Risk factors for overuse injuries in short- and long-distance running: A systematic review.

Running injuries are common, but it has long been unclear which factors actually raise someone's risk, and whether those risks differ for people running short versus long distances. This systematic review pulled together 29 prospective cohort studies to compare risk factors identified separately for short-distance runners (generally 20 km or less per week) and long-distance runners (over 20 km per week). The clearest pattern across both groups was that a history of injury mattered most, though the type differed: long-distance runners were most at risk if they had a previous running-related injury, while short-distance runners were most at risk if they had any previous injury, even one unrelated to running. Several other factors, including higher body mass index, older age, male sex, limited running experience, and lower weekly mileage, were linked to injury risk in short-distance runners, though with moderate-quality evidence.

Attempts to build predictive risk models performed poorly, with only low-quality evidence backing them, underscoring that running injuries arise from multiple interacting factors rather than one dominant cause.

If you run regularly, you may have wondered what actually puts you at risk of injury. Researchers reviewed 29 studies that tracked runners over time to see which personal factors were linked to later injuries, looking separately at people who ran shorter distances (around 20 km or less a week) and those running longer distances. The strongest signal was past injury: long-distance runners who'd previously had a running injury were more likely to get injured again, and short-distance runners with any past injury, even one not caused by running, faced higher risk too.

Among short-distance runners, being older, having a higher body mass index, being male, having little running experience, or running fewer miles were also associated with injury, though this evidence was only moderate in quality. Tools designed to predict who will get injured didn't hold up well, with weak supporting evidence.

The review doesn't tell us why these links exist or how to prevent injuries, just which factors tend to appear alongside them.

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

For clinicians trying to identify runners at elevated injury risk, this systematic review synthesises findings from 29 prospective cohort studies, split between short-distance runners (mean weekly distance 20 km or less, sessions up to 10 km) and long-distance runners (above those thresholds), using the GRADE framework to rate evidence quality. The most consistent finding was that injury history predicts future injury, but the nature of that history differs by population: a prior running-related injury was the strongest predictor in long-distance runners (moderate-quality evidence), while any prior injury, including non-running-related ones, was the strongest predictor in short-distance runners (high-quality evidence).

Additional factors reaching moderate-quality evidence in short-distance runners included higher body mass index, older age, male sex, lack of running experience, and lower running volume. Notably, formal risk prediction models performed poorly, supported only by low-quality evidence in both groups, which limits their clinical utility. This review does not establish causal mechanisms, nor does it test whether modifying any of these factors reduces injury incidence.

The abstract does not specify the individual study designs' sample sizes or risk-of-bias ratings beyond the GRADE summary, and the overall message is that running injuries are multifactorial, making single-factor screening an incomplete approach for risk stratification.