Increases in training volume associated with injuries among runners
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Results presented at the American Medical Society for Sports Medicine Annual Meeting showed an association between increases in training volume with injuries among runners training for a marathon.
“Significant increases in training volume do seem to put [runners] at risk for injury, which is not surprising for a lot of runners or clinicians, but it starts to put numbers to what we have known for years,” Brett G. Toresdahl, MD, assistant attending physician at Hospital for Special Surgery Sports Medicine Institute, told Healio Orthopedics. “What we can now do, since we have the numbers, is start to provide people more objective guidance so, hopefully, they can increase their mileage safely without being interrupted by injury.”
Toresdahl and colleagues monitored 732 runners participating in the 2019 New York City Marathon starting 16 weeks before the race. Participants logged training runs using an exercise training application (Strava, Strava), and researchers surveyed runners every 4 weeks about injuries and to verify all runs were logged. Researchers used the acute-to-chronic workload ratio to analyze 57,546 training runs logged during the study period.
“We did a fairly standard approach to the acute-to-chronic workload ratio where we looked at the training mileage over the past 7 days and compared it to the training mileage over the past 28 days,” Toresdahl said. “Then, we did a rolling average of that and we counted how many days over a course of a 4-week period runners exceeded a threshold of 1.5 and then we associated the number of days over that threshold with the recurrence of injury.”
Results showed 33% of participants reported injuries between 16 and 4 weeks prior to the race. Linear regression analysis that controlled for age, sex, BMI, running history and goal finishing time showed an association between risk of injury and number of days when the acute-to-chronic workload ratio was 1.5 or greater. Researchers found the risk of injury increased by 1.8 percentage points for each additional day when the acute-to-chronic workload ratio was 1.5 or greater. The risk for injury also increased by 0.9 percentage points for each additional day when the acute-to-chronic workload ratio was 1.3 or greater, according to results.
“Overuse injuries and running injuries in general are a part of why people see sports medicine physicians and, if we can find ways to decrease those injuries using the data that they are already collecting with watches or smartphone apps, then we can hopefully keep people active and out of the office which is, at the end of the day, what we are all hoping for [and that] is that they can keep running,” Toresdahl said.
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Toresdahl BG, et al. Acute-to-chronic workload ratio associated with injury in marathon runners. Presented at: American Medical Society for Sports Medicine Annual Meeting; April 13-18, 2021 (virtual).
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