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Is Running on a Treadmill Better for Knees Than Outside?

For beginner runners or people returning to running from an injury, a question that comes into mind is whether running on a treadmill is better for the knees than outside running? There are specific pros and cons of running on a treadmill and outside running for your knees.

An important factor in having knee-related issues or injuries is the surface you’re running on.

A common knee-related issue or injury is “Runner’s Knee” or patellofemoral pain syndrome. It is an overall soreness in the anterior knee or behind the knee cap. It is caused by weak thigh muscles, poor foot support, too much training, and misaligned walking patterns. Weakness of thigh muscles and imbalance cause the knee not to be held in its proper place.

These knee injuries can be avoided by wearing proper running shoes, proper cushioning, not over-training, being consistent in choosing running surfaces, having a proper foot orientation, running gait, and most importantly, properly stretching and working on running and supporting thigh and leg muscles. Having the appropriate environment to run on is also a key component in avoiding injuries.           

Running on a treadmill can be lower impact for knees depending on the conditions.

Is Running on a Treadmill Better for the Knees Than Outside Running?

Running on a treadmill may be better for the knees if you are a beginner or recovering from an injury. But, running on a treadmill can also increase the risk of repetitive motion injury. With heavy treadmill use, maintaining speed on the treadmill at ground level may increase stress and strain on the knees.

Running on a treadmill is bad for your knees if you’re not careful about proper posture and gait. Instances of shortening your stride to adjust to the treadmill length and speed increase the risk of knee stress as it causes an unnatural movement on your knees. It is best to run in the middle of the treadmill belt to help sustain a more natural stride that will not stress your knees.

Although running on a treadmill may be bad for your knees if you overdo it, it can provide a controlled environment for rehabilitation on injuries. It can, however, be tougher on the shins as well.

Outside running on concrete or asphalt may not be able to provide that cushioning support that recent treadmills have, which is great for bone development but straining on your joint health as it will also lead to knee strain.

Does Running on Treadmill Damage Your Knees?

A recent study in Sports Medicine stated that there is little difference between running on a motorized treadmill and running outside. The variables for treadmill running and outside running depend on the running speed. Treadmill damage on the knees will depend on overexertion or overuse of the lower muscles, which would likely cause an injury to the knee. Knee damage may also be caused by improper running gait muscle imbalance or prior injuries.

In the study, joint productivity was also analyzed; they equate exercise to a drug that prevents joint disorders. Each individual has a threshold or limit, and excessiveness will be detrimental as it can lead to the development of joint injuries. Between running outdoors and usage of treadmills, there are no significant differences in the outcome when engaging in physical activity.

Having the treadmill on an incline of +1-2% will also help avoid knee injuries. It simulates normal outside running with variances in terrain that will activate and use different muscle groups in your leg. What is considered is the moderation and intensity when engaging in such activities.

The legs will be sore after the routine, so proper rest is vital to help the muscles adjust to the movement they underwent. In short, muscles worked on a treadmill will improve if appropriate precautions, discipline, and aftercare are followed.

Should I Use the Treadmill if My Knees Hurt?

With proper routine and consistency, the use of the treadmill is a beneficial rehabilitation exercise for all ages as its primary purpose is to improve one’s balance, strengthen endurance, and reduce knee pain. To have an effective workout, keep in mind that safety and discipline must be prioritized at all times.

Meeting with your health practitioner is also advised to determine if you can use a treadmill. The inability to consider these things would put you more at risk than a benefit for your overall health.

Usage of the treadmill also allows you to ease knee pain. Before starting a run, do some stretches to loosen your joints, and apply heat compress for 15-20 minutes to your joints if they are bothering you. Start slow and find your preferred running pace. Studies say that physical activities such as running provides more significant advantages for one’s development only if they are in moderation.

If you have just started, do not over-exert yourself as running too much on a treadmill, increasing your speed, or running for more extended periods can have the opposite effect on rehabilitation and further damage your knee.

As there are a variety of functions on a treadmill, runners should also determine their preferred pacing, incline, and intervals. Work your routine by increasing its intensity weekly, and after each workout, some soreness will occur, which is normal.

The treadmill should be appealing and comfortable for the user and have safety precautions such as handrails on both sides, a safety clothing clip, an emergency stop button, and cushioned tread belt if you’re injured. It is also important to remember that you should only use proper running or athletic shoes to avoid possible further injury and secure shoelaces to avoid tripping during walking or runs.


To answer the question, “Is running on a treadmill better for knees than outside running?” it depends on the force of impact of your running gait and the moderation of your exercise, as overexertion inevitably causes damage to your muscles and knee. Running on a treadmill with proper posture and running speed is the key to preventing knee injury; additionally, the treadmill provides cushioning support in running which absorbs the force impact on your knees.

Treadmills are a great alternative to outside running as it is in a controlled environment, wherein you can control your pace. Lastly, the treadmill’s incline is also an important factor in using different muscle groups to prevent an injury once you decide to try outdoor running. 

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About the author

Jasper loves to write about fitness, running, and anything else that gets him moving outdoors. He's an avid hiker, backpacker, and climber who loves to stay fit so he can make sure he's healthy enough to enjoy his favorite hobbies. He also spends time writing about his true passions in life.