Running related injuries (RRI) have remained reasonable unchanged since the early 1980s and range from 17-79%. RRI are the most prevalent reason why runners cease participation with the most commonly affected areas being the knee and lower leg. Studies have looked at demographic and anthropometric factors to determine risk factors for RRI injuries with consideration given to age, sex, BMI. These factors were found to be associated with certain injuries where females are more likely to sustain anterior knee and ITB pain, while men were more likely to suffer from Achilles and plantar fasciitis.

A recent study by Hollander, et.al anchored by expert running biomechanists Irene Davis, retrospectively looked at 550 recreational runners to determine the different factors that might play a role in RRI and to give further weight to the notion that RRI are multifactorial. Their study examined biomechanics, demographics and anthropometric factors.

Running Related Injury Risks

Their paper found the foot striking patterns were associated with certain injuries; Achilles injuries were 2 times more likely in those with a midfoot strike pattern. This is potentially a result of the changes in Achilles loading due to the position of the foot and ankle on impact. Posterior leg injuries (most commonly calf injuries) were associated with forefoot strike patterns.

They also found that higher peak vertical ground reaction forces, the forces directly impacted on the body as the foot hits the ground were associated with hip and groin pain. Interestingly though, they didn’t find an association between cadence (steps per minute) and injury location, whereas other studies have found that a lower cadence is associated with anterior (front) leg pain.

Key Injury Risk Factors

Some of the key overall injury risk factors Hollander found indicate your risk increases for:

  • An Achilles injury if you are older, male and a midfoot striker
  • An ITB injury if you are older
  • A hip/groin injury if you are female
  • A thigh injury or anterior knee pain if you are female
  • A patella or quadriceps tendinopathy if you are male.

How To Avoid A Running Injury

The most important factor to mitigate the risk of a RRI is appropriate load management. This means periodizing training, having appropriate rest periods and deload weeks of training, and to scale up training in roughly 10% increments each week.

Tendinopathies are extremely prevalent in running including Achilles, plantar fasciitis, glute medius, patellar and quadriceps. Tendinopathies are directly associated with load levels however, the best way to prevent tendinopathies is by having strong tendons. Therefore a gym based strengthening program is vitally important for runners.

Identifying and correcting any technique and/or biomechanical deficiencies will ensure a more evenly loaded musculoskeletal system in addition to reducing high peak vertical growth reaction forces both of which are related to RRI.

Finally, make sure you rehabilitate any injuries you have sustained as prior injuries, especially soft tissue injuries such as calf strains are a risk factor for a subsequent injury.

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