As a sprinter on the track, my journey has been more than just a race against time; it’s been a battle against overuse injuries. In high school, I faced the setbacks of injuries that sidelined not just me but countless athletes. Fueled by a passion for both running and the untapped potential of technology, I embark on a journey to explore how technology could revolutionize the world of running by preventing such injuries.
Overuse injuries are very common within the running community; a study by The National Center for Injury Prevention and Control, involving 300 experienced recreational runners, found that 66% experienced overuse injuries during the two-year study period. Within this group, 56% faced additional overuse injuries (Messier et al., 2018). Similarly, The Journal of Sport and Health Science reported data from 29 studies, with over 18000 participants from different backgrounds, which showed about 80% of running-related injuries (RRIs) are related to overuse (Poppe et al., 2020).
With aims of identifying the causes of overuse injuries in runners, The University of West Scotland and The Journal of Sport and Health Science held questionnaires and conducted studies, identifying the following as leading causes for overuse injuries:
Higher BMI,
Old age,
Using a self-devised training plan,
Limited running experience,
Running on harder surfaces, and
Abnormal foot arch types.
(Poppe et al., 2020, Mousavi et al., 2021).
Given the numerous factors that can contribute to overuse injuries, it is clear that designing a completely risk-free running workout is challenging for individuals and coaches. As a solution, I developed a program that offers a practical solution by generating safe running workouts for individuals. To achieve this goal, my program thoroughly assesses the risk factors identified by the University of West Scotland and The Journal of Sport and Health Science, which were determined as the primary causes of overuse injuries. By doing so, the program creates a customized and safe workout plan tailored to each athlete’s individual needs and circumstances. Now, let’s take a closer look at how the program carefully examines each of these risk factors to create a personalized and safe workout for the user.
1. BMI
Runners with a higher Body Mass Index (BMI) strike the ground with a greater impact force, which places increased stress on joints and muscles. They are also more likely to have poor running biomechanics. In a recent study, runners with obesity (those who have a BMI of 30 or higher) had 18% wider strides and 3% longer stance times than nonobese runners (Vincent et al., 2020). Wider strides and longer stance times further increase the stress on joints and muscles which increase the odds of them developing an overuse injury.
Conversely, runners with a BMI below the healthy range have a slightly increased rate of overuse injuries than healthy runners because they are more likely to have a lower muscle mass and reduced muscle strength. In my program, users can input their height and weight, allowing the program to calculate their BMI for a user-friendly experience. The injury risk is elevated with a high BMI, marginally increased with a low BMI, and remains the same with a healthy BMI.
2. Age
As individuals age, natural declines in muscle mass, strength, flexibility, and bone density can contribute to an increased risk of overuse injuries. Overuse injury risk is lowest in children and teenagers, slightly higher in young adults, elevated in adults, and most pronounced in the elderly. In the program, users can input their age, and the corresponding injury risk level adjusts accordingly, as reflected in the following table.
Table 1: Impact of athlete age on injury risk in the program
3. Training plan
Runners using self-devised training plans may face an increased risk of overuse injuries due to potential lack of expert guidance. Also, changes in training frequency impact injury risk significantly. A study conducted by the British Journal Of Sports Medicine on Australian football players revealed a direct correlation: as weekly training load increases, the likelihood of player injuries also rises, as illustrated in the graph below (Gabbett, 2016).
Graph 1: Relationship between change in training load (%) and athlete injury probability
In the program, users can specify if they use a self-devised training plan and indicate the extent of their recent training load increase. Depending on their inputs, the injury risk level adjusts accordingly, as outlined in the table below.
Table 2: Impact on athletes’ usage of self-devised training plan and recent change in training load on injury risk
4. Running experience
Novice runners have the highest risk of overuse injuries while intermediates face lower risks, and experienced runners have the least risk. Newer runners face a higher risk of overuse injuries due to weaker muscles, insufficient strength, and poor biomechanics, placing strain on joints and muscles. In a comprehensive 5-year study (2010 to 2014) involving 28,000 athletes in the Netherlands, the injury incidence rate per 1000 hours of participation revealed that novice athletes consistently experienced a higher frequency of injuries compared to their experienced counterparts, as shown in the graph below (Kemler et al., 2014). On average, novice athletes experienced 53% more injuries than experienced athletes.
Graph 2: Injury incidence rate per 1000 hours of participation between 2010 to 2014 for novice and experienced athletes
In my program, users can select their running experience level as novice, intermediate, or experienced and the program updates their injury risk level, as shown below.
Table 3: Impact of athletes’ running experience on injury risk
5. Running Surface
In a recent study comparing running on different surfaces (synthetic track, grass, and concrete) and its impact on injury risk, concrete showed the highest mean and peak total accelerations, followed by grass, with the track demonstrating the least impact (Sánchez et al., 2023). Essentially, running on concrete exposes the runner to the highest and most intense forces with each step, thereby increasing the risk of injury, while the synthetic track poses the least risk, decreasing the likelihood of overuse injuries. In my program, users can choose their training surface, and their injury risk adjusts accordingly, as indicated below.
Table 4: Impact of athletes’ training surface on injury risk
6. Foot arch type
Foot arch types impact overuse injury rates in runners. Abnormal foot arch types are rare and increase risk of overuse injuries such as shin splints, flat feet plantar fasciitis, and knee pain. In my program, users can select their foot arch type — normal or abnormal. In the program, those with an abnormal foot arch type experience a significant increase in injury risk, while the risk remains the same for those with a normal foot arch type.
Conclusion
In the program, all these factors are given equal weight to collectively determine the user’s risk of overuse injury, generating a personalized, safe workout. Additionally, the program considers training duration and focus, making it suitable for sprinters to long-distance runners, and tailors workouts based on the user’s preferred workout time.
With the ability to factor in all the significant risk factors associated with overuse injuries in running, my goal is for the program to save thousands of athletes from developing such injuries. I developed the program using various programming languages (Javascript, HTML, CSS) and the link to the program is here.
References
van Poppel, D., van der Worp, M., Slabbekoorn, A., van den Heuvel, S. S. P., van Middelkoop, M., Koes, B. W., Verhagen, A. P., & Scholten-Peeters, G. G. M. (2021). Risk factors for overuse injuries in short- and long-distance running: A systematic review. Journal of sport and health science, 10(1), 14–28. https://doi.org/10.1016/j.jshs.2020.06.006
Messier SP, Martin DF, Mihalko SL, et al. A 2-Year Prospective Cohort Study of Overuse Running Injuries: The Runners and Injury Longitudinal Study (TRAILS). The American Journal of Sports Medicine. 2018;46(9):2211–2221. doi:10.1177/0363546518773755
Mousavi, S. H., Hijmans, J. M., Minoonejad, H., Rajabi, R., & Zwerver, J. (2021). Factors Associated With Lower Limb Injuries in Recreational Runners: A Cross-Sectional Survey Including Mental Aspects and Sleep Quality. Journal of sports science & medicine, 20(2), 204–215. https://doi.org/10.52082/jssm.2021.204
Vincent, H.K., Kilgore, J.E., III, Chen, C., Bruner, M., Horodyski, M. and Vincent, K.R. (2020), Impact of Body Mass Index on Biomechanics of Recreational Runners. Journal of Injury, Function and Rehabilitation, 12: 1106–1112. https://doi.org/10.1002/pmrj.12335
Gabbett T. J. (2016). The training-injury prevention paradox: should athletes be training smarter and harder?. British journal of sports medicine, 50(5), 273–280. https://doi.org/10.1136/bjsports-2015-095788
Kemler E, Valkenberg H, Verhagen E. More people more active, but there is a counter site. Novice athletes are at highest risk of injury in a large population-based retrospective cross-sectional study. BMJ Open Sport & Exercise Medicine 2022;8:e001255. doi: 10.1136/bmjsem-2021–001255
Ferro-Sánchez, A., Martín-Castellanos, A., de la Rubia, A., García-Aliaga, A., Hontoria-Galán, M., & Marquina, M. (2023). An Analysis of Running Impact on Different Surfaces for Injury Prevention. International journal of environmental research and public health, 20(14), 6405. https://doi.org/10.3390/ijerph20146405
Hutchinson, Alex. “Does ‘Overuse’ Really Cause Injuries?” Runners World, 2016, www.runnersworld.com/health-injuries/a20860906/does-overuse-really-cause-injuries/.
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