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Published Version (Advanced Access)CC BY-NC V4.0, Open Access
Journal article
How much running is too much? Identifying high-risk running sessions in a 5200-person cohort study
British Journal of Sports Medicine, Vol.59(17), pp.1203-1210
2025
PMID: 40623829
Abstract
Objectives: We explored whether a spike in running distance during a single session or over 1 week, compared with the preceding period, was associated with increased risk of running-related overuse injury.
Methods: Adult runners were recruited for an 18-month cohort study. Three training-related exposures were defined based on a relative change in running distance, using data collected via Garmin devices: (1) session-specific running distance relative to the longest distance run in the past 30 days; (2) 1-week period relative to the preceding 3 weeks using the acute:chronic workload ratio (ACWR); (3) 1-week period using a week-to-week ratio. Runners were categorised into one of four time-varying states: (1) regression, or up to 10% increase (reference); (2) ‘small spike’ between >10% and 30% increase; (3) ‘moderate spike’ between >30% and 100% increase; and (4) ‘large spike’ >100% increase. Outcome was self-reported overuse running-related injury. A multistate Cox regression model was used to estimate adjusted hazard rate ratios (HRR).
Results: Among 5205 runners (mean age 45.8 years, SD=10.4; 22% female), a total of 1820 (35%) sustained a running-related injury during 588 071 sessions. Significantly increased rates were identified for small spikes (HRR=1.64 (95% CI: 1.31 to 2.05, p=0.01)), moderate spikes (HRR=1.52 (95% CI: 1.16 to 2.00, p<0.01)) and large spikes (HRR=2.28 (95% CI: 1.50 to 3.48, p<0.01)) in single-session running distance. A negative dose-response relationship was observed for the ACWR. No relationship was identified for the week-to-week ratio.
Conclusion: A significant increase in the rate of running-related overuse injury was found when the distance of a single running session exceeded 10% of the longest run undertaken in the last 30 days.
Details
- Title
- How much running is too much? Identifying high-risk running sessions in a 5200-person cohort study
- Authors
- Jesper Schuster Brandt Frandsen - Aarhus UniversityAdam Hulme - University of the Sunshine Coast, Queensland, Thompson InstituteErik Thorlund Parner - Aarhus UniversityMerete Møller - University of Southern DenmarkIda Lindman - University of GothenburgJosefin Abrahamson - Sahlgrenska University HospitalNina Sjørup Simonsen - Aarhus UniversityJulie Sandell Jacobsen - VIA University CollegeDaniel Ramskov - University College of Northern DenmarkSebastian Skejø - Aarhus UniversityLaurent Malisoux - Luxembourg Institute of HealthMichael Lejbach Bertelsen - Aarhus UniversityRasmus Oestergaard Nielsen (Corresponding Author) - Aarhus University
- Publication details
- British Journal of Sports Medicine, Vol.59(17), pp.1203-1210
- Publisher
- BMJ Group
- Date published
- 2025
- DOI
- 10.1136/bjsports-2024-109380
- ISSN
- 1473-0480; 0306-3674
- PMID
- 40623829
- Copyright note
- This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
- Data Availability
- According to the informed consent, no data can be shared outside Aarhus University.
- Grant note
- AUFF-E-2015-FLS-9-9 / Aarhus University Research Foundation; R160-A5157 / Danish Rheumatism Association
- Organisation Unit
- Thompson Institute
- Language
- English
- Record Identifier
- 991144502402621
- Output Type
- Journal article
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