What do we know about injuries?

This article was originally posted by Ryan at the original HillRunner.com Blogs.


Ask science and injuries are still in many ways a black box. We don’t really know what causes them. We have some ideas but there is no concrete evidence. Some will tell you heel striking causes injuries. Others will tell you midfoot or forefoot striking causes injuries.

The truth is that different injuries have different causes. What we don’t know is that there are some overarching causes that apply across the board.

Well, there have been a couple recent developments on this front.

Forget the term "overuse injury"?

First, a letter published in the British Journal of Sports Medicine makes the case that we should ditch the term "overuse injury" in favor of the term "training load errors".

Their idea is that it’s not how much you train, it’s how your training load changes over time. They talk about an "acute:chronic load ratio" which essentially compares your workload over the past week to the average of your past 4 weeks. If your ratio is above 1.2:1 (meaning your most recent week is more than 120% of your 4 week average), you have an elevated risk of injury. If your ratio is 1.6:1 (meaning your most recent week is more than 160% of your 4 week average), you are far more likely to get injured.

This seems like common sense. If you’re increasing your training load, either volume or intensity, there’s a risk. You’re much less likely to get injured if you don’t increase. The more gradual you build, the less likely you are to suffer an injury. However, at times at least, we need to increase and possibly risk injury if we want to get better. This is a good reminder that there is risk that goes with the reward so we should keep that in mind and take good care of ourselves as we increase our training load.

How to prevent running injuries?

Has the question really been answered? Well, this article suggests it might have.

While the idea is sound, a more gentle foot plant (I have always preferred that term to "foot strike" which, in my mind, conjures an image of a violent collision with the ground) should reduce impact forces and lead to less stress, I’m not fully convinced of the final conclusions drawn.

Consciously focusing on changing your form can backfire. Maybe it’s worth experimenting with if you suffer injuries already but there is risk involved. Just be careful if you give it a try.

Image credit: Running painful ankle injury by 4Chion Marketing, on Flickr

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