Do Exercise-Based Prevention Programs Reduce Injury in Endurance Runners? A Systematic Review and Meta-Analysis.

Runners get injured a lot, and exercise programs like strength or stability training are often suggested as a way to prevent that. This review pooled data from randomized trials comparing runners who added such exercise programs to their training against runners who just ran or did a placebo exercise. Overall, across the pooled studies, there was no statistically significant difference in either injury risk or injury rate between the two groups. What makes this interesting is a post hoc, secondary look at just the supervised programs, which did show a significant reduction in injury risk compared to control groups.

That hints supervision, and perhaps the compliance that comes with it, might matter more than the exercises themselves. The authors caution that most of the underlying studies were low quality, so this pattern needs confirmation from better designed, supervised trials before anyone can draw firm conclusions.

If you're a runner who has looked into strength or injury-prevention exercises hoping to avoid getting hurt, this review is relevant to you. Researchers combined results from nine trials, involving just over 1900 runners, comparing people who added exercise programs to their running against those who just ran or did a placebo exercise.

Overall, adding exercise programs didn't show a statistically significant reduction in how often runners got injured or how many injuries occurred. There was one interesting wrinkle: when researchers looked specifically at programs where a professional supervised the exercises, injury risk was significantly lower in that group. This might be because supervision helps people stick with the program more consistently, but this analysis was done after the fact, and most of the individual studies had quality concerns. So while the idea of supervised exercise showing some promise is worth knowing about, the overall evidence for exercise programs preventing running injuries in general is currently uncertain, and more high-quality research is needed before firm conclusions can be drawn.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review and meta-analysis pooled nine randomized controlled trials totaling 1904 participants, comparing non-running exercise-based interventions against running-only or placebo-exercise controls in endurance runners. Using random-effects models for both log risk ratio and log incidence rate ratio, the overall pooled analysis found no statistically significant difference in injury risk (z = -1.60, p = 0.110) or injury rate (z = -0.98, p = 0.329) between intervention and control groups. A post hoc subgroup analysis restricted to supervised interventions showed a statistically significant reduction in injury risk favoring the intervention group (z = -3.75, p < 0.001).

This finding should be interpreted cautiously given its post hoc nature and the fact that seven of the nine included studies were rated as low quality on the Cochrane Risk of Bias Assessment Tool 2. The GRADE approach was used to assess certainty of evidence, though specific certainty ratings for each outcome are not detailed in the abstract. Overall, this body of evidence does not support a general claim that exercise-based prevention programs reduce running-related injury risk or rate, though the supervised-subgroup signal suggests compliance or supervision quality may be an important moderating variable warranting more rigorous trial designs.