Training volume and previous injury as associated factors for running-related injuries by race distance: A cross-sectional study




Running, Epidemiology, Athletic Injuries, Etiology, Sports


Objective: This study aims to determine the relationship between weekly pre-competition running volume and the presence of running-related injuries (RRIs) by race distance. Methods: An online questionnaire was sent to 25,000 participants, 14 days following the running event. The questionnaire included the presence and topography of RRIs, previous injury in the last 12 months, running experience, training, and sociodemographic characteristics. Univariate and multivariable binomial regression was used to analyse the crude and adjusted relationship of RRI and training volumes. Results: 4380 surveys were analysed (10km, n=1316; 21km, n= 2168; 42km, n=896). The median age was 36 years. Previous injury was reported by 51.8% of the respondents. Median training volume in the previous month was 15 km/week (IQR 6-24), 30 km/week (IQR 15-40) and 45 km/week (IQR 30-60), for the 10km, 21km, and 42km distances, respectively. During the race, 14.1% reported a RRI, with 43.1% located at the knee. The multivariable analysis showed previous injury and distance as the main associated factors, whereas weekly training volume, age, and previous participation were protective. Conclusion: Race is an inciting event for developing a RRI. Running race distance is an important factor itself and should be incorporated with other modifiable risk factors in current injury models.


Santiago Marathon and Prokart Productions, Mr. Roberto Urzua, Mr. Pablo Suarez and Mr. Camilo Pavez, Universidad del Desarrollo


Download data is not yet available.


Bahr, R., & Krosshaug, T. (2005). Understanding injury mechanisms: a key component of preventing injuries in sport. British Journal of Sports Medicine, 39(6), pp. 324-329.

Besomi, M., Leppe, J., Di Silvestre, M. C., & Setchell, J. (2018). SeRUN® study: Development of running profiles using a mixed methods analysis. PloS One, 13(7), p e0200389.

Buist, I., Bredeweg, S. W., Bessem, B., Mechelen, W. V., Lemmink, K. A. P. M., & Diercks, R. L. (2010). Incidence and risk factors of running-related injuries during preparation for a 4-mile recreational running event. Brithish Journal of Sports Medicine, 44(8), pp. 598-604.

Clarsen, B., Rønsen, O., Myklebust, G., Flørenes, T. W., & Bahr, R. (2014). The Oslo Sports Trauma Research Center questionnaire on health problems: a new approach to prospective monitoring of illness and injury in elite athletes. British Journal of Sports Medicine, 48(9), pp. 754-760.

Diderisken, M., Soegaard, C., & Nielsen, R. O. (2016). Validity of Self-Reported Running Distance. Journal of Strength and Conditioning Research, 30(6), pp. 1592-1596.

Finch, C. (2014). A new classification scheme for the coding, analysis and reporting of the incidence and impact of subsequent sports-related injury. Journal of Science and Medicine in Sport, 18S, pp. e52-e52.

Fredericson, M., & Misra, A. K. (2007). Epidemiology and Aetiology of Marathon Running Injuries. Sports medicine (Auckland, N.Z.), 37(4), pp. 437-439.

Hespanhol LC Jr, Pena Costa LO, Lopes AD (2013). Previous injuries and some training characteristics predict running-related injuries in recreational runners : a prospective cohort study. Journal of Physiotherapy, 59(4), pp. 263-269.

Hodges, P. W., & Tucker, K. (2011). Moving differently in pain: A new theory to explain the adaptation to pain. Pain, 152(SUPPL.3), pp. S90-S98.

Hulme, A., Nielsen, R. O., Timpka, T., Verhagen, E., & Finch, C. (2017). Risk and Protective Factors for Middle- and Long-Distance Running-Related Injury. Sports Medicine, 47(5), pp. 869–886.

Jungmalm, J., Grau, S., Desai, P., Karlsson, J., & Nielsen, R. O. (2018). Study protocol of a 52-week Prospective Running INjury study in Gothenburg (SPRING). BMJ Open Sport & Exercose Medicine, 4(1), p e000394.

Kluitenberg, B., van Middelkoop, M., Diercks, R., & van der Worp, H. (2015). What are the Differences in Injury Proportions Between Different Populations of Runners? A Systematic Review and Meta-Analysis. Sports Medicine (Auckland, N.Z.), 45(8):1143-1161.

Lopes AD, Hespanhol Jr LC, Yeung SS, Pena Costa LO. (2012). What are the main running-related musculoskeletal injuries? A Systematic Review. Sports medicine (Auckland, N.Z.), 42(10), pp. 891-905.

Malisoux, L., Nielsen, R. O., Urhausen, A., & Theisen, D. (2015). A step towards understanding the mechanisms of running-related injuries. Journal of Science and Medicine in Sport, 18(5), pp. 523-528.

Oestergaard Nielsen, R., Buist, I., Sørensen, H., Lind, M., & Rasmussen, S. (2012). Training Errors and Running Related Injuries: a Systematic Review. The International Journal of Sports Physical Therapy, 7(1), pp. 58-75.

Ooms, L., Veenhof, C., & de Bakker, D. H. (2013). Effectiveness of Start to Run, a 6-week training program for novice runners, on increasing health-enhancing physical activity: a controlled study. BMC Public Health, 13(1), pp. 697-697.

Rasmussen, C. H., Nielsen, R. O., Juul, M. S., & Rasmussen, S. (2013). Weekly running volume and risk of running-related injuries among marathon runners. International Journal of Sports Physical Therapy, 8(2), pp. 111-120.

Saragiotto, B. T., Yamato, T. P., Hespanhol Junior, L. C., Rainbow, M. J., Davis, I. S., & Lopes, A. D. (2014). What are the Main Risk Factors for Running-Related Injuries? Sports Medicine, 44(8), pp. 1153-1163.

Toohey, L. A., Drew, M. K., Cook, J. L., Finch, C. F., & Gaida, J. E. (2017). Is subsequent lower limb injury associated with previous injury? A systematic review and meta-analysis. British Journal of Sports Medicine, 51(23), pp. 1670-1678.

Toohey, L. A., Drew, M. K., Fortington, L. V., Finch, C. F., & Cook, J. L. (2018). An Updated Subsequent Injury Categorisation Model (SIC-2.0): Data-Driven Categorisation of Subsequent Injuries in Sport. Sports Medicine.

Van Der Worp, M. P., Ten Haaf, D. S. M., Van Cingel, R., De Wijer, A., Nijhuis-Van Der Sanden, M. W. G., & Bart Staal, J. (2015). Injuries in runners; a systematic review on risk factors and sex differences. PloS One, 10(2), pp. 1-18.

van Gent, R. N., Siem, D., van Middelkoop, M., van Os, A. G., Bierma-Zeinstra, S. M. A., Koes, B. W., & Taunton, J. E. (2007). Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review * COMMENTARY. British Journal of Sports Medicine, 41(8), pp. 469-480.

van Middelkoop, M., Kolkman, J., van Ochten, J., Bierma-Zeinstra, S. M. a., & Koes, B. W. (2007). Course and predicting factors of lower-extremity injuries after running a marathon. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 17(1), pp. 25-30.

Van Middelkoop, M., Kolkman, J., Van Ochten, J., Bierma-Zeinstra, S. M. A., & Koes, B. W. (2008). Risk factors for lower extremity injuries among male marathon runners. Scandinavian Journal of Medicine and Science in Sports, 18(6), pp. 691-697.

van Poppel, D., de Koning, J., Verhagen, A. P., & Scholten-Peeters, G. G. M. (2016). Risk factors for lower extremity injuries among half marathon and marathon runners of the Lage Landen Marathon Eindhoven 2012: A prospective cohort study in the Netherlands. Scandinavian Journal of Medicine and Science in Sports, 26(2), pp. 226-234.

van Poppel, D., Scholten-Peeters, G. G. M., van Middelkoop, M., Koes, B. W., & Verhagen, A. P. (2018). Risk models for lower extremity injuries among short- and long distance runners: A prospective cohort study. Musculoskeletal Science and Practice, 36, pp. 48-53.

Videbæk, S., Bueno, A. M., Nielsen, R. O., & Rasmussen, S. (2015). Incidence of running-related injuries per 1000 h of running in different types of runners: a systematic review and meta-analysis. Sports Medicine, 45(7), pp. 1017-1026.

Windt J, Gabbett TJ How do training and competition workloads relate to injury? The workload—injury aetiology model Br J Sports Med 2017;51:428-435.


Statistics RUA



How to Cite

Besomi, M., Leppe, J., Mauri-Stecca, M. V., Hooper, T. L., & Sizer, P. S. (2019). Training volume and previous injury as associated factors for running-related injuries by race distance: A cross-sectional study. Journal of Human Sport and Exercise, 14(3), 549–559.



Sport Medicine, Nutrition & Health