Most of us think that strength training can potentially play a role in injury prevention, but what does the research say? Let’s delve into this topic and discuss the studies that have attempted to answer this question: can strength training prevent running injuries?
One study conducted by Baltich in 2017 aimed to assess the impact of different training interventions on running injuries in novice runners. The participants were randomized into three groups: a resistance strength training group, a functional strength training group, and a stretching control group. The interventions were carried out for 8 weeks, followed by a reduced frequency over the next 12 weeks. Surprisingly, the study found no significant difference in injury rates between the groups. However, it's worth noting that the exercise intensity and progression were not adequately addressed in this study, suggesting that the exercises may not have been sufficient to yield significant strength gains.
Another study by Bredeweg in 2012 focused on the effectiveness of a preconditioning program in preventing running-related injuries in novice runners. Participants either completed a 4-week preconditioning program or did nothing before embarking on a 9-week running program. The preconditioning program consisted of walking, hopping, and additional walking sessions. The study found no significant difference in injury rates between the preconditioning and control groups. It is important to note that a 4-week program may not provide enough time to build substantial strength, and the effectiveness of the exercises in creating positive adaptations is questionable.
In a more recent study conducted by Desai in 2023, the researchers investigated the effectiveness of an 18-week general strength and foam-rolling intervention on running-related injuries in recreational runners. The intervention involved twice-weekly strength training sessions combined with foam rolling exercises. Interestingly, there was no significant difference in injury rates between the intervention and control groups. However, compliance with the intervention played a significant role. Runners who adhered to the program had an 85% lower risk of injury, which highlights that strength training can reduce the risk of injury, but only if it is consistently performed.
A study by Mendez-Rebolledo in 2021 examined the protective effect of neuromuscular training in female track and field athletes. The athletes were randomly assigned to either conventional training or neuromuscular training. The results showed a significantly lower incidence of injuries in the neuromuscular training group compared to the conventional training group (6.58 injuries per 1000 hours running exposure vs 17.89), particularly medial tibial stress syndrome (0.82 vs 5.96 injuries per 1000 hours). However, it is difficult to determine which specific components of the neuromuscular training program contributed to its success.
In a study focusing specifically on marathon runners training for the New York Marathon, Toresdahl conducted a randomized study in 2020 to assess the effectiveness of a strength training program in preventing injuries. The intervention consisted of a 12-week self-directed 10-minute program to be completed three days per week. However, the study found no significant differences in injury rates between the control and strength training groups. The exercise selection in this study may not have been sufficient to elicit positive adaptations.
Taddei in 2020 examined the impact of foot core training compared to stretching in preventing running-related injuries. The participants were randomized into a foot-strengthening group or a control group that performed static stretching. The foot strengthening protocol involved supervised exercises once a week and additional exercises performed at home with remote supervision. At the end of the 12-month follow-up period, the foot strengthening group were 2.42 times less likely to sustain an injury and larger gains in foot strength over the 8 weeks of training were correlated to a longer time in developing an injury
Lastly in 2024, Leppänen compared the effects of Hip & Core strengthening and Foot & Ankle strengthening to stretching in 325 novice runners. The participants were randomized into each group and followed over 24 weeks. The end results revealed a 39% lower injury rate in the Hip & Core exercise group, but unlike Taddei's study, they did not find a decreased risk of injury in the Foot & Ankle group. However, the exercises prescribed in this group may have been insufficient to see benefit.
Key takeaways:
Based on the reviewed studies, it is clear that strength training alone does not guarantee injury prevention in running. However, several important considerations arise:
Multifactorial nature of running injuries: Strength training is just one component in a larger picture that includes training load, running technique, and stress management. It should be part of a comprehensive injury prevention approach.
Exercise intensity and selection: To reap the benefits of strength training, exercises should be challenging and progressively overloaded over time. Generic programs may not offer significant benefits compared to customized programs tailored to individual needs.
Compliance matters: Adherence to a strength training program is crucial for injury prevention. The studies highlight the importance of consistent and sustained participation.
Conclusion:
While the evidence on the preventive effects of strength training for running injuries is mixed, incorporating strength training into a comprehensive injury prevention strategy can still be beneficial. The selection of appropriate exercises, careful progression, individual customization, and ensuring compliance are key factors for maximizing the effectiveness of strength training. As health professionals, we should encourage runners to include strength training as part of their training regimen, alongside other injury prevention measures.
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REFERENCES
Baltich, J., et al. (2017). "Running injuries in novice runners enrolled in different training interventions: a pilot randomized controlled trial." Scand J Med Sci Sports 27(11): 1372-1383.
Bredeweg, S. W., et al. (2012). "The effectiveness of a preconditioning programme on preventing running-related injuries in novice runners: a randomised controlled trial." Br J Sports Med.
Desai, P., et al. (2023). "Effectiveness of an 18-week general strength and foam-rolling intervention on running-related injuries in recreational runners." Scand J Med Sci Sports.
Leppänen, M., et al. (2024). "Hip and core exercise programme prevents running-related overuse injuries in adult novice recreational runners: a three-arm randomised controlled trial (Run RCT)." Br J Sports Med.
Mendez-Rebolledo, G., et al. (2021). "The Protective Effect of Neuromuscular Training on the Medial Tibial Stress Syndrome in Youth Female Track-and-Field Athletes: A Clinical Trial and Cohort Study." J Sport Rehabil 30(7): 1019-1027.
Suda, E. Y., et al. (2022). "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." Am J Sports Med 50(1): 248-254.
Taddei, U. T., et al. (2020). "Foot Core Training to Prevent Running-Related Injuries: A Survival Analysis of a Single-Blind, Randomized Controlled Trial." Am J Sports Med 48(14): 3610-3619.
Toresdahl, B. G., et al. (2020). "A Randomized Study of a Strength Training Program to Prevent Injuries in Runners of the New York City Marathon." Sports Health 12(1): 74-79.