By Chris Wilson - https://www.reactphysiotherapy.co.uk/

Top 5 factors that may influence running injury according to evidence and what we experience in the React clinic: 

1.Training errors/training load

Whether you are a new or experienced runner, training errors through an increase in training load are among the main reasons injuries occur. Consideration should be given to: 

• Training volume; Sudden changes in volume such as distance will increase demands on tissues that are not used to tolerating these loads.

• Speed; Rapid speed changes will increase load exposure to tissues.

• Terrain; A change in landscape will expose different demands to tissues, e.g. The load to cover 4 miles over flat ground will be different to 4 miles over hilly terrain.

All these variables are suitable for developing tissue tolerance, coordination and neuromuscular control. Ideally, these need to be incorporated in a structured way. Changing too many variables at once may increase injury risk! 

2. Rest / recovery (inadequate);

Our work, family and social commitments can affect our ability to managing appropriate rest/recovery. Key factors: 

• Sleep allows the body to adapt and regenerate to the stress placed on it from running.

• Recovery between sessions is vital. Each type of run will give you a varied stimulus; the muscles need to recover from running and internal stress.

• Awareness of accumulative running load needs to be considered. Changes in duration or frequency may need further rest to enable adaptation.

• Nutrition also plays a key role. (Check out our blogs on nutrition for more information).

3. Strength training 

Strength training is associated with reducing the risk of injury. A well-designed strength programme can build tissue tolerance, capacity and improve running economy. It is always recommended to seek advice on appropriate strength training. The addition of load to strength training increases tissue tolerance and provides a stimulus to generate force application into the ground! 

4. Training age 

When starting a running programme or returning after a break, consider your past experience of running activity or exercise. Suppose previous sports you have participated in included running, jumping, sprinting or changing direction. In that case, you may be more accustomed to running load compared to others who do not have any past experience of those activities. Therefore progressing a running programme may be more comfortable for someone with a higher training age (previous experience) than someone with a low training age. 

5. Footwear 

We have added footwear to this list as it is a topic discussed a lot between runners and commonly discussed in the React clinic with our patients. There is a vast amount of confusing and flawed information out there about footwear. When it comes to footwear, the evidence concerning injury is significantly lacking. There is not one particular make or model that will reduce injury! Footwear and how it behaves (applies load to the foot/body) will act differently on the individual. The primary influence on an injury that footwear has is when someone makes a significant change between footwear, such as a big change in geometry of the footwear, which may add load to structures that are not usually accustomed to this when in other footwear. The comfort filter is probably the main advice we have regarding the proper footwear for the individual. 

Conclusion

You can probably guess that this list is not exhaustive, and therefore many other factors will contribute to why someone may become injured. Now I wish it was as easy as prescribing an exercise, a change of footwear, or even delivering a treatment to prevent someone from getting injured, but unfortunately, it is not that easy. Each individual responds differently to the same stimulus, and there are several things to consider with injury. I think it is safe to say that we will never be able to prevent damage, but we can hopefully make informed decisions to reduce the risk of injury. 

The key to reducing the risk of running injury is to make sure you have the basics done well. These may include training load, recovery, sleep, strength training and nutrition. 

Ensure the basics are done well before looking at the more complicated elements!