Biggest Risk Factors for Running Injuries
How to Avoid Running Injuries
What are the biggest risk factors for running injuries? This 1-year prospective cohort study was designed to investigate (1) the number of new running-related injuries (RRIs) sustained per runner within 1 year, (2) the most common body regions that are injured, and (3) the correlations between RRI and factors such as previous injury, running experience, weekly running distance, age, sex, and body mass index (BMI).
224 recreational runners were included in the study. These runners averaged a weekly running distance of at least 15 km for the past 12 months. Running-related pain and injuries sustained were reported weekly for 1 year and diagnosed by an experienced physician. All RRIs that resulted in time loss from running or medical consultation were recorded.
Here’s what the researchers found:
1. 75 RRIs were sustained by 75 runners over 1 year
a. Cumulative incidence proportion of 46%
b. 40% of runners with a previous RRI sustained a new RRI
c. 24% of runners without a previous RRI sustained a new RRI
A cumulative incidence proportion of 46% means almost half of the runners sustained a new RRI within the 1-year period. But notice the difference between runners with a previous injury and those without. Runners who had a previous running injury were much more likely to experience a new running injury!
2. The most frequent body region injured was the knee at 27%, followed by the Achilles tendon/calf at 25% and the foot/ankle at 20%.
a. In men, knee injuries were most common
b. In women, there was an equal proportion of injuries to the foot/ankle, Achilles tendon/calf, and hip/pelvis areas.
These findings were mostly consistent with previous reports.
3. Runners with a previous RRI were 1.9 times more likely to sustain an RRI compared to runners with no previous injury.
In other words, runners with a previous RRI had a 90% higher rate of RRI compared to those without a previous RRI! It is plausible that the individual factors which predispose a runner to injury can increase the risk of additional injuries without proper intervention. It could also be that new injuries are simply exacerbations or repeated episodes of previous injuries that have not fully recovered. It may also be the case that compensatory running strategies are developed in response to pain, which increase the risk of future injury. The exact mechanism explaining why runners with a history of RRI have such a higher risk of future injury is unclear. It is clear, however, that prevention of future reinjury is important, especially when almost half of recreational runners sustain injuries from their sport within 1 year.
4. Running experience, weekly running distance, age, sex, and BMI were not significantly correlated with RRI.
So these factors are not as important as previous injury history when assessing injury risk for runners, according to this study.
Limitations of the study:
Runners with a running injury within the last 6 months were excluded from the study. It can be argued that a 6-month period for previous injuries is too short, allowing for exacerbations of previous injuries to be misclassified as new injuries. Depending on the type and severity of injury and the success of rehab, 6 months may not be enough time for a previous injury to fully recover.
The runners in the study were mostly experienced recreational runners with 75% of the runners having more than 5 years of running experience. So the results here may not be generalized to novice or elite runners.
Weekly running distance represents only one aspect of a runner’s previous training load. Other variables of training load such as weekly running exposures (frequency) may impact RRI rates, and should be accounted for.
Closing Remarks:
Half of experienced recreational runners sustained a running-related injury over 1 year.
Amongst experienced recreational runners, those with a previous running injury were twice as likely to sustain a new running injury compared to runners without a previous injury.
After a running injury, it is important to address deficits such as range of motion, strength, flexibility, and biomechanics, while implementing a gradual return-to-run program to safely return to the high load demands of running.
If you are experiencing pain or injury from running, please contact us below to schedule an appointment.
Disclaimer: This is not intended to be formal medical advice. Your individual needs should be met by the appropriate health care practitioners. Please consult with a trusted provider.
Dr. Vincent Liu, PT, DPT
Doctor of Physical Therapy
The Game Plan Physical Therapy