footnote1 running answers, grounded in research

eval set · question 11 of 22 · graded by hand

Does weekly training volume predict running-related injury?

Evidence is mixed: some studies find higher weekly training volume is protective (associated with lower injury risk) in adolescent and adult distance runners. 1 2 3 4

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Running less than 15 km/week combined with slower pace is associated with higher injury risk in half-marathon trainees, suggesting a volume threshold effect. 5

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Other studies find no significant prospective association between week-to-week changes in training volume and running-related injury in high school runners. 6

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Relative or absolute weekly volume changes combined with pace progression are not significantly associated with increased injury risk in recreational runners. 7

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No significant difference in injury risk between runners who progress training volume versus training intensity. 8

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Foot-core training's protective effect against injury is diminished at higher training volumes, suggesting volume interacts with other factors rather than acting alone. 9

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Overall, the relationship between weekly training volume and running-related injury risk is inconsistent across studies, with some showing protective effects, some showing threshold effects, and others showing no association. 6 2 3 4 5 7 8

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What we can't tell you


Sources

1

COVID-19 social distancing restrictions resulted in lower training volume, fewer running-related injuries, and reduced healthcare provider visits in youth long-distance runners.

pop. Youth long-distance runners aged 9-19 years (mean age 15.3 ± 1.7 years) participating in cross-country, track and field, road races, or recreational running (n=287; 124 male, 162 female). · direction Negative: reduced training volume and injury frequency during restrictions; reduced healthcare-seeking behavior · design Cross-sectional survey with within-subject comparison (pre vs. during COVID-19) · moderate

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Impact of COVID-19 Social Distancing Restrictions on Training Habits, Injury, and Care Seeking Behavior in Youth Long-Distance Runners (2020) · doi 10.3389/fspor.2020.586141

2

Previous injury and race distance are main associated factors for running-related injuries, while weekly training volume, age, and previous participation are protective factors.

pop. 4380 runners across three race distances (10km n=1316, 21km n=2168, 42km n=896); median age 36 years · direction Protective effect of training volume (higher volume associated with lower injury risk); positive association with previous injury and increased race distance · design cross-sectional · weak

passage withheld — license not verified for reproduction

Training volume and previous injury as associated factors for running-related injuries by race distance: A cross-sectional study (2019) · doi 10.14198/JHSE.2019.143.06

3

Higher training volume (number of sessions per week) is associated with lower risk of running-related injuries in competitive adolescent distance runners.

pop. Competitive adolescent distance runners aged 13-18 years in England (n=113) · direction negative (lower injury risk with higher training volume) · design cross-sectional · weak

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Training Practices and Injuries in Competitive Adolescent Distance Runners: A Retrospective Cross-Sectional Study. (2020) · doi 10.31236/osf.io/6hrpn

4

Among Ethiopian 10,000-meter long-distance runners, the incidence of lower-extremity running-related injuries is 62.4%, with previous injury history, training volume, and shoe replacement frequency as significant risk/protective factors.

pop. 10,000-meter long-distance runners in Ethiopia (from running clubs and Youth Athletics Training Programs in Amhara Regional State and Addis Ababa) · direction Protective effect at moderate training volumes (40-60 km/week) and regular shoe replacement (8-11 months); previous injury increases risk 8.20-fold · design prospective cohort study · moderate

passage withheld — license not verified for reproduction

Lower-extremity running-related injuries among 10,000-meter long distance runners in Ethiopia (2019) · doi 10.14198/JHSE.2019.142.09

5

Runners covering less than 15 km per week and/or running slower than 6 min/km may sustain more running-related injuries than counterpart runners during a 14-week half-marathon training program.

pop. Healthy runners (n=784) following a specific half-marathon running schedule · direction negative (lower injury risk with higher weekly volume and faster pace) · design prospective cohort study · moderate

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ProjectRun21: Do running experience and running pace influence the risk of running injury-A 14-week prospective cohort study. (2019) · doi 10.1016/j.jsams.2018.08.014

6

Week-to-week changes in training volume, duration, intensity, and training stress are not prospectively associated with running-related injury in high school cross-country runners.

pop. High school cross-country runners (434 enrolled, 161 completed ≥75% of daily surveys) · direction null association · design Prospective cohort study · moderate

passage withheld — license not verified for reproduction

Week-to-week changes in training were not prospectively associated with injuries among Wisconsin high school cross-country runners (2024) · doi 10.1136/ip-2024-045233

7

Relative weekly change >10% in running volume combined with running pace progression, and absolute weekly change >5km in running volume combined with running pace progression, are not statistically significantly associated with increased injury risk in recreational runners.

pop. 586 injury-free recreational runners in Denmark · direction No significant positive interaction effect · design Prospective cohort study with secondary analysis of randomized trial data · moderate

passage withheld — license not verified for reproduction

Interactions between running volume and running pace on injury occurrence in recreational runners: A secondary analysis. (2021) · doi 10.4085/1062-6050-0165.21

8

There is no difference in running-related injury risk between recreational runners who progress running intensity versus those who progress running volume

pop. Healthy recreational runners (n=447 completing 16-week intervention) · direction No difference; risk differences ranged from -14.0% to 2.9% with overlapping confidence intervals crossing zero · design Randomized controlled trial · moderate

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Run Clever – No difference in risk of injury when comparing progression in running volume and running intensity in recreational runners: A randomised trial (2018) · doi 10.1136/bmjsem-2017-000333

9

Foot-core training is a protective factor against lower limb running-related injuries in recreational runners, with this protective effect modulated by age and training volume.

pop. Middle- and long-distance recreational runners (N = 118, mean age and sex distribution not specified in abstract) · direction negative (protective effect of foot-core training), but diminished with older age and higher training volume · design secondary analysis of randomized controlled trial (cohort study design) · moderate

passage withheld — license not verified for reproduction

Predictive Effect of Well-Known Risk Factors and Foot-Core Training in Lower Limb Running-Related Injuries in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial. (2022) · doi 10.1177/03635465211056329