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eval set · question 15 of 22 · graded by hand

Does increasing weekly distance by more than 30% raise injury risk?

No card directly tests the classic '10% rule' or a specific 30% weekly mileage increase threshold for injury risk. no source

not yet graded

Sudden spikes in single-session running distance relative to the prior 30-day longest run are associated with increased overuse injury risk, with risk increasing as spike magnitude increases. 1

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In Korean recreational runners, increasing weekly mileage from 20-30km to 30-40km was associated with higher injury odds (OR 1.66), though evidence is weak. 2

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Higher weekly running distance is associated with increased asymptomatic MRI-detected ankle injury findings in amateur marathoners, though evidence is weak. 3

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High total training distances per week/month are associated with increased injury/pain risk in endurance athletes, with an inverted-U relationship suggested (both very low and very high volumes/durations increase risk). 4

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Lower weekly mileage and undertraining, rather than high mileage, were associated with increased race-related injury risk in marathon/half-marathon runners. 5

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Lower weekly distance (3km vs 6km start) was associated with fewer injuries in obese novice runners, supporting caution with rapid increases in distance for this population. 6

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What we can't tell you


Sources

1

A spike in single-session running distance compared with the longest distance run in the past 30 days is associated with increased risk of running-related overuse injury, with the effect increasing with spike magnitude.

pop. Adult runners (n=5205, mean age 45.8 years, 22% female) · direction Positive dose-response: small spike HRR=1.64, moderate spike HRR=1.52, large spike HRR=2.28 · design Cohort study · strong

passage withheld — license not verified for reproduction

How much running is too much? Identifying high-risk running sessions in a 5200-person cohort study (2025) · doi 10.1136/bjsports-2024-109380

2

In Korean recreational runners, previous exercise experience, setting specific running goals, and mileage increases from 20-30 km to 30-40 km weekly are associated with increased running-related injury risk.

pop. Korean recreational runners (1046 respondents: 624 male, 422 female) · direction positive (exercise experience OR 1.57, goal-setting OR 1.57, mileage increase OR 1.66) · design cross-sectional survey · weak

passage withheld — license not verified for reproduction

3 Epidemiology of running-related injuries in the Korean population: a cross-sectional survey of 1046 runners (2021) · doi 10.1136/bjsm-2021-basemabs.3

3

Amateur marathon runners demonstrate multiple asymptomatic MRI-detectable ankle injuries, with bone marrow edema-like signal intensity, peritendinous effusion, and partial lateral collateral ligament injury being the most common findings, and risk factors including increased age, running years, weekly running distance, and rearfoot strike pattern.

pop. 113 asymptomatic amateur marathon runners · direction positive association with increased age, running years, weekly distance; mixed for rearfoot strike pattern (increases some injuries, protective for others) · design cross-sectional observational study · weak

passage withheld — license not verified for reproduction

MRI features of and factors related to ankle injuries in asymptomatic amateur marathon runners (2020) · doi 10.1007/s00256-020-03530-9

4

High total training distances per week/month and extreme training durations (both low weekly <2 hours/week and high monthly) are associated with increased injury and/or pain risk in endurance sport populations

pop. Endurance sport athletes (running, triathlon, rowing) · direction positive (both high total distances and extreme durations increase risk; inverted-U relationship suggested) · design Systematic review of prospective cohort studies · strong

passage withheld — license not verified for reproduction

The associations between training load and baseline characteristics on musculoskeletal injury and pain in endurance sport populations: A systematic review. (2018) · doi 10.1016/j.jsams.2018.03.001

5

Previous running injuries, undertraining, lower weekly mileage, and inexperience increase race-related injury risk in marathon runners

pop. Adults participating in half marathons (n=1043) and full marathons (n=624) · direction negative for injury risk with higher training mileage (>23 miles/week for half marathons, >40 miles/week for full marathons); positive for injury risk with previous injury, lower mileage, younger age (half marathons), female sex (half marathons), and less experience (full marathons) · design Observational cross-sectional study · moderate

passage withheld — license not verified for reproduction

Factors Associated With Half- and Full-Marathon Race-Related Injuries: A 3-Year Review (2019) · doi 10.1097/JSM.0000000000000775

6

A start-to-run distance of 3km per week is associated with fewer running-related injuries and significantly fewer symptoms of overuse injury compared to 6km per week among obese novice runners.

pop. Obese novice runners with BMI 30-35 · direction negative (protective effect with lower weekly distance) · design Randomized controlled trial · moderate

passage withheld — license not verified for reproduction

THE START-TO-RUN DISTANCE AND RUNNING-RELATED INJURY AMONG OBESE NOVICE RUNNERS: A RANDOMIZED TRIAL. (2018) · doi 10.26603/IJSPT20180943