can gradually start running with gentle short runs and gradually increase your intensity and duration.
Some people who have gone back to running after doing all that, report no knee pain. You can try doing this under the supervision of a physiotherapist to see how you feel.
▶️Will running damage my knee replacement?
As we have seen in most research studies running is generally not recommended after a knee replacement because of these reasons.
♦️Risk of implant failure and loosening.
♦️Risk of falls: High-impact sports also carry a greater risk of falling, which could severely damage the new joint.
♦️Increased wear and tear over time.
It’s been noted that low-impact exercises such as:
♦️Swimming.
♦️Cycling.
♦️Using an elliptical trainer.
All these are excellent ways to maintain cardiovascular health without stressing your new knee.
Some researchers think cycling and power walking seem to be the least demanding endurance activities for the knee joint (Kuster,2000).
▶️How long after knee replacement can I consider running?
Based on patients I see after a knee replacement, they are normally instructed by the surgeon:
♦️To make sure they are pain free and can move freely the operated knee without discomfort before they think of running again.
♦️To build strong leg muscles and movement control to help minimise stress on the joint by walking several tens of minutes before running.
♦️To start with light jogging between 6 to 12 months post-surgery.
♦️A full return to high-impact activities is generally discouraged due to increased risk of loosening.
♦️Or if possible, to try other activities such as walking, cycling and swimming that do not put pressure on the knee joint.
♦️Always listen to your body, stop any activity that causes pain or discomfort.
Reason being increased stress on the implant due to running can place repetitive high forces on the artificial joint, potentially leading to earlier wear and loosening of the implant over time.
However, there is limited evidence despite these concerns, there is a lack of substantial scientific evidence definitively proving that running significantly increases wear on artificial joints.
▶️Can you run after double knee replacement
I know after reading this article, you may be having mixed feelings if you can run or not and with double knee replacement it can be doubting.
You must understand that not all patients do resume running after a knee replacement, even when they were runners before.
And if you have had a double knee replacement this can be a bit difficult.
Based on research done by Antonelli 2020, Conversely, only 2 out of 10 patients returned to running after total knee replacement in over 2,000 patients followed (Antonelli 2020).
I can advise you to always consult your surgeon: It’s crucial to discuss your activity goals with your surgeon or physical therapist, as they can provide guidance tailored to your specific situation and implant type.
▶️What should you do if you are unable to run again after knee surgery?
If the causes hindering you to return to running after a knee surgery are:
♦️Pain and swelling.
♦️ Scar tissue formation that can form around the joint, restricting knee movement.
♦️ Muscle weakness: Feeling unstable on your knee
♦️ Anxiety and poor balance of the knee.
You may want to consider speaking to a physiotherapist to help you get back on your feet.
Try to monitor symptoms like pain, swelling and changes to your knee function and speak to your doctor.
Try to be patient and gradual because a slow, progressive approach to increasing running duration, speed, and surfaces is crucial for a successful return.
If you decide not to go back to running after a knee replacement you can focus on your general health and other activities with minimum impact.
That doesn’t mean you can’t stay active or push yourself physically. It just means choosing exercises that protect your new joint while keeping your cardiovascular fitness high.
Try to prioritize the gradual return to everyday activities and gentle exercise, following your physical therapist’s program.
Avoid activities that put high impact on the knee, and gradually increase intensity as your knee allows, always listening to your body and stopping if you feel pain
We have come to the end of this article; any experience or questions lets meet in the comments section below. Wishing you a quick recovery!
Here are some other articles you may be interested to read
⚫Stiff knee after knee surgery
⚫Is cycling good for knee arthritis.
⚫Does kneeling damage knee replacement.
Sources:
Faldini C, Traina F, Digennaro V, Berti L, Panciera A, Cecchin D, Ferri R, Benvenuti L, Calbucci L. Returning to running after total knee arthroplasty: a systematic review and a novel multimodal protocol. Musculoskelet Surg. 2025 Jun;109(2):145-153. doi: 10.1007/s12306-025-00892-y. Epub 2025 Feb 22. Erratum in: Musculoskelet Surg. 2025 Jul 25. doi: 10.1007/s12306-025-00912-x. PMID: 39987394.
Kuster MS, Spalinger E, Blanksby BA, Gächter A. Endurance sports after total knee replacement: a biomechanical investigation. Med Sci Sports Exerc. 2000 Apr;32(4):721-4. doi: 10.1097/00005768-200004000-00001. PMID: 10776888.
Mallon WJ, Callaghan JJ. Total knee arthroplasty in active golfers. J Arthroplasty. 1993 Jun;8(3):299-306. doi: 10.1016/s0883-5403(06)80093-8. PMID: 8326312.
Esculier JF, Besomi M, Silva DO, Passigli S, Rathleff MS, Van Middelkoop M, Barton C, Callaghan MJ, Harkey MS, Hoens AM, Krowchuk NM, Teoli A, Vicenzino B, Willy RW, Hunt MA. Do the General Public and Health Care Professionals Think That Running Is Bad for the Knees? A Cross-sectional International Multilanguage Online Survey. Orthop J Sports Med. 2022 Sep 30;10(9):23259671221124141. doi: 10.1177/23259671221124141. PMID: 36199830; PMCID: PMC9528027.
Antonelli B, Teng R, Breslow RG, Jamison M, Hepinstall M, Schwarzkopf R, Moschetti WE, Chen AF. Few Runners Return to Running after Total Joint Arthroplasty, While Others Initiate Running. J Am Acad Orthop Surg Glob Res Rev. 2023 Apr 19;7(4):e23.00019. doi: 10.5435/JAAOSGlobal-D-23-00019. PMCID: PMC10118379.