A Randomized Study of a Strength Training Program to Prevent Injuries in Runners of the New York City Marathon

Abstract

Background: Lower extremity overuse injuries are common among runners, especially first-time marathoners. Hip abductor and quadriceps strengthening is often recommended to reduce running-related injuries. Hypothesis: A 12-week strength training program would decrease the rate of overuse injuries resulting in marathon noncompletion and improve race finishing time. Study Design: Randomized trial. Level of Evidence: Level 2. Methods: Twelve weeks before the New York City Marathon, first-time marathon runners age 18 years and older were randomized into a strength training group or an observation group. The strength training group was instructed to perform a 10-minute program 3 times weekly using written and video instruction. This program targeted the quadriceps, hip abductor, and core muscle groups. Injuries were self-reported through biweekly surveys, with major injuries being those that resulted in marathon noncompletion and minor injuries being those that impaired training or race performance. Results: A total of 720 runners were enrolled (mean age, 35.9 ± 9.4 years; 69.4% female), of whom 583 runners started the marathon and 579 completed it. The incidence of major injury was 8.9% and minor injury was 48.5%. Fifty two of 64 major injuries were overuse, of which 20 were bone stress injuries. The incidence of overuse injury resulting in marathon noncompletion was 7.1% in the strength training group and 7.3% in the observation group (risk ratio, 0.97; 95% CI, 0.57-1.63; P = 0.90). The mean finishing time was 5 hours 1 ± 60 minutes in the strength training group and 4 hours 58 ± 55 minutes in the observation group ( P = 0.35). Conclusion: There is a high prevalence of injury among first-time marathon runners, but this self-directed strength training program did not decrease overuse injury incidence resulting in marathon noncompletion. Clinical Relevance: Prevention strategies such as strength training need to be developed and evaluated through clinical trials to reduce the high prevalence of overuse injuries in runners, especially for high-risk populations such as first-time marathon runners.

Fatigue-Induced Hip-Abductor Weakness and Changes in Biomechanical Risk Factors for Running-Related Injuries

“…36 Our findings suggest that the velocity of a task performed for injury-prevention purposes must be considered. Exercises performed in the Toresdahl et al 36 intervention were primarily focused on sagittal-plane movements (eg, squats, lunges, and single-legged toe touches) or isometric stability (eg, plank and side plank). Although additional work is needed to identify the role of HABD strength in running-related injury prevention, 37 clinicians should take into account both the magnitude and rate of force development when incorporating HABD strength training.…”

“…The study design allowed the effects of the intervention to be appropriately assessed because the strength-training and non-strengthtraining groups did not differ in training loads or finishing times. 36 Despite 12 weeks of strength training by the experimental group, no difference in injury rate was reported between groups. 36 Our findings suggest that the velocity of a task performed for injury-prevention purposes must be considered.…”

“…36 Despite 12 weeks of strength training by the experimental group, no difference in injury rate was reported between groups. 36 Our findings suggest that the velocity of a task performed for injury-prevention purposes must be considered. Exercises performed in the Toresdahl et al 36 intervention were primarily focused on sagittal-plane movements (eg, squats, lunges, and single-legged toe touches) or isometric stability (eg, plank and side plank).…”

“…These results, in relation to evidence supporting the importance of the rate of movement in the development of running-related injuries, 8,35 have applications for clinical injury prevention. In a randomized, controlled trial, Toresdahl et al 36 evaluated how a homeexercise strength-training intervention influenced injury rates in first-time marathon participants. The study design allowed the effects of the intervention to be appropriately assessed because the strength-training and non-strengthtraining groups did not differ in training loads or finishing times.…”

Estudo prospectivo de lesões musculoesqueléticas em praticantes de corrida: avaliação funcional e seguimento clínico

“…Macera et al Poderíamos avaliar um indivíduo que estava em seu período de base, e que já realizou todas as provas da temporada, ao mesmo tempo ter acompanhado indivíduos que estavam no ápice do seu treinamento e próximo de provas, gerando fatores diferentes de risco de lesões. Alguns estudos acompanharam sua amostra no início dos treinos para determinada prova, o que parece sensato partindo de uma mesma linha de base (TAUNTON et al, 2003;TORESDAHL et al, 2019).…”