Can “Obvious” Advice Stop Running Injuries?

It’s far from rocket science, but simple online reminders offer surprising benefits.

In the struggle against running injuries, as in so many areas of life, we’re always searching for new and better breakthroughs. In the process, we may be undervaluing the power of what we already know. Want to live a long, healthy life? Maintain a healthy weight and don’t smoke or drink to excess, and you can ignore the latest superfood or workout trend. Similarly, avoiding shin splits and stress fractures and other running hazards may not be as complicated as it seems.

That’s one of the takeaways from a new study in the British Journal of Sports Medicine, from a group of researchers at VU University Medical Center in Amsterdam. The study tested the effectiveness of automated online injury-prevention advice dispensed to trail runners every two weeks for six months, and found a significant reduction in injury risk compared to a control group.

The study involved 232 trail runners, all of whom received some generic advice for preventing running injuries, based on the following acronym-creating rubric:

  • Trail runners at higher risk
  • Running volume/intensity
  • Add warming up/cooling down
  • Implement general conditioning
  • Listen to your body
  • Shoes for trail running

After that, the runners checked in every two weeks to fill out a questionnaire that classified them as currently having no running-related injury, a non-substantial running-related injury, or a substantial running-related injury. Half of the runners then received automated online advice based on their injury status; the other half (the control group) got nothing.

The “specific” advice the injured runners got wasn’t very specific at all. They replaced two of the letters in “TRAILS,” so that T became “Treatment: seek a health care professional,” and L became “Lay ice until you feel necessary.” (We’ll assume something was lost in translation, but you get the gist.) Under each category, they elaborated on how much to warm up and cool down, when to ice, and so on.

Let’s be honest. When you read the description of this study, it’s hard to believe that it will do anything useful. If some online bot sends you an e-mail saying “Hey, you said you’re injured, you should ice that sucker and see a professional,” is that really going to change your behaviour?

The short answer is no. And indeed, in follow-up questionnaires two months and six months after the study started, there didn’t seem to be any significant difference between the control and intervention groups in their adherence to the injury-prevention advice provided.

And yet, somehow, the runners in the online-advice group ended up less likely to sustain an injury compared to the runners in the control group, even though the two groups had very similar characteristics overall. Overall, they were 13.1 per cent less likely to get injured during the six-month study period, and the “number needed to treat” was eight – meaning, roughly speaking, that for every eight runners who participated in the online program, one dodged an injury bullet as a result.

It’s not clear how or why this happened. It may be that subtle but statistically insignificant changes in a few of the injury-prevention behaviours (warming up, cooling down, and wearing specialised trail running shoes) might have combined to provide a protective effect. Or it may be something even more nebulous. Perhaps simply receiving these common-sense reminders was enough to tilt runners in a more cautious direction, convincing a few not to push through worrisome aches and pains at crucial junctures.

The authors conclude that there’s “very strong” evidence that “online tailored advice” on running injuries can play a role in reducing running injuries. It’s cheap, easy to implement, and easily scalable, so there may well be some truth in that.

But I’d add an even simpler message. There were so secrets in this advice – no trademarked techniques, patented devices, or miracle supplements. You already know all the advice they were giving. So even if you’re not getting an online reminder every two weeks, try to remind yourself and your training partners to be patient, cautious, and diligent. It’s easier said than done – but apparently it works.

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