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Man running under dark cloudsOne of my favourite things to emphasise to new runners is the importance of consistency. And that leads to my Golden Rule of running: Don’t Get Injured. Running injuries will quickly destroy your running habit.

It stems from my own fear. Running is such an important element to my own wellbeing, especially my psychological health, that I am horrified at the prospect of missing out on it for more than a few days. ‘Don’t Get Injured’ can sound a little trite. After all, you can be unlucky and accidents do happen. You could get knocked over by a rampaging dog or you could slip on some mud and rick your back. There are 101 ways to get injured through no fault of your own.

In turns out that most running injuries are due to overuse and what the researchers like to call ‘training errors’. Don’t get injured through your own enthusiasm or ignorance. A systematic review of runners’ injuries was published in the medical journal PLOS One in 2015. They scooped up 15 studies and pooled the results. Here’s what they found.

Newbie runners are at greater risk – what about the 10% rule?

Men who had been running for less than two years had a greater risk of injuries. The conventional wisdom here is that you have to give your body time to adapt to running. The resilience in muscles and connective tissue that knits us together doesn’t come overnight. Too much, too soon, and you push your risk up.

That’s where the ’10% rule’ comes in. This is the oft-quoted advice that you shouldn’t increase your training volume by more than 10% a week. This is thought to reduce the risk of your injury. But has it actually been tested in novices? Is there any evidence behind this?

There was a randomised controlled trial in 2008 in Groningen in the Netherlands that set out to answer that exact question using over 500 people. The GRONORUN (what is it with researchers and study names?) put two groups of novice runners through a standard 8-week training programme or a graded ’10% rule’ 13-week programme.

The 10% rule group had the same number of injuries as the control group

And… they found no difference between the two groups. The standard programme had running injuries in 20.3% and the 10% rule group had injuries in 20.8%. Looking at the study I’m not convinced there was enough of a difference between the training done by the two groups. An 8-week programme is still a reasonable length of time given the event targeted was a relatively modest 4 miles (6.7km).

What is worth noting is just how high the injury rates were: both groups were over the 20% mark. In a similar bit of research, the Vancouver Sun Run study, the injury rate was up at 29.5 per 100 runners. Another study with novice runners training for a marathon had rates as high as 58 per 100 runners (though their definition of injury was a little wider and included any running related pain that reduced their running in some capacity).

Establishing a running habit as a novice isn’t without risk of injury. Bear it in mind. Do everything you can to stop it.
But don’t jack it all in if you do pick up an injury. It’s part of the journey for many of us.

Re-starters are at greater risk of running injuries

Any kind of break in running also ramps up the risk. It’s easy to see how this could happen. You might have been running at much higher mileages and going for longer runs. It’s tedious and frustrating to have to rein in your enthusiasm. The mind is willing but the body ain’t quite there yet.

Patience here is obviously key. Live in the moment and enjoy the running you can do – not the running you want to do next month.

Previous injury predicts the chance of future injury

There was strong evidence that a history of previous running injury is associated with future injury. That’s bad news because there isn’t a darn thing you can do about your past. However, it might make you ultra cautious about your approach to your training. If a previous injury has left you with some kind of biomechanical kink then it’s easy to see how you are vulnerable.

Be careful about following generic programmes and be prepared to modify your own if you start to feel a twinge or a tweak.Train for yourself. Listen to those niggles and nurse your body.

Pair of running shoes Orthotics and shoe inserts

These were found to be associated with an increase in running injuries. The key word in that last sentence is associated. There is the possibility that orthotics are causing injuries. That can’t be excluded. It is perhaps more likely that they are a marker for people who have biomechanical problems. (And they may not be doing much to fix those.) You are in the same boat as those with previous running injuries. Follow your own path and be careful of any significant increases in training volume.

It’s not the years honey, it’s the mileage*

How far you run matters.
Men who ran more than 40 miles per week were at greater risk. There was some evidence that older men were at more risk of hamstring injuries and achilles tendinopathies. A good reason for the older guys to hit that stretching mat.
That said, one study found that increased hours of running was protective against overall injuries. It might be that these are a self-selected group who can tolerate higher training volumes. They also found that running more than six times per week gave a significant risk for running injury.

Summary

If you are a newbie or just getting back to it after a break then be very cautious.

Build it up slowly, be consistent. OK, the 10% rule is pretty much based on someone holding a wetted finger up in the air. But evidence is tough to come by in this field. The phrase “limited evidence” is used 27 times (I counted) in the PLOS One paper. But, as commonsense goes, the 10% rule is not a bad place to start. If you have been injured in the past or you use orthotics then be extra vigilant.

Don’t be the bloke who thrashes himself for a fortnight, gets hurt, and then loses motivation for months. Consistency trumps intensity for almost all normal people. Be the guy who cranks out week after week and builds resilience.

And enjoy it.

 

Coming soon: Injury Prevention for Runners: What Actually Works?

Notes:
Photos by Jenny Hill and Kristian Egelund at unsplash.com.
*Raiders of the Lost Ark quote in case you were wondering…

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