How to Protect Your Knees When Running on a Treadmill

Protecting your knees during treadmill running

Khakimullin Aleksandr/

By Simon Gould

Running by its very nature is not all that great for the knees. They act as a shock absorber and a pivot point for your stride. The harder the surface the more shock is delivered through your legs. Running shoes help absorb a lot of this energy but the lower leg and knees do their job too. So, is the softer the surface of a treadmill the better for your knees?

Treadmills are better for your knees than running outside

The softer surface does it. Even treadmills that have no extra built-in shock absorption are generally kinder to the knees. The deck eases during landing and helps you push off at the end of your stride. If you find that running outside is causing you knee pain or you’re returning from an injury, then a treadmill may help bring you back to running normally.

Some treadmills have extra built-in absorption decks that are ideal for runners who have trouble with their knees. Many brands have these, they often give the deck a special name in relation to the support it has. One calls it a “cushion flex suspension system” and these all help reduce the amount of impact on your knees from landing.

You don’t have any difficult terrain to deal with. You run in a predictable way for your knees. As long as you make sure you run in the same way as you would outside, on a treadmill. Then it’s easier on the knees than hard surfaces like concrete or asphalt. You also don’t do any twisting or turning that can challenge the knees in uncertain ways.

A treadmill can still damage your knees though

You’re not totally knee safe on a treadmill. Don’t think you can run at speed for miles regularly, and not experience injuries. These are typically overuse injuries. The most common is “runner’s knee”. The medical term is patellofemoral pain syndrome and the symptom is pain around the knee when you run. This will get worse as you continue or increase the intensity.

Experts recommend resting which should resolve minor pain. If it lasts for a week or longer, then you should see a physiotherapist or doctor as there could be something more severe. There are various scans like MRI and CT, and other tests that can help diagnose knee problems. They add that if your pain is severe or your knee is swollen, then seek medical attention immediately.

7 Ways to make a treadmill kinder to your knees

1. Build up slowly

It’s increasing the intensity too quickly that can cause problems for your knees the most. If you’re running long distances, don’t increase the distance by too much in one go. Extend your distance by a mile or two each week or run for 10 minutes longer until you’ve reached your goal. So if you’re preparing for a race, then think about training for it sooner.

2. Don’t run on the incline

Running on an incline for long periods puts unnecessary stress on the knees. You rarely find 30 minute uphill climbs in nature and you shouldn’t do it on your treadmill. You can always set the incline to 1% or 2% to replicate running outside, but don’t go any higher. Our knees aren’t used to running up hills, so proceed with caution if you want to add it to your treadmill routine.

3. Walk on the incline instead

You can always walk on a high incline instead. Brisk walking at 12% to 15% can be just as hard as a run and far kinder to your knees. There is little impact on your joints when walking. While it’s not as exciting as running, it may be worth a try to see if you can get something out of it. A day or two per week can really ease the pressure on your knees if you’re a regular runner.

4. Buy running shoes

You may associate running shoes with running outside, but they have the same benefits for a treadmill. They provide that extra level of support for your knees and other joints. Running in the wrong shoes can cause injuries by itself. Ideally, get running shoes fitted for your particular feet and the way you run. Replace them every 300 miles or 6 months, whichever is sooner.

5. Improve your posture

It’s quite easy to run with the wrong posture on a treadmill. The deck is small and you need a certain level of concentration to stay on the deck. As long as you look ahead and not down. Don’t hold onto the handrails. Run tall with your back straight. Even if you feel a little tired on a long run, try to maintain the correct posture.

6. Strengthen supporting muscles

Your supporting muscles can really help prevent knee problems occurring. You can use your body weight or equipment in a gym to do a lower body workout. Squats, lunges and side to side lunges should be your go to. Strengthen the core with abdominal exercises. The muscles that help support the knee are the quads, hips and glutes. Do these exercises twice per week.

7. Cross train

If your knees are susceptible to injuries then even a treadmill can exacerbate them. You may want to consider some cross training on a few days of the week. Something with less impact like a bike, elliptical, rowing or swimming. Personally my left knee can sometimes get sore, so I have a Peloton bike I enjoy using. You may find you can enjoy something else too.


Overall, a treadmill is far kinder to your knees than hard surfaces you can run on outside. That cushioned deck is what does it, it’s easier to run on. That’s not to say you still can’t get overuse injuries or aggravate an existing one. To get the best out of your treadmill, if you’re worried about your knees, follow the 7 steps above.

It’s increasing intensity too quickly which is usually the culprit for knee and other running injuries. It’s so easy to do if you’re just getting into your exercise routine, or you want to achieve a better time or distance. This is especially the case as you get older. Flexibility and suppleness decreases as we age. So take care and look after your knees, even on a treadmill.

Thinking of buying a treadmill? Here’s my favorite, I always recommend it when asked.

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