Despite countless how-to articles, research papers, improved shoe designs and runners’ clinics, the injury rate among runners hasn’t changed in decades. Eighty per cent experience at least one injury during their running career, and anywhere from 65-70 per cent of runners are injured during any given 12-month period.
With so many runners on the limp, there’s no shortage of advice when it comes to treatment strategies. The same goes for advice on how to run injury free. Runners aren’t shy to share their opinion on how new shoes, new techniques and/or new training programs can make the difference. Still, injury rates remain unchanged.
Why do runners get hurt? Running on pavement is tough on the joints — not to mention the repetitive stress of the estimated 1,000 foot strikes per foot runners accumulate per mile. But what runners really want to know is, is there a way to reap the joys of running without getting injured?
To find out more about running injuries, researchers from Australia, the United States, Ireland and Hong Kong polled members of their running communities about their training habits, including their history of injury and shoe choices. The goal was to highlight training practices that could lead to injury, defined as any pain or discomfort that resulted in missing at least two days of training and/or required treatment from a medical professional.
Three hundred and twenty-five runners, with a mean age of 38 and an average of 10 years of running experience, completed the survey. Just over 50 per cent were male and 48.3 per cent were women. Sixty-eight per cent reported being injured within the last 12 months, with 43.8 per cent claiming one injury, 39.2 per cent had two injuries, 13.8 per cent had three injures, with seven runners reporting four or more injuries in the last year. Of those injuries, one-quarter were severe (they weren’t able to run for more than a month), 30 per cent were serious (had to take one-to-four weeks off running), 20 per cent moderate (a halt in running for less than a week), 19 per cent mild (slowed their pace and decreased weekly mileage) six per cent were minor (maintained the same weekly mileage, but at a slower pace).
“The main outcome of the present study is that self-reported injury incidence remains high (68.3 per cent) with an even distribution of injuries in the foot, knee, calf/shin and hip/groin,” said the researchers. “This research also identified a large variation in the training, shoe and technique choices of runners.”
As for what causes the injuries, the researchers suggest that there’s no one particular training practice, shoe design or running technique that stands out as increasing the risk of injury; rather, it’s a combination of factors that leads to pain severe enough to take time off from running.
“Observed factors associated with injury were competitive running, running on more than one surface, younger age, having a lower running age (running history) and the proportion of running at an easy intensity,” said the researchers.
The idea that competitive running is an injury risk could be related to a number of factors, including high volume training and failure to let the body fully recover between hard training runs. It also jibes with another study stating that participation in more than six races a year increases the risk of injury.
Surprisingly, the researchers reported that running on more than one surface was associated with injury, which is contrary to the idea that changing up the surface changes up impact stress. It could be that a sudden change in running surface could lead to injury, simply because the body isn’t able to adapt quickly enough to the change in mechanics that occurs when moving from the road to a new surface, like a trail.
Chronological age and running age (the number of years of running experience) are frequently linked to injury, with young and novice runners at a higher risk than older runners, often due to inexperience or to the classic novice error — doing too much, too soon.
As for the injury risk related to the proportion of training miles done at an easy intensity, the researchers suggest switching some of your long, slow runs to shorter, higher intensity miles, which reduces the number of foot strikes per workout without diminishing your training goals.
Finally, keep in mind that almost all running injuries are the result of repetitive strain versus a single incident like a rolled ankle or twisted knee. It’s also worth noting that injuries beget injuries, either due to running before the injury has adequately healed or to the resulting biomechanical changes that transfer the stress to another body part inadequately prepared for the extra load. Bottom line is if you run long enough, you’re bound to experience a few new aches and pains due to your running habit. And as much as we’d all like to link running injuries to specific training practices, shoes, age or a lack of running experience, it’s most likely a combination of factors. Rest followed by a modified and/or gradual return to training is the first course of action when an injury hits, followed by seeking the advice of a health care professional trained in treating athletic injuries if the pain or discomfort persists.