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Strength training and overuse injuries in first-time marathon runners

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Summary of an article testing the effect of strength exercises on the rate of overuse injuries in the first-time runners.


720 first-time New York City Marathon runners aged above 18 years (USA).

Strength training group
352 athletes (female: 245, male: 107)
aged 35.4 (±9.1)
BMI 24.2 (±4.1)
Control group
368 athletes (female: 255, male: 113)
aged 36.3 (±9.8)
BMI 24.0 (±3.3)


Randomized controlled trial of an e-intervention.

Strength training group

  • 10 minutes video + handout with exercises focusing on strength of core, hip abductor, and quadriceps in beginners and advanced versions
  • 3 times per week for 12 weeks

Control group

  • trained by themselves
  • no restriction of strength training

Outcome measures

  • repeated surveys (every two weeks) of injuries (minor, major), overuse injuries
  • marathon finishing time

Main results

  • Runners performed the strength training on average 2 (±1.2) times per week.
  • The average finishing time was 5h 1.1minutes (60.4 minutes) in the strength training group and 4h 57.5 minutes (54.4 minutes) in the control group (no difference).
  • There was no difference in major injuries between the groups.
  • Most overuse injuries happen in the training 6 to 2 weeks before the race. These injuries were: bone stress injuries (20), tendon/fascia injuries (11), joint injuries (9), muscle injuries (9) and 3 unspecified.
  • No difference in minor injuries during training period between groups. 46.3% of runners in the strength training group and 50.5% in control group got at least one injury during the study.
  • No difference in minor injuries during the race: 14.7% in strength training group and 16.1% in the control group.
  • When compliant (strength training 2 times per week) and non-compliant runners from the strength training group were compared, the compliant runners had a lower incidence of minor injuries (41.5% vs 56.2%). Compliant runners ran slower (5h 2.7 minutes vs 4h 58.2 minutes) and had higher incidence of major injuries (9.1% vs 8.0%).

Take home message

For a clinician & coach
This strength training was effective in reducing minor injuries, but not major injuries. No improvement in the marathon completion time was found.
For a parent
Consult a health professional before using this program.
For an athlete
Consult a health professional before using this program.

Original article

Toresdahl BG, McElheny K, Metzl J, Ammerman B, Chang B, Kinderknecht J. A randomized study of a strength training program to prevent injuries in runners of the New York City Marathon. Sports health. 2020 Jan;12(1):74-9.

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