Why Runners Let Overuse Injuries Happen and How to Stop Them

Judi Ketteler
by Judi Ketteler
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Why Runners Let Overuse Injuries Happen and How to Stop Them

As a group, we runners tend to have close relationships with our bodies. We know how far we can push, what factors put us at risk for injury, when to run through a nagging pain and when to let up. Or at least, that’s what we like to think.

However, new research may point to something else. Two studies — one on competitive runners and one on recreational runners — found that, when it comes to preventing injury, runners don’t always know themselves as well as they might think.


The first study looked at Swedish male and female middle-distance runners from the national team. When researchers surveyed this group, they found athletes were very good at changing their training schedules and backing off when they were ill with recognizable symptoms (like a fever or bad sore throat) or when they had an obvious injury with a sudden onset. However, when dealing with pain of a more gradual onset, the athletes tended to keep their training schedules as usual. The authors quote one of the athletes in the study as saying: “I would say I think differently when injured and ill. When I am ill … I prefer to wait and rest an extra day before starting to exercise. But when I am injured I go on anyway.”


Researchers found the athletes played an interesting game of reasoning with themselves: If they didn’t know the underlying cause of the nagging pain, it must not really be a problem — especially if they had important competitions coming up. They also used something the study authors call, “magical thinking,” or the notion that the pain would just “magically” disappear if ignored. So they continued to train hard.

The outcome of these athletes who continued to ignore the nagging pain seems obvious from here. Eventually, they had to take time off because the pain developed into a full-blown injury and/or their coach sidelined them. The study authors concluded, “Myths and different forms of magical thinking are prevalent among competitive runners (“You can ‘run through’ tendinitis”) that are not supported by scientific evidence.”


The second study looked at what recreational runners thought were the major risk factors for developing injuries. The authors interviewed 65 men and 30 women, ranging in age from 19–71 years old. On average, these runners had been running for about 5 1/2  years, logging about 22 miles a week. A little less than half of them had experienced a running-related injury.

These runners cited factors such as “not respecting the body’s limits” as being related to injury — so they were on the right track in some of their beliefs. But they held fast to other beliefs that science has disproven — such as that stretching can prevent injury. The study authors theorize that runners may be confusing stretching with warming up — and there is evidence that warming up cold muscles can help prevent injuries.


Bottom line: When we are not sure of the mechanism behind something (What might injure me?), we fill it in with our own beliefs — which may or may not help us.


“We all put faith in things that seem they will be helpful. It’s hard to know what’s best,” says Rob Udewitz, PhD, veteran runner and clinical psychologist who works with many runners at his practice, Behavior Therapy of New York. “It’s about finding a balance between what you hear on the outside and trusting and knowing yourself.”

If you find it challenging to sort through everything you hear, as well as your own fears of getting injured, Udewitz recommends taking a step back and tuning into your inner coach. A coach’s role is to see the big picture of your training. Do that for yourself, he advises. “When you are deciding whether or not to run, ask yourself what a coach would say.”


The competitive runner study suggested that cultivating mindfulness is one thing that may help runners discern when they need to back off. This makes sense, Udewitz says, because mindful meditation while running involves deeply “listening in” to your body. “If you cultivate your ability to listen using a mindfulness practice, you can do a better job differentiating between discomfort or fatigue and injury,” he says.

Even the most tuned-in runner can still disconnect as the miles wear on. The best defense against kidding yourself may be as simple as checking in with yourself — and really listening to the answer.

About the Author

Judi Ketteler
Judi Ketteler

Judi is a Cincinnati-based freelance writer. She’s been running for more than 20 years, and has a particular soft spot for doing half-marathons. Her work has appeared in outlets such as The New York Times, Runner’s World, Women’s Health and Good Housekeeping. Find her at judiketteler.com or @judiketteler on Twitter


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