Running Injuries: Big changes, big risk?

Running injuries in sport can occur with a prevalence as high as 80%. That means runners are constantly battling injuries.  In my opinion, most running injuries occur due to sudden increases in training volumes. Couple the increase in volumes with the fact that none of us are getting any younger (in other words, our tissues are not able to handle the loads we once placed on them during long mileage runs) and we have higher risks of injuries. I’d like to take this opportunity to provide some cautionary advice to all those runners who are in dire need of the constant need to pound the pavement and mileage and wish to reduce the risk of running injuries.

Sudden increases in volume or attempting to maintain the duration of time you previously ran last fall (ie. That personal best half-marathon you ran in October) may not always be beneficial. In fact, there is a large body of literature that suggests higher intensity over shorter distances is a more effective way of training. The evidence suggests that interval training for shorter periods may provide greater performance gains than long, drawn-out, steady state endurance training bouts.1 For runners, that means spending more time on repeats and hill runs rather than long runs. It should be noted that any new training regime for runners should be slowly introduced. I recommend small city blocks for repeats, and hill training that requires no longer than 10 seconds of uphill running, as an introduction with no more than 3-5 repeats (which means very short, hard intensity, runs to start). This prescription is simply anecdotal and runners should remember what works for one might not work for others.

When we look to the academic evidence for an interval training-based run program that involves scientific, clinical testing, we see the 10-20-30 protocol.2 The study out of the University of Copenhagen, Denmark, looked at moderately trained runners and running economy with adaptations to higher intensity, shorter duration interval running. The results of the study suggest a significant reduction in training volume while increasing intensity may improve running economy. The protocol is as follows:

7 week training program with 3 weekly sessions of 10-20-30 protocol

10-20-30 protocol:

1-1.5km warm-up at low intensity (below threshold using talk test=able to carry on a conversation easily).

3-4 sets of 5 minutes running followed by 2 minutes rest.

5 minutes running: 1 minute intervals divided into:

10 seconds maximal intensity running

20 seconds moderate intensity running

30 seconds easy intensity running

It is worth noting that the runners in this study were moderately trained for running. If you feel you are not yet a moderately trained runner then perhaps using the anecdotal advice might be more beneficial. Either way, you are attempting to minimize the damage to tissues that comes with the repetitive strain associated with long distance running.

Another tip to take advantage of prior to hitting the long and winding road is improving tissue tolerance through strength training. Certainly when I inquire with most weekend warriors and/or endurance athletes, especially those who are getting on in years, there is a lack of understanding with how and when to implement a strength training program. There is a significant body of evidence that suggests those adults who make use of a strength training program, however, have greater running performance improvements compared to those who do not. A recent study found marathoners can improve running economy with the help of a 6-week maximal strength training program.3 The training program was performed twice a week and the most significant gains were found in the group who performed lower amount of repetitions, combined with higher amounts of intensity.

In conclusion, one of the most effective ways to reduce the risk of running injuries is to incorporate interval training such as the 10-20-30 protocol. Second is to prepare your tissues for the loads they will encounter by using a high intensity strength training program. Now before I send you out onto the pavement or your local gym to throw the weights around, I caution you to consult a healthcare professional before starting any new training regime. You also need to remember that most runners have the mindset that they are built for one thing…running. So… when sudden changes in volumes of running occur without preparation (such as using the 10-20-30 protocol and a strength training program) then your risk of injury are much higher. The last thing any runner wants is to mandatory time off due to injuries.

  1. Queiroz AC, Kanegusuku H, Chehuen M, Costa LA, Wallerstein L, Dias da Silva V, et al. Cardiac Work Remains High after Strength Exercise in Elderly. Int J Sports Med. 2012 Nov 22.
  2. Gunnarsson TP, Bangsbo J. The 10-20-30 training concept improves performance and health profile in moderately trained runners. Journal of Applied Physiology. 2012 Jul 1;113(1):16–24.
  3. Francesca PM, Giulia DI, Stefania C, Alessandro S, Gianluca V, Antonio LT. Concurrent strength and endurance training effects on running economy in master endurance runners. Journal of Strength and Conditioning Research. 2012 Nov:1.


About the Author: Dr. Piper

Dr. Piper is the only sports specialist chiropractor in Edmonton. In addition to joining the Evolve Strength team, he works alongside sports medicine specialists, orthopaedic surgeons, radiologists, physiotherapists and athletic therapists at the Edmonton Sport Institute helping athletes of all levels achieve their goals and recover from injury. Dr. Piper has an extensive post graduate education in rehabilitative medicine and sport sciences

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