Mend Physical Therapy Blog and Injury Information

Reducing Your Risk Of A Running Related Injury This Off Season

December 1, 2023

The running season may be winding down, but that doesn’t mean you should stop exercising. Though you might not be logging as many miles, it is an excellent time to work on other areas of training such as strength and mobility. Many of the runners we see in our Boulder Physical Therapy and Lafayette Physical Therapy clinics have found improving these areas may reduce your risk of running related injuries in the future. A recently published article summarized risk factors for running related injuries among high school and collegiate cross-country runners. The article looked at both modifiable factors (such as training characteristics, running mechanics, strength, and mobility) and non-modifiable factors (such as sex, anthropometrics, and energy availability). This data provides insight into areas of training or health than can specifically affect your running performance. Below is a summary of the article findings.

The strongest predictors of a running related injury were found to be associated with mainly non-modifiable factors:

  • Runners with a prior history of running related injury were at a greater risk of sustaining another running related injury (up to 5x greater rate).
  • When comparing overall injury incidence between male and female runners, females experienced a higher rate of running related injuries than males.
  • Increased RED-S risk factors also placed runners at greater risk of injury. RED-S or “Relative Energy deficiency in Sport” describes a syndrome of poor health outcomes when athletes do not get enough fuel intake to support the energy demands of their daily lives and training habits. RED-S can affect any athlete, regardless of gender, and can lead to various physiological and psychological dysfunction (e.g., poor bone health, menstrual dysfunction, disordered eating habits).
  • There was also weak evidence to support that variations in postural alignment may increase risk of injury. These included measures such as leg length discrepancy, excessive Quadriceps-angle (being “knock-kneed”) and excessive navicular drop (foot overpronation).

The literature also revealed a number of modifiable factors that can influence risk of injury:

  • The literature suggests that some variation in training volume may be beneficial, but large increases (greater than 10 miles per week) should be avoided.
  • Lower step rates (<170 steps/minute) were associated with a greater risk of injury, but variations in vertical ground reaction force were not.
  • Hip and leg weakness (including weakness in the hip external rotators, hip abductors, knee extensors, and knee flexors) may also increase risk of injury and risk of developing anterior knee pain.
  • Poor sleep quality may increase risk of injury.

So what can you do about these factors? Evidence supports utilizing functional tests such as the Y-Balance Test (YBT), Functional Movement Screen (FMS), Bunkie test, and dynamometry to identify mobility and strength asymmetries which may put you at increased risk of injury. If you are interested in reducing your risk of injury, or are currently recovering from a running related injury, schedule an appointment with a Mend expert. We will perform an evaluation utilizing these functional tests and measures to develop a specific plan for your needs to keep you running at your highest potential.

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Joachim MR, Kuik ML, Krabak BJ, Kraus EM, Rauh MJ, Heiderscheit BC. Risk Factors for Running-Related Injury in High School and Collegiate Cross Country Runners: A Systematic Review. J Orthop Sports Phys Ther. 2023 Nov 16:1-36. doi: 10.2519/jospt.2023.11550. PMID: 37970801.