What Risk Factors Are Associated With Run Related Injury


Ok so you have decided to participate in a running race. Fantastic! Congratulations, you are now an athlete doing what athletes do (hopefully at least), embarking on a new  training protocol! You’ve probably heard the statistics circulating out there that up to 79% of running athletes -that’s you and people like you- will sustain a running related injury over the course of their training life. If that sounds high it’s because it is! Running injuries can manifest in all kinds of different ways and affect a large swath of the body ranging from the low back though the whole lower extremity – hip to foot.

What kinds of risk factors should we be considering when starting a new training protocol? Several research studies, some of which are listed below have looked at what factors seem to be most associated with running injury. Let’s discuss a few, this list is not comprehensive but it certainly does present a good starting point for things that you can address on your own or with a little bit of professional help.

Poor movement mechanics – We need to move beautifully! This is fundamental and cannot be overlooked! I’ve recently done another article on good movement mechanics during run and you should definitely check that out. Remember that in general if you are adopting the forefoot running style that I describe in the aforementioned article that you will focus on leading with your chest, running with parallel and forward facing feet, taking smaller steps and of course landing on your forefoot. See the previous form article for more details and when adjusting your running gait be patient, change is possible but takes practice and time!.

Less experience –  New runners tend to experience more injuries. Likely because their movement mechanics (as discussed above)  movement are unlikely to be as good as more experienced runners. Since connective tissues like tendons also have a slow adaptation time to training these structures are more likely to sustain trauma  in newer runners. Managing tendonitis is sadly a more likely reality for this reason in new running athletes versus the experienced.

Old shoes – They say that running injury is more common in running athletes whose shoes are older than four months old. Sorry! No word yet as to how much the science that suggested this risk factor was funded by the big sneaker lobby!

Running surface –  At least one research study has found that running on concrete more than two thirds of the time is a risk factor for injury in runners. This can be difficult to manage for city dwellers running on sidewalks all day. A good strategy here is to vary the surfaces your urun on. Try to include alternatives like tracks, earthen surfaces (trails), treadmills and even boardwalks if your city has them. The variety will make your running life more interesting as well as reduce risk of injury.

Structural issues – It goes without saying that injury will be more common for some folks with less run friendly joint alignments, for example women with a larger valgus angle (the “inward kink” angle at your knee), or even degenerative injuries like hip/knee osteoarthritis or lack of extension at the base of the big toe. If this is you then professional help is more in order. You still may be able to run well but some extra special attention to form and a little bit of manual therapy to help manage any flare ups may be in order.

There you have it! Some things to think about when considering your risk of run related injury. None of these should be an automatic “stop running” signal, but if you think one or more applies then you may want to seek out some help as you proceed through your running journey.

As always I’m here to help as needed, don’t hesitate to reach out with questions around this or any other area you may have concerns over!


For further reading (if you really want to impress all of your friends).

van der Worp, M. P., de Wijer, A., van Cingel, R., Verbeek, A. L., Nijhuis-van der Sanden, M. W., & Staal, J. B. (2016). The 5-or 10-km Marikenloop Run: A Prospective Study of the Etiology of Running-Related Injuries in Women. Journal of Orthopaedic & Sports Physical Therapy, 46(6), 462-470.

Heiderscheit, B. (2011). Gait retraining for runners: in search of the ideal. journal of orthopaedic & sports physical therapy, 41(12), 909-910.

Buist, I., Bredeweg, S. W., Bessem, B., Van Mechelen, W., Lemmink, K. A., & Diercks, R. L. (2010). Incidence and risk factors of running-related injuries during preparation for a 4-mile recreational running event. British journal of sports medicine, 44(8), 598-604.

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