Mend Physical Therapy Blog and Injury Information

Why Are Running Injuries So Prevalent?

October 17, 2022

Runners and endurance athletes are one of most common patients we treat in our Boulder Physical Therapy and Lafayette Physical Therapy clinics. A 2019 article by Damsted, Parner, et al. examined the relationship between running injuries and changes in weekly running distance for the recreational runner. It its now understood that running related injuries are “sustained when the load capacity of the runner’s musculoskeletal system has been exceeded by the applied structure-specific training load” (1). Training volume (i.e. miles run per week) is one way to modify the load placed on a runner’s body.

The authors begin with the premise that the research has shown that running time lost due to injury increases as runners increase the race distance they are training for. Approximately 32% of runners who have trained for a 10k and now are training for a half marathon have reported injury leading to lost running time at a 1-year follow-up and this number skyrockets to 52% when the race distance is increased to a marathon (1). For this study, the authors defined running related injury as a lower extremity injury which caused the athlete to restrict their training or miss training entirely due to pain for a period of >7 days or 3 consecutive training sessions, or as an injury that required a consultation with a health professional (1).

One could make the assumption that longer races require more time on your feet training. However, this study showed that the variable that was more predictive of whether the recreational athlete sustained an injury was, in fact, the amount that the runners increased their initial training distance each week. Runners who increased their training distance by 20% or less each were least likely to be injured compared to those who increased their training distance from 20-60% each week after training for 21 days (1). Interestingly, as the study continued to look at the runners at days 56 and 98 this association for distance increase and injury rate were no longer statistically significant and the authors warn that simply capping your training load increase to 20% or less per week likely is an ineffective injury prevention strategy (1).

Training volume is one of the many variables we consider at our Boulder Physical Therapy and Lafayette Physical Therapy clinics when trying to keep our runners injury-free while training for a race. One takeaway from this study is that initial change in training load may be of greater importance than changes many weeks into a training cycle. Training with the guidance of an experienced coach may help better individualize training cycles and relative load on the body to help maximize a runner’s injury-free training.

If you are limited by pain with running, schedule an appointment with one of our running specialists at MEND to help you diagnose what’s keeping you from running and to build a safe an effective training program to get you back on your feet.

Mend is a physical therapy clinic with locations in Boulder and Lafayette, Colorado. At Mend our orthopedic specialists have gone through extensive training to ensure we are delivering the best possible care to our clients. For more information on running injuries and treatment options, please visit our blog and schedule a free consultation with one of our orthopedic clinical specialists.


(1) The Association Between Changes in Weekly Running Distance and Running-Related Injury: Preparing for a Half Marathon. Camma Damsted, Erik Thorlund Parner, Henrik Sørensen, Laurent Malisoux, Adam Hulme, and Rasmus Østergaard Nielsen, Journal of Orthopaedic & Sports Physical Therapy 2019 49:4, 230-238