Does Strength Training Prevent Running Injuries? A Look at the Latest Research
While running is a very effective form of exercise, it comes with injury risk. A significant percentage of runners will end up with an injury every year, which has caused researchers to investigate causes of injuries and ways to reduce injury risk.
For many years, we didn’t have much data- only snapshots of injured vs. uninjured runners, and analyses into their strength (or weakness) in key muscle groups. We didn’t have any randomized control trials where different strengthening programs were tested to examine their effect on injury rates.
In recent years, running researchers have been able to perform some randomized controlled trials to give us more info about strength training and it’s effect on injuries. Here’s what we know so far:
Hip and Core Strengthening: A Promising Approach
A 2024 study examined how strengthening the hips and core may impact injury rates in novice runners. The trial followed 325 participants (245 female, 80 male) all of which were between 18 and 55 years old.
This study included “novice” runners. To be included in the study, the runners had to meet the following criteria to be considered novices:
Less than 2 years of running experience,
Running less than 20 km/12.4 miles per week
Able to run 3 km/20 minutes
No major leg injuries/surgeries in the last 3 months
After being enrolled in the study, the participants were randomly assigned to three groups:
Hip and Core Strength Group
Ankle and Foot Strength Group
Control Group (Static stretching)
All runners trained with a running program 2x per week over 24 weeks and completed their strengthening or stretching program with guidance from a physiotherapist in a group session.
The researchers followed the runners for 24 weeks and tracked injuries over that timeframe. They measured both prevalence and incidence of running injuries.
Prevalence vs incidence:
Prevalence: Researchers divided the number of participants that reported a LE overuse injury by the number of respondents that week
Essentially calculates the % of runners who reported an injury on any given week
Incidence: Calculated as the number of injuries per 1000 hours of running exposure
Results:
Injury Incidence per 1,000 Hours of Running:
Hip/Core group: 17.2 injuries (statistically significant)
Ankle/Foot group: 26.6 injuries
Control group: 24.8 injuries
Incidence of Time-Loss Injuries:
These are injuries that caused the runner to miss at least 7 days of running due to injury.
Hip & Core Group: 34% lower injury rate compared to control and foot/ankle group
Ankle & Foot Group: No significant difference compared to control
Prevalence of Overuse LE Injuries
Participants reporting more than 1 episode of overuse injury:
Hip & Core Group: 42% (45 participants), 9.2% weekly prevalence.
Ankle & Foot Group: 59% (65 participants), 12.0% weekly prevalence.
Control Group: 54% (57 participants), 15.5% weekly prevalence.
Summary: Hip and core group had a lower weekly prevalence of running injuries.
Substantial Overuse LE Injuries
“Substantial overuse” was defined as an injury leading to moderate or severe modifications in training, moderate to major effects in performance, or an inability to participate in training.
Hip & Core Group: 3.3% weekly prevalence.
Ankle & Foot Group: 5.0% weekly prevalence.
Control Group: 7.7% weekly prevalence.
Summary: Hip & Core group had 52% lower prevalence compared to control
Results Summary:
The Hip & Core Group saw a 39% lower prevalence of all overuse injuries and 52% lower prevalence of substantial overuse injuries compared to the control.
Hip and core group had a lower incidence of all lower extremity injuries
17.2 injuries per 1000 hours vs. 26.6 in the ankle/foot group and 24.8 in the control group.
The Ankle & Foot Group did not reduce injuries and showed a higher incidence of acute muscle injuries compared to the control.
Limitations of this study:
Lack of blinding for participants and physiotherapists.
Population was low-volume, novice runners.
Hard to generalize this data to more experienced runners, who may have a higher level of baseline strength or tolerance to running stress.
What does this paper tell us?
Hip and core strengthening was beneficial for novice, lower volume runners. It may or may not be effective for higher volume runners.
Foot Core Training: Another Promising Area
Published in 2020, this study investigated the effectiveness of an eight-week foot strengthening program on running injury rates.
To be included in this study, the runners had to meet the following criteria:
18-55 years old
1 year of running between 20 and 100 km per week (~12-62 miles/week)
No running injurues in the 2 months before baseline assessment
No experience running barefoot or in minimalist shoes
No history of lower limb surgery
No chronic diseases that influence running performance (ex: osteoarthritis)
Participants were then divided into 2 groups:
Control group: Continued regular running and a static stretching routine.
Strengthening group: Regular running AND an eight-week foot and ankle strengthening program.
Foot/Ankle Strengthening Program
The program included:
Sitting foot taps
Standing heel raises
Ankle inversion and eversion isometrics
Resisted ankle inversion, eversion, and dorsiflexion
Toe curls with ball
Toe squeezes
Toe abduction
Short foot exercises
The sets and reps of this program were gradually progressed over an 8 week period.
Researchers followed the runners in both groups for a year and tracked injury rates.
Results
The control group was 2.4 times more likely to sustain injuries than the strengthening group. Additionally, the time to injury correlated with changes in foot posture and strength gains.
Key Takeaways and Limitations
Overall, this study demonstrates promising outcomes, indicating that the specific foot program reduced injury rates among healthy runners. The researchers controlled for other variables such as training volume, running experience, foot strike pattern, and injury history which strengthens the results.
However, as the participants were all healthy runners, the program's effectiveness for those with recent injuries remains uncertain. Additionally, the study did not differentiate between types of running injuries. This leaves questions about if the program is more effective for foot injuries vs. knee, hip, or back injuries.
A Look at General Strength Training
While the last 2 papers focused on individual muscle groups, a 2023 study looked at generalized strength training and its effect on running injuries.
This trial included 453 recreational runners aged 18–55. To participate in the study, the runners had to meet the following criteria:
Average at least 15 km (~9 miles) of running per week over the past year.
No injuries in the last six months.
The participants were randomly divided into two groups:
Intervention Group (n=228): Completed a structured strength and foam rolling program.
Control Group (n=225): Continued their usual training with no intervention.
Strength Protocol
The intervention group a strength and foam rolling program 2x per week for 18 weeks.
Strength Training (19 minutes):
Each session included 1 set of 10 reps for all exercises with bodyweight or resistance bands only. Illustrations of the exercises can be found here.
1-leg squat (forward step down)
Forward lunges
Side-steps with a band
Supine abduction with a band
Side plank (30 seconds per side)
Bird Dog
Ankle inversion with a band
Foam Rolling (11 minutes):
Foam rolling targeted:
Upper leg muscles (hamstrings, quadriceps, glutes, abductors)
Lower leg muscles (plantar fascia, calves, shin muscles)
Each muscle group was rolled for one minute.
Results
Based on the previous 2 papers, you might expect that the strength training group sustained fewer injuries than the control group. That is not exactly what happened. There were no differences in injury rates between the groups.
However, when the researchers controlled for compliance with the program, the runners who were highly compliant with the program sustained 85% fewer injuries.
You might think “I just need to be highly compliant and my injury rate will be way lower!” But that’s not exactly what these results mean.
High compliance was associated with lower injury rates, but we can’t say for sure that it was the active ingredient to the lower injury rates.
Runners who are highly compliant with their strength training program likely have more time to train, or less stressful schedules. The runners who were not compliant with their strength training were more likely to sustain an injury.
Think of the most common reasons why someone may not be compliant with their strength training: time, scheduling, stress, motivation. If someone doesn’t have time to do a strength program, they may have a more stressful schedule. They also might be getting less sleep, which would increase risk of injury. Or perhaps they have less motivation, which may mean a less structured training schedule.
Based on what we’ve seen from the other papers, the strength training likely plays a role in the decreased injury risk in the highly compliant group- but other factors probably helped too.
Limitations
While the results are promising, the study had limitations in addition to the compliance issue described above.
Population Selection:
Excluded novice and elite runners as well as those with recent injuries- it’s unclear how these groups would respond to the strength program.
Injury Types Not Specified:
The study didn’t differentiate between injury types, leaving questions about whether the intervention is more effective for some types of injuries vs. others.
Key Takeaways for Runners
Personally I’ve waited a long time to see these types of studies completed in runners. It’s nice to finally have some data to look at when it comes to strength training and injury rates. While you can’t reduce injury risk simply by looking at the data, there are some lessons we can take from these papers:
Hip and core strengthening appears to be beneficial for novice or lower volume runners. While we don’t know how elite runners would benefit from this type of training, but I certainly wouldn’t omit hip and core strengthening from an elite program.
Foot core strengthening may benefit runners with specific weaknesses or foot posture issues, though its broader applicability remains uncertain.
Consistency is important: Strength training must be performed regularly to deliver results. All of these papers used programs where strength training was completed at least 2x per week for 8+ weeks.
The effectiveness of strength training may vary by population. Novice runners may benefit more than experienced runners who may already have a baseline level of strength and resilience.
What’s Next?
While these findings are promising, they also highlight gaps in our current understanding. Future research should investigate:
The impact of strength training on more experienced or higher volume runners.
Comparative effectiveness of different types of strength programs.
Long-term outcomes of integrating strength work into regular training.
For now, incorporating two to three strength sessions per week—focused on the hips, core, or other specific weak areas—offers an evidence-based way to build resilience and reduce risk of injuries.
