Limited evidence on changes in training load and running-related injury

A new RUNSAFE-based systematic review by Damsted et al. in IJSPT reveals weak evidence on changes in training load and running injury


Sudden changes (increases and decreases) in training load have been suggested to play a key role in the development of running-related injuries. However, the compiled evidence for an association between change in training load and running-related injury does not exist.  Therefore, the purpose of the present systematic review was to compile the evidence from original articles examining the association between changes in training load and running-related injuries.  Four databases (Pubmed/Medline, SPORTDiscus, Embase, and Scopus) were systematically searched. Articles were included if 1) the study design was a randomized trial, a prospective cohort study, a cross-sectional study or a case-control study, 2) participants were runners between 18-65 years, and 3) specific information on changes in training load was provided. Methodological quality of included articles was assessed using the Newcastle Ottawa Scale or the PEDro rating scale. Four articles fulfilled the eligibility criteria of which three found an association between increases in training load and an increased risk of running-related injuries: This association was shown by an increased injury risk amongst runners if they: 1) recently had performed one or more changes in either velocity and/or distance and/or frequency compared with the non-injured runners (p=0.037), 2) increased their average weekly running distance by more than 30% compared to an increase of less than 10% (Hazard Ratio =1.59 (95% Confidence Interval: 0.96; 2.66)), 3) increased their total running distance significantly more the week before the injury origin compared with other weeks (mean difference: 86%; 95% Confidence Interval: 12%; 159%, p=0.026). However, no difference was found between a 10% and a 24% average increase in weekly volume (HR=0.8, 95% CI: 0.6; 1.3).  The authors concluded that very limited evidence exists supporting that a sudden change in training load is associated with increased risk of running-related injury among amateur and novice runners.


Damsted, C.; Glad, S.; Nielsen, R.O.; Sørensen, H.; Malisoux, L. Is There Evidence For An Association Between Changes in Training Load and Running-Related Injuries? A Systematic Review. International Journal of Sports Physical Therapy, December, 13(6): 931-942.

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