As a running athlete and coach, over-use seemed to be the most common cause of injury.
This means overusing or stressing a part of the body beyond what it can recover and adapt to.
The main cause of this is two-fold, first from over-loading the body with something (volume, new shoes, speedwork, etc) that it is not adapted to and not giving the body appropriate time and opportunity to heal and adapt, but instead continuing to train.
However, new research has suggested that while all of this may hold true, the terminology may need some modifying.
The general belief is that running a lot is a main cause of injury.
However, research is beginning to show that this actually may not be the case. It’s the getting to more running volume that is the risk.
Danish researchers found that marathoners running less than 30k (about 20 miles) weekly were twice as likely to get injured than those who ran between 30 and 60k weekly. And those who ran 60+ were no more injured than those who ran 30-60 average weekly.
Another study found that those with the least amount of weekly training volume and the lowest number of runs were much more likely to be injured than those training over 2 hours weekly or more than twice weekly.
If running more does not cause injury, what does?
This is the tricky part.
Now that we know increased volume does not necessary mean increased risk of injury, where do we go from here.
A pair of researchers from the Australian Institute of Sport and the University of Canberra suggest that based on their research we should stop using the term “overuse” and instead say “training load error”.
Further research suggests the same when looking at rugby players. They found that athletes with a four week average workload of greater than 30 weekly kilometers of running during practice were again, less likely to be injured than those with a reduced average training load. The kicker was that injuries increased when players would bump up their training by 60% over their 4 week average.
What does this mean?
It means that instead of simple overusing a muscle and it becoming injured being the risk, the risk comes from the transition period from lower volume to higher volume.
If you go from 30km weekly to 60km, your body is not adapted to this new load and stress. When you safely reach 60km weekly volume and stay there, your body adapts and your injury risk goes back down to the baseline.
What’s interesting is that this was fairly well know, now we’re only calling it what it really is and thus understanding it more fully.
Putting it into practice.
Great great great. But you want to know what you should do about it!
What all this means is that you should not fear running more. If anything, it’s clear that running more is the easiest method of improving as a runner.
But now you know that the transition to running Y weekly miles to Y x 2 weekly miles is when the risk sets in. The researchers found an acute:chronic load ratio of 1.5 was roughly the threshold. If you go from a four week average volume of 30 miles right to a 45 you’re at a 1.5 acute:chronic ratio and have drastically increased your injury risk.
Instead when you increase your training volume, even if that’s to a previously comfortable level, you must do so with caution. Increase your weekly running distance by no more than 10% week to week and be sure to take a lower volume week every three to four weeks will all help keep you safe.
A study with elite footballers found that “high, excessive workloads associated with the greatest injury risk. However, when the players were exposed to these high loads progressively, over a period of time, the risk of injury reduced significantly. Ultimately, players who safely train harder, may develop a greater resilience and tolerance for the intensity and fatigue of competition by increasing their physical capacities.”
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