Rheumatologists in this qualitative BMJ Open study agreed that running can offer meaningful physical and mental health benefits for patients with rheumatoid arthritis (RA)—including improved cardiovascular fitness, reduced analgesic use, and better overall disease control—yet they remain cautious due to limited RA-specific evidence and persistent patient fears about joint damage. Clinicians emphasized that safe running requires well-controlled disease, gradual training progression, and symptom-guided pacing, with particular attention to foot/MTP vulnerability, active inflammation, and risks associated with corticosteroid use. Most rheumatologists recommended individualized guidance, allied health support, structured beginner programs, and prioritizing patient-led goals. While some clinicians with personal running experience felt more confident counseling active patients, others reported uncertainty due to the evidence gap and lack of formal guidelines.