Over my 35-year career as an exercise physiologist and athletic trainer, I have treated numerous athletes with acute and chronic injuries. Injuries in endurance sports including running, cycling, swimming and walking are usually the result of overuse. Overuse is a chronic condition that occurs when the athlete’s body cannot stand up to the regular stresses of training and competition without breaking down.
Before we delve further into this topic, I would like to dispel the common misconceptions regarding endurance injuries. Research shows that
- Males do not have higher injury rates than females.
- Training speed, racing speed, running surface and body weight are not related to injury risk.
- Foot strike pattern - heel versus forefoot has no impact on injury rate.
- Warm-up, cool-down and stretching before exercise do not reduce injury risk.
In this article, we will focus on running since it is classified as high injury sport. Statistically, 65% of runners are injured in an average year. This breaks down to one injury per 100 hours of running thus runners miss approximately 5-10% of their workouts due to injury. This rate could be significantly lower if runners knew more about the causes of injuries, made simple adjustments in their training schedules, and routinely strengthened their muscles and joints. In fact, research indicates that running injuries could be reduced by 25% with these recommendations.
Studies have shown that a runner who trains three hours per week will take 33 weeks to get injured. If the runner increases running to five hours per week then the injury rate would be once every 20 weeks. More training means more repetitive stress to the “weak link” in the body, which equals more frequent injuries. It is not surprising that the highest injury rates in runners occur with a training volume of 40 miles or more per week. Additionally, the more consecutive days one trains the higher the chances of getting hurt. The obvious solution would be to avoid too many consecutive days. For example, someone training Monday through Friday for an hour each session would be training on five consecutive days before their first rest day on Saturday. Training this way substantially increases the runner’s potential for an overuse injury. If this runner changed the training program to four days a week for 75 minutes per session with one day of recovery between each training day the runner would significantly lower their risk for getting injured. Meaning, training on Monday, Wednesday, Friday and Sunday would give much more average recovery time between workouts.
Half of sports injuries are actually reoccurrences of previous problems. This indicates that athletes are not taking care of their injuries properly. An injury should be more than just a hindrance; it should be an indication that a body part is simply not strong enough and needs to be addressed/taken care of properly. Most athletes who are injured use the typical ice, rest and anti-inflammatory treatments. However, these treatments are not a cure, but a short-term remedy thus resulting in 50% of injuries reoccurrence. Athletes need to strengthen - not just rest and ice – vulnerable body parts, so that those areas will hold up to future training stresses. Athletes should strength train as an injury preventer. In fact, there is very strong scientific evidence to support the strength training recommendation. Studies have consistently demonstrated an inverse relationship between strength and injury; the stronger the muscle and joint the less likelihood of injury and vice versa. Strength training should be specific to the movement patterns of the sport, weight bearing in nature, and involve the large muscle groups of the body forcing the muscles to function powerfully and in synchrony.
Don’t allow an overuse injury to prevent you from being physically active and competitive. By following the above recommendations and working with exercise physiologists and certified strength and conditioning specialists, you can avoid the common setbacks associated with injury and continue an active lifestyle for many years to come.
Thank you to our readers for submitting this question. We have had many wonderful questions/comments, which have resulted in several of the articles written thus far and questions that have been submitted in the last few months will be answered in the upcoming months.
More information can be found in 100 Questions and Answers About Sports Nutrition and Exercise by Lilah Al-Masri, MS, RD, CSSD, LD and Simon Bartlett, PhD, CSCS, ATC.
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