The Association Between Running Injuries and Training Parameters: A Systematic Review

J Athl Train. 2022 Jul 1;57(7):650-671. doi: 10.4085/1062-6050-0195.21.


Objective: To synthesize the current evidence on the incidence of running-related injuries (RRIs) and their association with training parameters (distance, duration, frequency, intensity), as well as recent changes in training parameters.

Data sources: Searches were conducted in MEDLINE/Ovid, CINAHL, Embase, and SPORTDiscus from their inception through July 7, 2020.

Study selection: Included articles had to report prospective data on RRIs and training parameters or any changes in parameters and be published in English or French. Two reviewers independently screened the titles, abstracts, and full texts.

Data extraction: Two independent raters performed data extraction and quality assessment using QualSyst, a quality appraisal tool.

Data synthesis: A total of 36 articles that involved 23 047 runners were included. Overall, 6043 runners (26.2%) sustained an RRI (incidence range = 8.8%-91.3%). The incidence of RRI was 14.9% in novice runners (range = 9.4%-94.9%), 26.1% in recreational runners (range = 17.9%-79.3%), and 62.6% in competitive runners (range = 52.6%-91.3%). The 3 most frequently injured body parts were the knee (25.8%), foot/ankle (24.4%), and lower leg (24.4%). Overall, evidence about the association between weekly running distance, duration, frequency, intensity, or specific changes in training parameters and the onset of RRIs was conflicting.

Conclusions: Despite high rates of RRIs, current evidence does not consistently link RRIs with specific training parameters or recent changes in training parameters. Therefore, caution should be taken when recommending optimal parameters or progressions. Given the multifactorial nature of RRIs, future studies also need to consider the interactions between training parameters as well as psychosocial, hormonal, lifestyle, and recovery outcomes to better understand the onset of RRIs.

Keywords: exercise; incidence; prevention; sports medicine.

Publication types

  • Systematic Review

MeSH terms

  • Athletic Injuries* / epidemiology
  • Athletic Injuries* / etiology
  • Humans
  • Incidence
  • Lower Extremity / injuries
  • Prospective Studies
  • Running* / injuries