Strength training for runners; it seems pretty intuitive. It’s reasonable to say that the vast majority of running injuries we see are due to training error – or to put it more simply; exceeding the capacity of a given tissue at a given time. Thus, when we are guiding injured runners back from injury, strength work will often be a part of their rehabilitation to try and equip the body to cope better with applied external forces in future. Thus, it feels quite sensible to recommend strength work to any runner who is currently uninjured (whether they be new to running or are perhaps an experienced runner but training for a specific goal) as a way to “prevent” injury. The word prevent is certainly the headline seller usually but is not an appropriate term to use, and we should probably favour talking in terms of reducing injury risk instead.
However, solid as all that sounds, is the science behind it solid? Does strength work deliver on the promise of reducing injury risk to runners? The recent paper that made me think about writing this short piece on the topic was the really nice two year prospective study performed by Messier and colleagues. They found that lower extremity strength was not predictive of injury which, in their own words was contrary to the long held belief that it would be. Another prospective paper published this year (Torp et al.) made similar conclusions; that hip and knee weakness did not increases the risk of running injury (in a female cohort).
There is one well referred to paper, and that is the work of Lauersen et al. which was a large systematic review and meta-analysis (over 26,000 participants) which concluded that strength training DID reduce overuse injuries, by almost half. HOWEVER, the studies included within the review were predominantly from soccer, handball and basketball so we should bear this in mind during our tendency to extrapolate this to the running populace.
In fact, the more you look, the more you realise that we are rather devoid of data to support our beliefs that being weak increases your risk of developing a running related injury. We need to acknowledge that the terms ‘weak’ and ‘strong’ are a bit vague of course, and we actually really do not know how strong we need to be to run. We should also note the limitations of research (as always!) and also that in reality strength is simply one piece of a far more complex puzzle when it comes to injury. That said, the fact remains – we do not seem to have the evidence to support the comment that “strength work reduces injury risk” in runners.
What there does seem to be more data for is the improvements in running economy secondary to strength training, and as a great blog by Kevin Maggs summarised: “since it helps with performance most runners should be implementing strength training anyway, so if it reduces injuries that’s just icing on the cake” which I think is a great take away.
References:
Messier, S.P., Martin, D.F., Mihalko, S.L., Ip, E., DeVita, P., Cannon, D.W., Love, M., Beringer, D., Saldana, S., Fellin, R.E. and Seay, J.F., 2018. A 2-Year Prospective Cohort Study of Overuse Running Injuries: The Runners and Injury Longitudinal Study (TRAILS). The American Journal of Sports Medicine https://www.ncbi.nlm.nih.gov/pubmed/29791183
Torp, D.M., Donovan, L., Gribble, P.A., Thomas, A.C., Bazett-Jones, D.M. and Beard, M.Q., 2018. No baseline strength differences between female recreational runners who developed an injury and injury free runners during a 16-week formalized training program. Physical Therapy in Sport, 34, pp.1-7. https://www.ncbi.nlm.nih.gov/pubmed/30138779/
Lauersen, J.B., Bertelsen, D.M. and Andersen, L.B., 2014. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med, 48(11), pp.871-877. https://www.ncbi.nlm.nih.gov/pubmed/24100287
Kevin Maggs’ blog: http://runningreform.com/strength-training-for-runners/
