A Paradigm Shift in Understanding Overuse Running-Related Injuries: Findings From the Garmin-RUNSAFE Study Point to a Sudden Not Gradual Onset

This is the authors' abstract. We don't add key points for this paper.

OBJECTIVES: To investigate the proportion of running-related injuries that can be classified as (1) being based on overload with an acute mechanism with a sudden onset, (2) being overuse in the sense they are based on a repetitive mechanism with a sudden onset; and (3) being overuse in the sense that runners gradually develop problems that lead to an injury. DESIGN: Cohort study with an 18-month follow-up. METHODS: English-speaking runners aged at least 18 years who were tracking running activities were included. Running-related injury during follow-up categorized into 3 groups: (1) those with overload injury, (2) those with a running-related problem 7 to 28 days prior to reporting a running-related injury, and (3) those sustaining a running-related injury without any preceding problems. RESULTS: Overload injury accounted for 467 of 1666 injuries (28%), while 1199 injuries were overuse (72%). Among overuse injuries, the proportion of runners having a problem prior to injury occurrence was 6.9% (95% confidence interval [CI]: 5.5%, 8.4%) 7 days prior to injury and 11.1% (95% CI: 9.4%, 13.0%) 28 days prior to injury. CONCLUSION: Most of the overuse injuries occurring in adult runners may be classified as sudden repetitive overuse injuries rather than injuries that are based on a gradual onset. JOSPT Open 2025;3(1):85-92. Epub 1 October 2024. doi:10.2519/josptopen.2024.0075