Training Characteristics Related to Running Related Injuries

The risk for an overuse injury is multifactorial, consisting of mechanical factors that increase the load on the tissues; tissue vulnerability issues; and issues related to tissue adaptation to those loads. If an injury occurs or not is going to be a complex interaction of those three factors. Injuries occur if the cumulative load on the tissues exceed what the tissues can take. Management of them is aimed at reducing the load and increasing the ability of the tissues to take the load. More research is accumulating allowing the identification of more factors associated with that. This new study used a prospective survey to look at the training related characteristics that were related to running injuries.

L Malisoux, A Urhausen, D Theisen
Br J Sports Med 2014;48:631-632 doi:10.1136/bjsports-2014-093494.194 (Abstracts from the IOC World Conference on Prevention of Injury & Illness in Sport, Monaco 2014)
Background: Most running-related injuries (RRI) are attributed to training errors.
Objective: This study investigated which running training characteristics are potential risk factors for RRI.
Design: Prospective cohort study.
Setting: Recreational distance runners.
Participants: A total of 267 participants accepted to upload weekly all information about running training characteristics, other sport participation and injuries on a dedicated internet platform.
Risk factor assessment: This 9-month follow-up investigated if the risk for RRI was influenced by some of the following running training characteristics: weekly volume (hours/week), weekly frequency (session/week), self-reported session intensity (CR10-Borg Scale), week-to-week absolute change in distance (km/week) and the concomitant use of different pairs of shoes (parallel use of a minimum of 2 different pairs of running shoes).
Main outcome measurements: The primary outcome measure was total volume (hours) of running training and competitions (exposure) until the first RRI (Cox regression analyses). A RRI was defined as any physical complaint located at the lower limbs or lower back region, sustained during or as a result of running practice and impeding planned running activity for at least 1 day.
Results: Overall, 89 participants (33%) recorded an RRI. The total incidence was 6.05 injuries per 1000h of exposure. The adjusted Cox regression analysis revealed that participants who practiced more than 2 hours/week were at a lower risk of RRI (Hazard ratio (HR): 0.539; 95% Confident interval (CI): 0.295-0.986) even when controlling for running experience and training regularity during the previous 12 months. The parallel use of more than one pair of running shoes (HR=0.600; 95% CI=0.369–0.975) and the week-to-week absolute change in distance (HR: 0.882; 68% CI: 0.836–0.931) were also protective factors, while previous injury was a risk factor (HR=1.841; 95% CI=1.185–2.860).
Conclusions: This study identified training characteristics which are related to RRI risk.

Firstly, I don’t have access to any more than the above abstract as it was presented at a conference, so the eventual full publication may provide more detail. This was a prospective cohort study in which the runners that were recruited recorded training related data. They compared the training data between the group that got an injury and the group that did not.

What they found was:

  • those that ran more than 2hrs a week were at a lower risk for injury
  • parallel use of more than one pair of running shoes was protective
  • the week-to-week absolute change in distance was protective
  • a previous injury was a risk factor (which pretty much every study has also shown)

I don’t have much of a critique of the study as what we know is just based on the abstract above, but nothing jumps out at me at this stage as being an issue.

One last point is that the injury rate in this study was 33% over 9 months (~44% over 12 months, if we can extrapolate). This is similar to what so many other studies are showing and is way lower than the one cherry picked study of 76% over 12 months that the fan boys like to keep quoting.

As always: I go where the evidence takes me until convinced otherwise.

Malisoux, L., Urhausen, A., & Theisen, D. (2014). IMPACT OF TRAINING CHARACTERISTICS ON RUNNING-RELATED INJURIES IN RECREATIONAL RUNNERS British Journal of Sports Medicine, 48 (7), 631-632 DOI: 10.1136/bjsports-2014-093494.194

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