Top Risk Factors for Common Running Injuries

Top Risk Factors for Common Running Injuries

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As running becomes more popular, unfortunately so do running injuries. There is a long list of factors that can increase your chances of a running-related injury. Some are in your control, but many are not. But with some knowledge about what you an do to prevent injuries, and which you may be predisposed to deal with, you can be a smarter, more injury-free runner.

First, you can look at the general intrinsic (within the person) and extrinsic (outside the person) risk factors for injury.

For adults, general intrinsic risk factors include:

  • Previous injury (Saragiotto 2014, van Gent 2007 ,van der Worp 2015)

  • Increasing age (Kluitenberg 2015, Ristolainen 2014)

  • Hip abductor muscle weakness (Niemuth 2005)

  • Higher BMI (Kluitenberg 2015, van Poppel 2015)

  • Male sex (van der Worp 2015)

  • Decreased gastroc-soleus strength

Teen runners have a different set of factors. For high school cross-country athletes, common risk factors include:

  • Hip abductor, knee extensor & flexor weakness (Luedke 2016)

  • Previous Injury (Rauh 2000, Rauh 2006, Reinking 2010)

  • Greater [ >20º] or asymmetric [4°] Q-angle (Rauh 2006)

  • Greater navicular drop (Bennett 2001, Plisky 2007)

  • Greater Leg-length inequality [1.5 cm –boys only] (Rauh 2018)

  • Higher BMI (Plisky 2007)

  • Menstrual irregularity [oligoamerroheic/amenorrheic]

Some of those are outside the realm of control for the runner. The extrinsic risk factors generally are related to training. Adults face these extrinsic risk factors:

  • Less running experience (Kluitenberg 2015, van Poppel 2015)

  • Excessive weekly training distance (males) (van Gent 2007SR)

  • Lower stride rate [increased stride length] (Schubert 2014)

  • Lower running volume (Kluitenberg 2015)

  • Excessive weekly training progression in novices: [>30%] (Nielsen 2014)

  • Less than 2 resting days weekly (Ristolainen 2014)

  • Having used orthotics/inserts (van der Worp 2015SR)

  • Minimalist footwear (Ryan 2014)

Studies of high school runners found a different set of extrinsic risk factors, including:

  • Low step rate [step rate 3.3 m/s <164 steps/min vs >174 steps/min; self-selected speed <166 steps/min vs >178 steps/min] (Luedke 2016)

  • Running 8 weeks or less in the summer before fall season (Rauh 2014)

  • Not frequently alternating short and long days <25% of summer training runs (Rauh 2014)

  • Frequently running on hills >33% of summer training runs (Rauh 2014)

  • Frequently running on flat, irregular terrains (tracks with banked curves, banked street inner lans, uneven grass fields, trails in woods) >33% of summer training runs (Rauh 2014)

When you look at these long lists of running injury risk factors, it easy to see that pinpointing one factor for a patient is extremely difficult! It’s no wonder that staying injury-free can be such a challenge for those running on their own and without exercises and training from a professional.

In general, common risk factors for runners of all ages and experiences include:

  • Previous injury

  • Proximal factors: abnormal hip motion and muscle weakness

  • Distal factors: abnormal foot mechanics

  • Training issues: excessive or insufficient

  • Running experience: limited or too much

So how can you truly avoid injury? With thoughtful training, the right strengthening exercises, and by taking care to listen to your body and rest when needed.

If you’re concerned that you are experiencing some pain when running, or are looking to recover from a running injury, make an appointment with Dr. Davis today.

Jen Davis