Most runners are clueless about what causes injuries in their sport. When researchers asked 95 runners with an average of 3.5 years of running experience and who averaged 35 kilometers (approximately 21.7 miles) of running per week about the cause of running injuries, most got it wrong.
Seven Universal Myths About Runner’s Injuries

According to a piece by Scott Douglas for Runners World & Running, the reason given by the most runners for injury was “not stretching.” They gave that reason 31 times. Research simply does not support that conclusion.
According to Douglas, the other reasons for injury that the runners gave were:
- Excessive training (28 times)
- Wearing the wrong shoes for foot type (22 times)
- Inadequate/unbalanced diet (20 times)
- Not warming up (20 times)
- Lack of strength (19 times)
- Not respecting the body’s limits (18 times)
- No professional supervision (17 times).
What does the research say? Douglas reported that studies show that increasing mileage too quickly and a history of injury are the most commonly associated activities which correlate with a higher incidence of injury.
They have found NO link between regular stretching and reduced risk of injury.
The third most frequent response was “wearing the wrong shoes for foot type.” That belief was also not supported by research. Douglas wrote that several studies in recent years have found that injury rates are unaffected by runners’ shoe choices.
Those runners who blamed overtraining got it right. The authors of the study wrote that “the belief of the interviewed runners about the risks of overtraining is consistent with the literature.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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