sports
Article
A Randomized Pilot Study Comparing the Impact of
Strengthening-Based Running Training with Only Running on
the Incidence of Running-Related Injuries among
Novice Runners
Anh Phong Nguyen 1,2,3, * , Noé Abeels 2 , Romain Van Brussel 2 and Benoit Pairot de Fontenay 3,4,5
1 NeuroMusculoSKeletal Laboratory (NMSK), Institut de Recherche Expérimentale et Clinique,
Université Catholique de Louvain, Avenue Mounier 53, 1200 Brussels, Belgium
2 Faculté des Sciences de la Motricité, Université Catholique de Louvain, Place Pierre de Courbertin 1,
1348 Louvain-La-Neuve, Belgium
3 The Running Clinic, Lac Beauport, QC G3B 2J8, Canada;
[email protected] 4 Laboratoire InterUniversitaire de Biologie de la Motricité, Université de Lyon, Rue Raphael Dubois 4,
69100 Villeurbanne, France
5 Ramsay Santé, Clinique de la Sauvegarde, 69009 Lyon, France
* Correspondence:
[email protected]; Tel.: +32-496-781158
Abstract: Background: Running-related injuries (RRI) are common in novice runners. Reducing
early training running volume with strengthening activities may improve RRI without imped-
ing running performance. Objectives: 1. Gather feasibility data for a randomized, controlled
trial comparing a strengthening-based program to a conventional running program; 2. Assess
RRI; and 3. Assess running performance. Methods: Seventy-four university students (38 females,
21 ± 2.3 years, 68.2 ± 10.8 kg, BMI: 22.6 ± 2.97), all novice runners, were randomized in two groups,
i.e., a strengthening and running group (INT) and a running group (CON). The completed sessions,
RRI, dropout, and maximal aerobic speed were recorded through an online application. Results:
Citation: Nguyen, A.P.; Abeels, N.; The INT group had 52.6% attrition, while the CON group had 41.7%. The INT group had 56.6%
Van Brussel, R.; Pairot de Fontenay, B. adherence, while the CON group had 45.7%. The Chi-square test showed no significant difference in
A Randomized Pilot Study RRI incidence across groups (CHI2 = 2.958, p value = 0.08). A two-way ANOVA showed no significant
Comparing the Impact of difference in maximal aerobic speed across groups (p = 0.822) or before and after training (p = 0.304).
Strengthening-Based Running Conclusions: This pilot study confirmed the feasibility of this randomized, controlled trial with a
Training with Only Running on the
needed sample size of 194. However, novice runners had greater attrition rates when starting. Based
Incidence of Running-Related Injuries
on those limited data, strengthening activities that replaced running volume did not improve RRI or
among Novice Runners. Sports 2024,
maximal aerobic speed.
12, 25. https://doi.org/10.3390/
sports12010025
Keywords: resistance training; aerobic training; novice athletes; primary prevention; sports injuries
Academic Editor: Norihiro Shima
Received: 6 December 2023
Revised: 2 January 2024
Accepted: 4 January 2024 1. Introduction
Published: 9 January 2024 The advantages of running, whether for personal well-being, leisure, or professional
pursuits, are widely acknowledged and supported by ample evidence [1,2]. However,
scientific research also highlights a significant prevalence of running-related injuries (RRI),
ranging from 20% to 80% [3]. Individuals most vulnerable to such injuries are typically
Copyright: © 2024 by the authors.
inexperienced runners, who may lack the necessary skills to manage running discomfort or
Licensee MDPI, Basel, Switzerland.
modify their training regimen appropriately [4,5].
This article is an open access article
Running-related injuries (RRI) can be defined as physical complaints that necessitate
distributed under the terms and
a modification or the interruption of training or competition [6]. In running, most RRI
conditions of the Creative Commons
are musculoskeletal overuse injuries that gradually develop during training [7,8]. Several
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
factors are predictive of RRI, including training errors, such as an increase in the volume,
4.0/).
intensity, elevation, or duration of running [9–11].
Sports 2024, 12, 25. https://doi.org/10.3390/sports12010025 https://www.mdpi.com/journal/sports
Sports 2024, 12, 25 2 of 10
Running stakeholders are eager to discover interventions that can prevent RRI. How-
ever, interventions such as foot orthoses [12,13], running shoe prescriptions [14–16], specific
warm-up and cool-down routines, and stretching and strengthening programs have re-
ported conflicting results, and therefore, no clear recommendations can be made.
It is widely recognized that adding strengthening exercises to a running program can
enhance running economy and performance [17–20]. In team sports such as football or
basketball, the incorporation of strength training has been shown to also reduce injury
incidence [21]. However, this conclusion cannot be generalized to running. Taddei et al.
reported promising results in a randomized, controlled trial with experienced runners who
received eight weeks of additional foot core training, resulting in a 2.42 reduction in RRI
incidence compared to a non-strengthening group [22]. However, Toresdahl et al. proposed
a 12-week marathon training program with the intervention group performing weekly
strength exercises, but no difference was observed in RRI incidence compared to a control
group [23]. In both studies, strength exercises were added on top of the running program.
Although the addition of strength training to a running program did not appear to
prevent RRI, there may be some benefit in reducing the amount of running training and
replacing it with strength training. Paavolainen et al. demonstrated that replacing 32% of
running with explosive strength training over a nine-week period in elite male runners
resulted in greater improvements in maximal aerobic speed and running economy in the
intervention group, mainly due to neuromuscular adaptations [20]. RRI incidence was not
monitored in this study; however, we can hypothesize that implementing strengthening
exercises and reducing running volume may be beneficial in terms of RRI.
The present study had, therefore, multiple objectives. Firstly, it aimed to assess
the feasibility of a strengthening-based running program for novice runners, including
evaluating the attrition rate dropout potential and calculating the required sample size.
Secondly, the study aimed to investigate the effects of the strengthening-based running
program on RRI incidence and performance compared to a control group engaging in
standard running training.
2. Methods
This pilot study was designed as a prospective randomized, controlled trial and
followed the CONSORT Checklist of information to include information when reporting a
pilot or feasibility trial. It lasted 21 weeks and took place in the Université Catholique de
Louvain facilities (Ottignies-Louvain-la-Neuve, Belgium). The recruitment was conducted
by word of mouth in the surroundings of the University and local communities. All
participants understood French and received information about the protocol and aims of the
study. Every included participant provided their signed written consent upon enrollment.
The study was approved by the local ethical committee (CEHF, N◦ : B403201942384). The
study was recorded in clinical trial database (NCT05656755).
2.1. Participants
Following the recruitment period, the participants were screened for eligibility. They
were included if (1) they were between 18 and 30 years old, (2) they matched our definition
of novice runners, (3) they had not sustained a musculoskeletal injury in the past six months,
and (4) they agreed to subscribe to an online application and to report each session of
running training on this platform. A novice runner is defined as someone who has not
been running more than once a week for more than six months. The participants were
systematically excluded if they did not match the interval of age and were not considered
novice runners, i.e., they ran twice or more times a week for more than six months. They
were also excluded if they had sustained an injury in the last 6 months or suffered from
any musculoskeletal or neurological disorders. Finally, the participants were asked to
complete a survey to collect demographical variables such as gender, age, height, weight,
regular sport activity, any previous injury, the use of their running shoes, and their contact
Sports 2024, 12, 25 3 of 10
information. This information was collected on a password-protected file. After completion
of the survey, the participants were included for randomization.
2.2. Randomization
The participants were randomized with a stratified randomization method (age × gender)
using MedCalc® software version 22.016. They were divided into an intervention group
(INT) and a control group (CON).
2.3. Training Programs
Both groups started a 21-week training program with three sessions per week. Each
week, two sessions of one hour were supervised by two investigators, and one mandatory
unsupervised session of 30 min was completed by the participants. The supervised sessions
took place in the evening on an indoor track, whereas the unsupervised sessions took
place at any time on a treadmill or outside. The CON group received a standard running
program exclusively composed of supervised running sessions. The training sessions
were composed of running (RUN) and recovery (walking or slow running (REC)) periods.
The INT group performed strengthening exercises instead of some running volume (static
strengthening exercises (SSE) and dynamic strengthening exercises (DSE)). Strength training
was performed exclusively with body weight and consisted of exercises such as squats,
deadlifts, hip thrusts, and step ups or downs, planks. Estimated time of training in each
category for the two groups can be found in Table 1.
Table 1. Time in minutes planned per person in each training category.
Category CON INT
RUN 2065 1606
REC 329 207
SSE 0 214
DSE 8 387
Total training time 2402 2414
RUN: running; REC: recovery; SSE: static strengthening exercises; DSE: dynamic strengthening exercises;
CON: control group with only running; INT: intervention group with strengthening and running training.
2.4. Outcomes
2.4.1. Attrition Rate and Adherence
Attrition rate and adherence to the program were recorded throughout the intervention
period with the use of an online platform that facilitates communication between the
athletes and the coaches (Nolio, Seyssins, France). Attrition rate refers to the percentage of
participants who did not complete the training program, whereas adherence refers to how
well participants followed the program protocol.
Each participant was instructed to confirm every session that had been performed
on the platform. If a participant had not completed his profile on Nolio for one week, a
reminder was sent by an online notification. After two weeks of inactivity on Nolio, a
phone call was systematically made. A dropout was defined if a participant did not follow
three training sessions for any other reason than RRI.
2.4.2. Running Related Injury
RRI was monitored during the follow-up. After each training session, the participants
were requested to report any sensation of discomfort. An initial screening was performed
by the investigators, and in case of recurrent or crescent pain, an appointment with a
physician and/or a physiotherapist of the Belgian Track and Field Federation was made.
According to Yamato et al., an RRI was reported if a participant complained about physical
issues and interrupted or reduced their training for at least three consecutive sessions or if
they consulted a health professional [6].
Sports 2024, 12, 25 4 of 10
2.4.3. Running Performance
The maximal aerobic speed (MAS) was chosen to evaluate running performance. For
this purpose, the VAM-Eval test was used [24]. A first VAM-Eval test was conducted
during the 4th week, and the second was performed during the 21st week. Landmarks
were spaced 20 m apart on an indoor athletic track. The starting running speed was set
at 8 km·h−1 , then it was increased every minute by 0.5 km·h−1 . The test was considered
finished if the runner failed to reach the following landmark on time or decided to stop by
themself. The last completed stage or half stage, i.e., 30 s into the stage, was considered as
the MAS of the participants.
2.5. Statistical Analysis
Statistical analysis was performed using MedCalc® Statistical Software version 20.106
(MedCalc Software Ltd., Ostend, Belgium). Descriptive data were collected as mean,
standard deviation, minimal, and maximal values. The attrition rate was calculated with
the randomized sample at baseline. The adherence was calculated as the number of sessions
performed compared to the initial training schedule. The intention-to-treat analysis method
was used for the primary outcome, i.e., the incidence of RRI. To determine the distribution
of RRI between the INT and the CON, a Chi-squared test was performed. If needed, a
Cramer’s V was calculated to demonstrate the effect size of the difference between groups.
Then, the Relative Risk (RR) and the Number Need-to Treat (NNT) in regard to RRI were
all calculated following the methods described by McCoy et al. [25]. A two-way, repeated
ANOVA (Group × Time) was executed to compare MAS performance. The Alpha of
significance was set at 0.05.
3. Results
A total of 120 individuals responded to the study recruitment campaign, with 46 that
did not match the eligibility criteria. Therefore, 74 novice runners were randomized into
the two groups, with 38 in the INT group and 36 in the CON group (Figure 1). The baseline
descriptive characteristics can be found in Table 2.
3.1. Attrition Rate and Adherence
The attrition rate was 52.6% in the INT group and 41.7% in the CON group (20 and
15 dropouts, respectively). Thirty-one participants stopped their participation due to a lack
of interest or motivation; one had a non-RRI, one traveled abroad, and two were ill. The
adherence rates to the training programs were 45.7% in the CON group and 56.6% in the
INT group, respectively.
3.2. Running Related Injuries
Eleven runners out of the thirty-nine participants who completed the study reported
having an RRI. Eight runners reported an RRI in the CON group (38%), of which one non-
identified glute muscle pain, one identified patellofemoral pain syndrome, one identified
ilio-tibial band syndrome, two identified medial tibial stress syndromes (MTSS), and
three identified non-identified calf or tibial pain. Three runners reported an RRI in the
INT (16.6%), of which one had greater trochanteric pain syndrome, and two had patellar
tendinopathies.
The Chi-squared test failed to demonstrate a significant difference in RRI incidence
between CON and INT groups (χ2 = 2.958, p value = 0.08). The implementation of the
strengthening program while reducing the total running volume in the INT group compared
to the CON did not report a significant reduction in the risk of injuries (RR = 0.355, 95%
confidence interval (95%CI) of (0.102 to 1.235), p value = 0.1; z = 1.628). The NNT concerning
the INT group was seven runners.
Sports 2024, 12, 25 5 of 10
3.3. MAS
The two-way, repeated measure ANOVA did not demonstrate an interaction
Sports 2024, 12, x FOR PEER REVIEW 5 of 10
(Group × Time) for MAS with a p value of 0.119. There was no GROUP (p value = 0.822) or
TIME (p value = 0.304) effect.
Figure 1. Flow diagram of participants. CON:
CON: control group; INT: intervention group.
Table
3.1. 2. Baseline
Attrition Ratecharacteristics
and Adherence of runners.
The attrition rate was 52.6% in the INT group and(n41.7%
CON = 36) in the CON
INTgroup (20 and
(n = 38)
15 dropouts, respectively). Thirty-one participants stopped their participation due to a
Gender Male 18 18
lack of interest or motivation;
Female one had a non-RRI, one 18
traveled abroad, and two20 were ill.
The
Ageadherence
(years) rates to the training programs were 45.7%
20.8 ± in
2.6the CON group20.9and 56.6% in
± 2.2
the INT (cm)
Height group, respectively. 173.5 ± 9.6 173.5 ± 7.8
Weight (kg) 69.2 ± 12.2 67.1 ± 9.3
BMI
3.2. Running Related Injuries 23 ± 3.1 22.4 ± 2.9
BMI: body mass index.
Eleven runners out of the thirty-nine participants who completed the study reported
having an RRI. Eight runners reported an RRI in the CON group (38%), of which one non-
4. Discussion
identified glute muscle pain, one identified patellofemoral pain syndrome, one identified
To our
ilio-tibial knowledge,
band syndrome,this
twois identified
the first study to investigate
medial tibial stressthe effect of replacing
syndromes running
(MTSS), and three
volume by strengthening exercises in novice runners on RRI and running
identified non-identified calf or tibial pain. Three runners reported an RRI in the INTperformance.
Our sample,
(16.6%), comprised
of which of university
one had students, exhibited
greater trochanteric a high attrition
pain syndrome, and tworate
hadand relatively
patellar ten-
dinopathies.
The Chi-squared test failed to demonstrate a significant difference in RRI incidence
between CON and INT groups (χ2 = 2.958, p value = 0.08). The implementation of the
strengthening program while reducing the total running volume in the INT group com-
pared to the CON did not report a significant reduction in the risk of injuries (RR = 0.355,
Sports 2024, 12, 25 6 of 10
low adherence to the training programs. Based on our limited sample results, both groups
reported a similar risk of injuries and no increase in MAS.
4.1. Attrition Rate and Adherence
The high rate of attrition and the low rate of adherence should invite the reader
to consider those results with caution. However, the high attrition rate was previously
reported in a novice runner population. Some authors reported a 47% dropout rate in
novice runners [26], while another study reported a 75% dropout rate in an obese novice
runner population [27]. It is worth noting that our sample consisted entirely of university
students who were recruited at the start of the academic year. These individuals may
not have fully understood the demands of three weekly running sessions over a 21-week
program. Furthermore, the student population is highly influenced by contextual factors
such as holidays or exam sessions that could impair their participation in social events
such as sports activities and, more precisely, a new one that could not be habitual yet. In
addition, adherence and session completion were recorded through an online application.
Some participants could have omitted or did not have the rigor to register their training,
which may lead to an overestimation of uncompleted sessions.
We thought that the inclusion of strength training could provide greater variation
in training sessions and limit monotony. This is not confirmed, as both groups reported
similar levels of attrition and adherence. Motivational factors of running practice in novice
runners were mostly influenced by schedule constrain, climate conditions, social support,
or previous levels of physical activity [28].
4.2. Running-Related Injuries
While the two groups did not report significant differences in RRI over the 21 weeks
of training, there seems to be a clinical tendency that replacing running volume with
strengthening exercises might reduce the incidence of RRI. To date, only foot-core training
has shown a positive impact on the prevention of RRI [29], while other strengthening
methods did not show any significant results [23,30]. One explanation is that similar
running volume and duration rather than strengthening modalities could be relevant
considering RRI incidence. In the previous studies, strengthening was added to the running
program resulting in an increase in the total workload. We might suggest that this increase
may cancel the benefit of strengthening. That is why we followed the recommendations
of some coaches to replace the running workload by strengthening exercises [31]. This
reduction of volume is thought to induce less repetitive mechanical stress on untrained
musculoskeletal tissue in novice runners and reduce RRI.
While Lauersen et al. showed, in their systematic review and meta-analysis, that
loaded strength training was helpful in preventing sports overuse injuries in soccer, basket-
ball, and football by approximately 50% [21], we decided to employ bodyweight muscular
strength training in our study. Explosive sports such as sprinting or soccer that are related
to short bursts of speed and acceleration could be more respondent to muscle quality and
function such as force or power. In contrast, bodyweight muscle strength training was
thought to be meaningful in inducing variable workload on the lower limbs for endurance
runners, specifically novice ones.
Eight of the eleven reported injuries occurred in the first seven weeks of training.
A pilot study by Baltich et al. on novice runners found the highest incidence of RRI in
the first eight weeks of the four-month training program [26]. In contrast, Kluitenberg
et al. reported a higher rate of RRI during the second and third weeks of their six-week
supervised “Start to Run” program for novice runners [32]. This emphasizes the criticality
of early training sessions for novice runners. Coaches, strength and conditioning coaches,
or healthcare practitioners should prioritize investing time and attention during the early
training periods.
Sports 2024, 12, 25 7 of 10
4.3. Performance
Many studies have already proved the benefits of adding heavy or plyometric strength
training programs on performance and running economy [17–19,23,33,34], untrained en-
durance runners should preferably follow a maximal-strength-oriented program to enhance
maximal force, power, and reactive-strength capabilities, which will lead to an improvement
in running economy. This differs from well-trained endurance runners with high-force
capabilities who should focus on specific explosive and reactive-strength training to im-
prove performance [24]. A replacement of a part of running volume by explosive-type
strengthening (sprints, jumps, leg press, and knee extensors–flexors exercises) also showed
improvements in terms of 5 km running performance and aerobic power in elite orienteer-
ing runners [20]. This could explain the non-efficacy of our strengthening program, as it
was general and more focused on endurance strength development.
Therefore, novice runners could benefit from load muscle strengthening. Using a 1RM-
based training program, rather than bodyweight-based exercises, could lead to greater
improvements in maximal force, strength endurance, and power. Moreover, 1RM-based
programs produce better results than bodyweight-based programs in terms of strength
gains and muscular endurance [25] and should be studied in the future.
In experienced runners, some studies found an existing correlation between running
workload, specifically running volume, and running performance [35,36]. The research
suggests that factors such as training volume and personal best time in marathons are
associated with performance in male 100 km ultrarunners [36]. Similarly, the volume of
training and the longest endurance runs have been found to be related to performance
and running injuries in marathon training [35]. Consequently, it can be hypothesized
that reducing running volume may hinder the development of aerobic performance, such
as maximal aerobic speed. However, this particular outcome was not investigated in
the present study and, therefore, cannot be confirmed. Additionally, caution should be
exercised when considering the external validity of these findings. The study did not
demonstrate improvements in the maximal aerobic speed for either the intervention or
control group. Several factors could contribute to this outcome. Firstly, the participants may
not have been as inexperienced as they claimed during enrollment, or they could have been
engaged in other forms of physical activity. Secondly, both running programs may have
been primarily designed for injury prevention rather than performance enhancement. Thus,
for future research, it would be beneficial to include another control group following a
performance running program. To summarize, the impact of strength training on mitigating
the decline in aerobic capacity caused by reduced running volume in novice runners
remains unclear and warrants further investigation.
4.4. Limitations
The present study is not without limitations. First, the high rate of attrition made it
imperative to proceed with caution when interpreting the findings of this study. Another
limitation is the non-measurement of muscle function, such as muscle maximal force, power,
or endurance. The strengthening program was not confirmed as efficient in increasing
muscle force and, therefore, could provide unclear results. In addition, while recruiting
only novice runners, the present study did not report any baseline value of physical activity
and sport level. Furthermore, no gender analysis was performed. This could lead to more
heterogenicity of the sample. Finally, the study did not provide any follow-up after the
21 weeks of sessions. These limitations make the present results unfit for external validity,
and researchers are invited to perform further studies.
4.5. Perspectives
Based on the proportion of RRI in our sample, we would need 194 participants ran-
domized into two groups to observe a significant RR (Type I error: 0.05, Type II error: 0.2).
As it could be potentially complicated, the need to decrease attrition and increase adherence
is needed. Therefore, we postulate four recommendations to optimize attrition and adher-
Sports 2024, 12, 25 8 of 10
ence. We believe that a 12-week program would be sufficient to observe a difference in RRI
incidence as novice runners tend to report RRI in their first trimester of practice. Taddei
et al. attested that an 8-week foot-core program could diminish the risk of RRI by 2.42 times
in a 12 month follow-up period in recreative runners [29]. On the other hand, the session
should be practiced in groups and with supervision to enhance participation and adherence.
In addition, the follow-up of RRI or dropout should be recorded within the following year
at least. Future studies should avoid taking only university students and avoid holiday
seasons. Finally, it was reported that a clear objective could help adherence [37]. The
objective of a race could benefit and motivate novice runners to end the training program.
5. Conclusions
Based on the limited results of this pilot study, there was no reduction of RRI in
novice runners that reduced running milage and implemented a bodyweight strengthening
program. The present study provided the insight needed to prepare a more robust clinical
study to permit relevant results to guide sports and health practitioners.
Author Contributions: A.P.N. and B.P.d.F. conceived and designed the experiments; A.P.N., N.A.
and R.V.B. performed the experiments; A.P.N., N.A. and R.V.B. analyzed the data; B.P.d.F. contributed
reagents/materials/analysis tools; A.P.N. wrote the paper. All authors have read and agreed to the
published version of the manuscript.
Funding: This research did not receive any specific grant from any public, private, or nonprofit association.
Institutional Review Board Statement: The study was conducted in accordance with the Declaration
of Helsinki and approved on 24 January 2020 by the Institutional Review Board (or Ethics Committee)
of the Catholic University of Louvain (UCLouvain) (CEHF, N◦ : B403201942384).
Informed Consent Statement: Informed consent was obtained from all subjects involved in the study.
Data Availability Statement: Data are unavailable due to privacy policies.
Acknowledgments: The authors wish to sincerely thank Sebastien Cornette for his help in the running
program and support during this project.
Conflicts of Interest: All authors declared having read and understood the Sports journal policies on
the declaration of interests and have no relevant interests to declare.
References
1. Hespanhol Junior, L.C.; Pillay, J.D.; van Mechelen, W.; Verhagen, E. Meta-Analyses of the Effects of Habitual Running on Indices
of Health in Physically Inactive Adults. Sports Med. 2015, 45, 1455–1468. [CrossRef] [PubMed]
2. Oja, P.; Titze, S.; Kokko, S.; Kujala, U.M.; Heinonen, A.; Kelly, P.; Koski, P.; Foster, C. Health benefits of different sport disciplines
for adults: Systematic review of observational and intervention studies with meta-analysis. Br. J. Sports Med. 2015, 49, 434–440.
[CrossRef] [PubMed]
3. Van Gent, R.N.; Siem, D.; Van Middelkoop, M.; Van Os, A.G.; Bierma-Zeinstra, S.M.A.; Koes, B.W. Incidence and determinants of
lower extremity running injuries in long distance runners: A systematic review. Br. J. Sports Med. 2007, 41, 469–480. [CrossRef]
[PubMed]
4. Verhagen, E.; Warsen, M.; Silveira Bolling, C. I JUST WANT to RUN: How recreational runners perceive and deal with injuries.
BMJ Open Sport Exerc. Med. 2021, 7, e001117. [CrossRef]
5. Videbæk, S.; Bueno, A.M.; Nielsen, R.O.; Rasmussen, S. Incidence of Running-Related Injuries Per 1000 h of running in Different
Types of Runners: A Systematic Review and Meta-Analysis. Sports Med. 2015, 45, 1017–1026. [CrossRef]
6. Parma Yamato, T.; Tirotti Saragiotto, B.; Carlos Hespanhol Junior, L.; Yeung, S.S.; Dias Lopes, A. Descriptors Used to Define
Running-Related Musculoskeletal Injury: A Systematic Review. JOSPT 2015, 45, 366–374. [CrossRef]
7. Dias Lopes, A.; Carlos, L.; Junior, H.; Yeung, S.S.; Oliveira Pena Costa, L. What are the Main Running-Related Musculoskeletal
Injuries? A Systematic Review. Sports Med. 2012, 42, 891–905. [CrossRef]
8. Kemler, E.; Blokland, D.; Backx, F.; Huisstede, B. Differences in injury risk and characteristics of injuries between novice and
experienced runners over a 4-year period. Physician Sportsmed. 2018, 46, 485–491. [CrossRef]
Sports 2024, 12, 25 9 of 10
9. Fredette, A.; Roy, J.S.; Perreault, K.; Dupuis, F.; Napier, C.; Esculier, J.F. The Association between Running Injuries and Training
Parameters: A Systematic Review. J. Athl. Train. 2022, 57, 650–671. [CrossRef]
10. Hespanhol Junior, L.C.; Pena Costa, L.O.; Lopes, A.D. Previous injuries and some training characteristics predict running-related
injuries in recreational runners: A prospective cohort study. J. Physiother. 2013, 59, 263–269. [CrossRef]
11. Hulme, A.; Nielsen, R.O.; Timpka, T.; Verhagen, E.; Finch, C. Risk and Protective Factors for Middle- and Long-Distance
Running-Related Injury. Sports Med. 2017, 47, 869–886. [CrossRef] [PubMed]
12. McKean, K.A.; Manson, N.A.; Stanish, W.D. Musculoskeletal injury in the masters runners. Clin. J. Sport Med. 2006, 16, 149–154.
[CrossRef] [PubMed]
13. Mousavi, S.H.; Hijmans, J.M.; Rajabi, R.; Diercks, R.; Zwerver, J.; van der Worp, H. Kinematic risk factors for lower limb
tendinopathy in distance runners: A systematic review and meta-analysis. Gait Posture 2019, 69, 13–24. [CrossRef] [PubMed]
14. Dubois, B.; Esculier, J.F.; Frémont, P.; Moore, L.; Richards, C. Effects of minimalist and traditional running shoes on injury rates: A
pilot randomised controlled trial. Footwear Sci. 2015, 7, 159–164. [CrossRef]
15. Perkins, K.P.; Hanney, W.J.; Rothschild, C.E. The Risks and Benefits of Running Barefoot or in Minimalist Shoes: A Systematic
Review. Sports Health 2014, 6, 475–480. [CrossRef]
16. Sun, X.; Lam, W.K.; Zhang, X.; Wang, J.; Fu, W. Systematic review of the role of footwear constructions in running biomechanics:
Implications for running-related injury and performance. J. Sports Sci. Med. 2020, 19, 20.
17. Blagrove, R.C.; Howatson, G.; Hayes, P.R. Effects of Strength Training on the Physiological Determinants of Middle- and
Long-Distance Running Performance: A Systematic Review. Sports Med. 2018, 48, 1117–1149. [CrossRef]
18. Denadai, B.S.; de Aguiar, R.A.; de Lima, L.C.R.; Greco, C.C.; Caputo, F. Explosive Training and Heavy Weight Training are
Effective for Improving Running Economy in Endurance Athletes: A Systematic Review and Meta-Analysis. Sports Med. 2017,
47, 545–554. [CrossRef]
19. Guglielmo, L.G.A.; Greco, C.C.; Denadai, B.S. Effects of strength training on running economy. Int. J. Sports Med. 2009, 30, 27–32.
[CrossRef]
20. Paavolainen, L.; Häkkinen, K.; Hämäläinen, I.; Nummela, A.; Rusko, H. Explosive-strength training improves 5-km running time
by improving running economy and muscle power. J. Appl. Physiol. 1999, 86, 1527–1533. [CrossRef]
21. Lauersen, J.B.; Bertelsen, D.M.; Andersen, L.B. The effectiveness of exercise interventions to prevent sports injuries: A systematic
review and meta-analysis of randomised controlled trials. Br. J. Sports Med. 2014, 48, 871–877. [CrossRef] [PubMed]
22. Taddei, U.T.; Matias, A.B.; Ribeiro, F.I.A.; Bus, S.A.; Sacco, I.C.N. Effects of a foot strengthening program on foot mus-cle
morphology and running mechanics: A proof-of-concept, single-blind randomized controlled trial. Phys. Ther. Sport 2020,
42, 107–115. [CrossRef] [PubMed]
23. Toresdahl, B.G.; McElheny, K.; Metzl, J.; Ammerman, B.; Chang, B.; Kinderknecht, J. A Randomized Study of a Strength Training
Program to Prevent Injuries in Runners of the New York City Marathon. Sports Health 2020, 12, 74–79. [CrossRef] [PubMed]
24. Beattie, K.; Kenny, I.C.; Lyons, M.; Carson, B.P. The effect of strength training on performance in endurance athletes. Sports Med.
2014, 44, 845–865. [CrossRef] [PubMed]
25. Haff, G.G.; Nimphius, S. Training principles for power. Strength Cond. J. 2012, 34, 2–12. [CrossRef]
26. Baltich, J.; Emery, C.A.; Whittaker, J.L.; Nigg, B.M. Running injuries in novice runners enrolled in different training interventions:
A pilot randomized controlled trial. Scand. J. Med. Sci. Sports 2017, 27, 1372–1383. [CrossRef] [PubMed]
27. Bertelsen, M.L.; Hansen, M.; Rasmussen, S.; Nielsen, R.O. The start-to-run distance and running-related injury among obese
novice runners: A randomized trial. Int. J. Sports Phys. Ther. 2018, 13, 943–955. [CrossRef]
28. Menheere, D.; Janssen, M.; Funk, M.; van der Spek, E.; Lallemand, C.; Vos, S. Runner’s perceptions of reasons to quit running:
Influence of gender, age and running-related characteristics. Int. J. Environ. Res. Public Health 2020, 17, 6046. [CrossRef]
29. Taddei, U.T.; Matias, A.B.; Duarte, M.; Sacco, I.C.N. Foot Core Training to Prevent Running-Related Injuries: A Survival Analysis
of a Single-Blind, Randomized Controlled Trial. Am. J. Sports Med. 2020, 48, 3610–3619. [CrossRef]
30. Bredeweg, S.W.; Zijlstra, S.; Bessem, B.; Buist, I. The effectiveness of a preconditioning programme on preventing running-related
injuries in novice runners: A Randomised controlled trial. Br. J. Sports Med. 2012, 46, 865–870. [CrossRef]
31. Sebastien, C. Moins Courir Pour Mieux Courir: La Methode Ecole de Trail; EDITIONS MONS: Angoulême, France, 2022.
32. Kluitenberg, B.; van Middelkoop, M.; Smits, D.W.; Verhagen, E.; Hartgens, F.; Diercks, R.; van der Worp, H. The NLstart2run
study: Incidence and risk factors of running-related injuries in novice runners. Scand. J. Med. Sci. Sports 2015, 25, e515–e523.
[CrossRef] [PubMed]
33. Blagrove, R.C.; Howe, L.P.; Cushion, E.J.; Spence, A.; Howatson, G.; Pedlar, C.; Hayes, P.R. Effects of Strength Training on
Postpubertal Adolescent Distance Runners. Med. Sci. Sports Exerc. 2018, 50, 1224–1232. [CrossRef] [PubMed]
34. Turner, A.M.; Owings, M.; Schwane, J.A. Improvement in Running Economy After 6 Weeks of Plyometric Training. J. Strength
Cond. Res. 2003, 17, 60–67. [PubMed]
35. Fokkema, T.; van Damme, A.A.D.N.; Fornerod, M.W.J.; de Vos, R.J.; Bierma-Zeinstra, S.M.A.; van Middelkoop, M. Training for a
(half-)marathon: Training volume and longest endurance run related to performance and running injuries. Scand. J. Med. Sci.
Sports 2020, 30, 1692–1704. [CrossRef] [PubMed]
Sports 2024, 12, 25 10 of 10
36. Knechtle, B.; Wirth, A.; Knechtle, P.; Rosemann, T. Training volume and personal best time in marathon, not anthropometric
parameters, are associated with performance in male 100-km ultrarunners. J. Strength Cond. Res. 2010, 24, 604–609. [CrossRef]
37. Justine, M.; Azizan, A.; Hassan, V.; Salleh, Z.; Manaf, H. Barriers to participation in physical activity and exercise among
middle-aged and elderly individuals. Singap. Med. J. 2013, 54, 581–586. [CrossRef]
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual
author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to
people or property resulting from any ideas, methods, instructions or products referred to in the content.
