Now that the warmer months are approaching, it’s not uncommon for people to either start running or increase their weekly running volume and/or frequency. It doesn’t matter if you are an experienced runner looking for the ‘runners high’ or a beginner looking for a healthier lifestyle, there are a few tricks to reducing your risk of getting a running related injury (RRI).
There are intrinsic and extrinsic factors that may influence RRIs. Intrinsic factors are typically very difficult to be modified, if at all and include your gender, age, high arch feet, leg length asymmetry, and health status (BMI). Extrinsic factors are more varied and can be modified more easily e.g. footwear, running technique, and nutritional status as examples. Running injuries are prevalent in the sport, with research indicating suggested that 19-80% of runners will suffer from an injury during their running career.1 This number varies due to the highly subjective definition of ‘injury’ in the research, and realistically is more likely to be around 30%.
Every runner will have a ‘sweet spot’ that will help you achieve your goals. This sweet spot is the correct balance of training stimulus and recovery so that the body can adapt. Too much stimulus, or stress, is a good way to find yourself sitting in the clinic waiting room. Not enough stress and you will not see any benefit for your efforts. Multiple observational studies report that training volumes of 65 kilometers or more per week increase the risk of injury, in recreational male runners at least.1,2,3
A formula that is used to measure the volume of work performed is called the acute to chronic workload ratio. To calculate the ratio, take the number of kilometers (km) that you have run in the past 4 weeks (chronic) and divide it by the km’s run in the 4th week (acute). Aim to keep your acute: chronic ratio between 0.8 and 1.35.4
It is important for runners to have a variety of (different) running shoe models in rotation. Researchers followed runners for 22 weeks and found that those that had, on average 3 models of shoes in rotation, decreased their risk of getting a RRI by 39%.5
Running coaches and researches will agree that there is no one ideal way for everyone to run. There is a consensus building for a generalized technique that individuals can then stamp their own ‘style’ on. This includes a relatively upright or tall posture, relaxed shoulders with no arm ‘cross-over’, adequate hip mobility, and a near perpendicular leg at initial contact in line (or close to) the hip. Variables like foot placement at initial contact (forefoot, midfoot and rearfoot) and cadence (steps per minute) have less consensus, and this is most likely due to individual variation.
Making wholesale changes to your running technique, or modifying your foot strike pattern in isolation, may not be necessary for runners that are not injured, and it may perpetuate future issues. Running is a skill, and just like any skill, it needs to be taught and practiced to become efficient. Medical specialists that specialize in running injuries will be able to provide assessment and guidance for runners that are looking to get back to running following an injury and screen for risk factors that may contribute to a RRI. Above all else, if in doubt, get it checked out!
Header image credit: Lululemon Athletica, used under Creative Commons License.
- van Gent RN, Siem D, van Middelkoop M, van Os AG, Bierma-Zeinstra SM, Koes BW. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med. 2007;41(8):469.
- Fields KB, Sykes JC, Walker KM, Jackson JC. Prevention of running injuries. Curr Sports Med Rep. 2010;9(3):176.
- Bovens AM, Janssen GM, Vermeer HG, Hoeberigs JH, Janssen MP, Verstappen FT. Occurrence of running injuries in adults following a supervised training program. Int J Sports Med. 1989;10 Suppl 3:S186.
- Hulin, B.T et al. (2015) The acute:chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players. Br J Sports Med doi:10.1136/bjsports-2015-094817
- Malisoux L, Ramesh J, Mann R, Seil R, Urhausen A, Theisen D. Can parallel use of different running shoes decrease running-related injury risk? Scand J Med Sci Sports. 2015 Feb;25(1):110-5. doi:0.1111/. Epub 2013 Nov 28.