Written by Luke Cancilla, DPT 

When it comes to increasing your running performance, load management is key. By introducing specific techniques into your training program, you can optimize your exercise and improve your running results. Learn how to set a progressive and sustainable workload to help you reach your goals and reduce your risk of injury.

As performance physical therapists, we see countless clients for common running-related injuries. In each case, the individual and the context is unique. However, one factor remains consistent in these non-traumatic injuries and that is the root cause of these injuries: training error. 

Research has demonstrated that the yearly injury rate for recreational runners lies between 37% and 56%. Unsurprisingly, injuries to the knee, ankle, and lower leg account for the highest proportion of running-related injuries. We see runners each day for these common conditions such as patellofemoral pain, Achilles tendinopathy, and stress reactions/fractures. In each of these running-related injuries, the common denominator is training load that exceeded the capacity of the musculoskeletal tissue.   

Set Proper Expectations and Goals. 

As you begin your training program, it is important to set proper expectations and goals. Doing so will help to determine what types of load management protocols are necessary for an efficient and safe training session. For example, if you are looking to increase your running speed, setting a goal of running easy for 30 minutes is more appropriate than running five miles every run at a moderate to hard effort. This will help you to plan how much time, intensity and volume are needed to reach that goal without overburdening the body.

In order to delve deeper it is important to understand training loads. Training load is very individualized and difficult to quantify perfectly, making it difficult to track. This may be the biggest reason running-related injuries are so common. Throughout my high school career, I always viewed my training as the distance I’ve run in a given week (some of you may fall into this thinking). As I learned more through my running career, variables such as paces and effort made their way into the definition of training load. Now, we know that there are even more factors involved that go into a better understanding of your training load. 

Training stress is the physiologic stress on your musculoskeletal system resultant directly from each single training session. On easier run days, this stress may be low while harder efforts and workouts can increase this given stress. For each of us, running and training for a race doesn’t take place in a vacuum. We all have additional daily stress, whether that be job-related, relationship related, financial related, or even sleep-related. This stress plays a major role in your training as well. 

When discussing running-related injuries, there are three types of loads that we focus on. The first is external load, which is the physical stress applied to you during a training session. This includes the duration of a run, distance, pace, step count, etc. The second is physiologic internal load, which are the cumulative stresses experienced in response to external loads during a training session as well as in response to additional daily stress. This is best represented as your rating of perceived exertion. The third type of load that we are focused on includes the specific tissue internal load which is the stress placed upon the musculoskeletal tissue by the external load, often represented by stress, strain, force, and stiffness.  

Monitor Workouts, Technique and Performance Metrics.

Proper load management helps to ensure that your running program is optimized. In order to do this effectively, it is important to monitor your workouts, technique and performance metrics. 

So what is your training load and what should you be tracking? Your training load is the cumulative product of the external loads and physiological internal loads that you experience. One way to quantify this is through multiplying the duration of a run (or distance) x your rating of perceived exertion for that run and tracking this on a weekly and monthly scale. Admittedly, this remains difficult to track perfectly, but highlights the importance to consider much more than just weekly mileage to direct your training program. 

Despite this remaining an imperfect science, when developing and executing your training program, there are a number of things that you can do to decrease your chances of experiencing a running-related injury. The first step is to optimize your load capacity through consistent progressive loading, addressing psychological stressors, and optimizing tissue physiology. The second step is to consider your attributes as a unique runner including your past medical history, your training history, and your goals. 

Injuries and training can be complicated. We are experts in running related injuries and can help you in your journey.

References:

Kakouris N, Yener N, Fong DTP. A systematic review of running-related musculoskeletal injuries in runners. J Sport Health Sci. 2021 Sep;10(5):513-522. doi: 10.1016/j.jshs.2021.04.001. Epub 2021 Apr 20. PMID: 33862272; PMCID: PMC8500811.

Napier C, Willy RW. The Prevention and Treatment of Running Injuries: A State of the Art. Int J Sports Phys Ther. 2021 Aug 1;16(4):968-970. doi: 10.26603/001c.25754. PMID: 34386275; PMCID: PMC8329326.

Paquette MR, Napier C, Willy RW, Stellingwerff T. Moving Beyond Weekly "Distance": Optimizing Quantification of Training Load in Runners. J Orthop Sports Phys Ther. 2020 Oct;50(10):564-569. doi: 10.2519/jospt.2020.9533. Epub 2020 Aug 1. PMID: 32741325.

van Mechelen W. Running injuries. A review of the epidemiological literature. Sports Med. 1992 Nov;14(5):320-35. doi: 10.2165/00007256-199214050-00004. PMID: 1439399.