Running Post-Knee Replacement: A Guide to Navigating the Highs and Lows

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Cross Training For Runners
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David Dack

So, you’ve got those new knee joints, and the runner’s itch is just too hard to resist. But here’s the deal: running, despite our love for it, is a high-impact exercise per excellence. And after a knee replacement surgery, you’ve got precious new joints that deserve some TLC.

For a long time, doctors were waving the caution flag, warning against hitting the pavement post TKR (Total Knee Replacement). The fear? The high-impact nature of running could wreak havoc on those freshly minted joints.

This left many former devout runners torn between their love for running and the fear of undoing the surgical magic.

In this article, we’ll peel back the layers to explore the pros and cons of lacing up those running shoes after knee surgery.

Now, a little disclaimer—we’re not playing doctor here. I’m not a medical pro, nor have I undergone any knee surgery. This topic, however, hits close to home for me due to my family’s history of knee arthritis. So, please, consider this a friendly chat rather than medical advice, and always consult a pro when it comes to everything related to health and well-being.

What is Knee Replacement Surgery?

Knee replacement surgery, also known as total knee replacement (TKR) or knee arthroplasty, is a surgical procedure that involves replacing the damaged or diseased parts of the knee joint with artificial components. This procedure is typically performed to relieve pain, improve knee function, and enhance the quality of life for individuals with severe knee joint problems. Here’s an overview of knee replacement surgery:


Knee replacement surgery is commonly recommended for individuals who have:

  • Osteoarthritis: The most common reason for knee replacement, osteoarthritis is a degenerative joint disease characterized by the breakdown of the knee’s cartilage.
  • Rheumatoid Arthritis: An autoimmune disease that causes inflammation and damage to the knee joint.
  • Traumatic Injury: Severe knee injuries or fractures that result in irreversible damage to the joint.
  • Other Degenerative Conditions: Conditions such as avascular necrosis, in which the bone loses its blood supply, can lead to joint deterioration.

Surgical Procedure:

During knee replacement surgery, the orthopedic surgeon makes an incision over the knee joint and removes the damaged cartilage and bone. The ends of the thigh bone (femur) and shin bone (tibia) are then reshaped to accommodate the artificial components.

Prosthetic Components:

The prosthetic components used in knee replacement surgery typically consist of:

  • A metal femoral component: This covers the end of the thigh bone.
  • A metal tibial component: This covers the top of the shin bone.
  • A plastic spacer: Placed between the metal components to provide smooth movement.
  • Sometimes, a patellar component:  If the back surface of the kneecap is also damaged, a plastic button may be used to resurface it.

Types of Knee Replacement:

There are different types of knee replacement surgeries, including partial knee replacement (replacing only a portion of the knee joint) and total knee replacement (replacing the entire knee joint). The choice of procedure depends on the extent of knee damage.


After surgery, patients typically undergo physical therapy to regain strength, flexibility, and mobility in the knee. Full recovery can take several months, with most patients experiencing significant pain relief and improved joint function.


While knee replacement surgery is generally considered safe, it is not without risks. Potential complications may include infection, blood clots, implant loosening, nerve or blood vessel injury, and persistent pain.


Knee replacement surgery can provide significant pain relief, improve mobility, enhance the ability to perform daily activities, and enhance the overall quality of life for individuals with debilitating knee joint conditions.

Longevity of Prosthetics:

The artificial components used in knee replacement surgery have a lifespan typically ranging from 10 to 20 years or more. Revision surgery may be required when the prosthetic components wear out or become loose.

Does Running Cause Osteoarthritis?

Alright, folks, let’s tackle a common question: Does running lead to arthritis? Well, I’ve covered this before, but it’s worth repeating – running all by itself doesn’t give you arthritis. Yep, that’s right!

In fact, the research has your back on this one. No, there’s no secret conspiracy between your running shoes and arthritis. They’re just not best buds.

But wait, here’s the cool part – some studies even suggest that running might be your joint’s superhero. It could help keep those pesky inflammatory processes, which are like the villains of the joint world, in check.

Now, here’s the deal with your knee joints. They’re like superheroes, too, built to last you a lifetime or even two. But, and it’s a big but, if you’re putting them through some crazy stuff, like running with a funky form or overdoing it without proper rest, they might start showing signs of wear and tear.

Additional resource – Running with arthritis 

runer woman with knee injury and pain

When Surgery is The Way?

Now, when you’re dealing with arthritis, your doctor’s first move is usually to try out the more conservative, non-invasive treatments. You know, stuff like anti-inflammatory meds, gentle exercises, maybe some yoga or stretching – all the good stuff.

But here’s the deal – when things take a nosedive, and your joint starts feeling like a rusty old door hinge, surgery might be your knight in shining armor. Especially if your joint has hit rock bottom, going bone-on-bone.

Early on, you’ve got options to fix, restore, or even replace the damaged tissues, like the articular cartilage, ACL, and meniscus. It’s like giving your joint a new lease on life!

How long Will A Knee Replacement Last?

Well, there’s no one-size-fits-all answer to that. It really depends on the individual. But generally speaking, those knee implants can go strong for about 15 to 20 years for most folks. Not too shabby, right?

Can You Run After Knee Replacement?

Well, technically, yes, you can hit the pavement or trails after TKR – but there’s a catch. It’s a decision that should be made with care, and it’s not the right move for everyone.

Before you lace up your running shoes, you’ve got some homework to do. You need to weigh the pros and cons of running post-surgery, and that means having a heart-to-heart with your doctor. They’ll help you map out all the possible scenarios and guide you toward the best choice.

Deciding whether it’s time to get back on the running track after knee surgery isn’t a one-size-fits-all decision. It’s all about a personalized approach between you and your doctor. So, whether you’re chasing that runner’s high or just aiming for a leisurely jog, make sure you’re on the right path for your unique situation.

The Research

Now, here’s the tricky part: there’s not a ton of scientific research out there on the impact of high-stress exercises like running on artificial knees. And what’s available is often outdated, unable to keep up with the leaps in materials and surgical techniques.

This lack of research also means we’re in the dark about a lot of things when it comes to exercise post-knee replacement. Questions like how long and how often you can safely run or if running is even a viable option after the surgery remain largely unanswered.

One reason for this gap is that researchers can’t just randomly assign patients to run after knee surgery while others stick to walking, which is the more traditional protocol for scientific testing. Instead, much of the research on this topic is retrospective. It relies on post-surgery patients to report on their own experiences with exercise after the procedure.

What makes things even more complicated is that many of the guidelines we have are anecdotal, coming from runners who’ve had the surgery themselves.

So, if you’re a passionate runner considering whether or not to hit the road after knee replacement surgery, keep in mind the lack of concrete scientific evidence. It’s a decision that requires careful thought and consultation with your healthcare team.

For more on the research, check the following resources:

The Factors To Consider

Here are some factors to consider:

Your Age

Your age is a significant factor when it comes to deciding whether or not to return to running after knee replacement surgery. As you get older, your overall health and fitness level may play a role in whether running is a suitable option for you. It’s essential to take into account your age and consult with your healthcare team to determine what forms of exercise are more age-appropriate and safe.

Accept The risk

Just like with any other activity, it’s important to understand that running or engaging in any weight-bearing exercise after knee replacement surgery does carry some risk. There’s a chance that you could damage the artificial implant or cause it to become loose. In such cases, you might need corrective surgery or even a replacement, which means undergoing another operation.

Consult Your Doctor

If you’re still enthusiastic about the idea of running after knee replacement surgery, it’s crucial to have a thorough discussion with your doctor. They can provide you with valuable insights into your specific situation, the type of implant you have, and what research on wear testing has revealed about it.

Keep in mind that over time, knee implants will naturally wear out to some extent, regardless of your activities. Your goal should be to minimize the wear and tear on the implant throughout the rest of your life, if possible, to avoid needing another surgery to replace the replacement.

Consider this: at 55 years old, you may have another 20 to 30 years ahead of you, and it’s a wise decision to try to avoid the need for additional surgeries during that time.

The good news is that you have alternative options for improving your cardiovascular fitness without putting as much load on the new joint. Walking and engaging in other lower-impact exercises can be effective ways to stay active while being gentler on your knee replacement. This approach can potentially add more years of comfortable joint function, which is definitely a positive outcome to aim for.

Additional Resource – Here’s how to use KT Tape for runners’ knee.

Recovering From Knee Surgery

Recovering from knee replacement surgery is a significant undertaking, and if your goal is to eventually return to running, you should be prepared for a longer recovery period with dedicated effort.

Here’s a general timeline of recovery milestones:

  • Three weeks post-surgery: You should be able to walk for more than 10 minutes at a time without assistance. You might still need some help from a physical therapist during this stage.
  • Six weeks post-surgery: You might receive clearance from your doctor to resume driving between weeks 4 and 6, depending on your progress and comfort.
  • Three months post-surgery: Most physical therapy programs last up to three months. By this point, you should be able to walk for longer distances, potentially covering a few blocks. You might also be ready to introduce exercises like swimming and cycling into your routine.
  • One year post-surgery: Recovery continues over the course of a full year following knee replacement surgery. By this point, your knee should have regained its full strength.

Additional resource – Knee brace for knee pain

Can You Run After Knee Replacement Surgery? – Conclusion

As a runner recovering from TKR, you should be in no haste to return to the sport. Instead, you should weigh all the pros and cons to determine if it is the right thing to be doing in the first place.

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