Research project Running-related injuries among recreational runners

Research project
Active research
Project size
3 580 185
Project period
2016 - 2021
Project owner
Center for Health and Performance, Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg

Short description

The purpose of the project is to investigate if runners with certain characteristics (with regard to flexibility, strength, running style and training) sustain more injuries than runners having other characteristics. A prospective cohort study was conducted between 2016 and 2018 that included more than 220 male and female recreational runners between the ages 18-55, reqruited from Gothenburg half marathon. The outcome of this project will be an important step towards the identification of factors related to injuries in recreational running.

This research project addresses one of the most popular forms of physical activity in Sweden, namely running. As physical activity, such as running, prevents many of the lifestyle-based diseases that are common in the western world, it is important from a public health perspective to minimize the risks of physical activity so that more people can continue to be active. However, runners are vulnerable to various types of injuries, and the most common reason to quit running is an overuse injury. The mechanisms behind overuse injuries are not clearly described in the literature, and the purpose of the project is therefore to identify risk factors that influence the development of running-related overuse injuries in recreational running.

The project was granted ethical approval by the Regional ethics review board in Gothenburg (file number 712-15) in the autumn of 2015 and data collection started in spring 2016 at Center for health and performance (CHP), University of Gothenburg's test center. With assistance from Gothenburg half marathon we were able to include 227 recreational runners (89 women, 138 men). All runners underwent a comprehensive physical examination regarding mobility, running style and strength and were then asked to register their training in a certain log for the upcoming 52 weeks. Data collection lasted for two years, as it took approximately one year to finish the initial physical examination for all participants.

The aim of the project is to increase knowledge about various risk factors that affect the development of running-related injuries in recreational runners. Among other things, the project has contributed to an increased understanding of the type of runners who have an increased risk of sustaining running-related injuries.

The following is a summary of the scientific articles that have been published within the project.

The study protocol (Jungmalm et al., 2018) describes the methods we have used in the project in detail. Moreover, we also discuss the importance of collecting training-specific data (such as distance, intensity, frequency) and data that represents runners' capacity (how much a person can train before injury occurs in a structure) as well as data on factors affecting load-distribution (eg running speed, type of shoes and surface).

The publication in BJSM (Jungmalm, Bertelsen & Nielsen, 2020) describes how cumulative injury incidence proportion changes depending on whether it is calculated with or without censoring. The more runners who are censored during the study period, the greater the differences. Four prospective cohort studies that together studied 2,798 runners (56.8% women) were included.

Data from Desai et al. (2020) shows that the most injured structure of recreational runners was the knee and the area around the Achilles tendon / calf muscles. The likelihood of suffering an injury was greater for runners who had previously been injured. Both for the previously injured runners and for those who had never had an injury, the likelihood of suffering a new injury with increased running distance per week increased.

Results from Jungmalm et al. (2020) shows that runners with a relatively late timing of maximum ankle eversion suffered 20.7% (95% CI = 1.3; 40.0) more injuries compared with runners with a later timing of the maximum ankle eversion. In addition, the study showed that runners with weak hip abductors in relation to hip adductors suffered 17.3% (95% CI = 0.8; 33.7) more injuries compared with the reference group.



  • Postdoc Andreas Lundberg Zachrisson
  • Postdoc Jonatan Jungmalm
  • Professor Stefan Grau
  • Professor Jón Karlsson
  • PhD student Pia Desai
  • Rasmus Nielsen (Aarhus University)