Kinetic Sports Physio Blog

It is a long held belief that static stretching (i.e. long holds of >15 seconds) plays an important role in improving running performance and decreasing injury risk (1). As such static stretching, undertaken as part of a ‘warm up’ prior to running or at the end of a run, or both, is a common practice amongst runners of all levels. 

Current research evidence definitively demonstrates that this belief is in fact incorrect.

Running places significantly high loads through the joints and tissues (i.e. bones, tendons and muscles) of the body. As a result runners are at a risk of developing running-related overuse injuries such as knee cap related pain, illiotibial band syndrome, and achilles tendinopathy (2). Overuse injuries occur when running loads (i.e. frequency, intensity, and/or duration) are progressed too rapidly and exceed the capacity of the tissue to adapt (i.e. strengthen) to loading. This results in tissue overload and then injury. Other factors including deficits in muscle strength, general health issues and past injury history can also predispose a runner to injury (2).

Research shows that stretching either in the short or long term has no impact on reducing the risk of overuse injuries experienced by endurance runners.1In fact static stretching prior to running has been demonstrated to potentially inhibit performance for up to one hour (1). This is thought to be caused by a reduction in the mechanical efficiency of the lower body, primarily impacting the ability of the muscles and tendons to store and release elastic energy (3).

Static stretching is often recommended to enhance recovery and reduce the impact of delayed onset muscle soreness (DOMS). Endurance runners commonly experience DOMS after particularly fast, hard or downhill running.  DOMS results in muscle pain, stiffness and fatigue, commonly in the thigh muscles, and will inhibit a runner’s performance for several days (1). Unfortunately stretching has not been shown to reduce the intensity or the duration of DOMS following exhaustive exercise (1).  

It is important to point out that regular static stretching after running will not do any harm.

Stretching will improve joint flexibility but these improvements have not been associated with any benefits to recovery, performance or running economy in the long term (4).  

Runners should therefore consider other strategies that will assist them to prepare for and recover well from running. A progressive warm up including a gradual increase in intensity prior to harder running efforts or a ‘session’ is recommended. Elite athletes in all running sports implement this practice. 

A typical active warm up for a runner could progress like this: 

1. 5-10 minutes of walking or jogging. 
2. Complete 6-8 dynamic movement drills for a total of 5-10 minutes that will move your joints through full range of movement with particular focus on the lower limbs e.g. walking lunges, leg swings etc. 
3. Finish with 3-4 fast running efforts at goal running pace e.g. 3-4x100 meters. 

To enhance recovery, ensuring you are getting enough sleep i.e. 7-9 hours or more each night, is the most important, cost effective and time efficient recovery method available for runners . Getting more sleep has proven beneficial effects on performance and recovery .

References: 

1. Baxter, C., Mc Naughton, L. R., Sparks, A., Norton, L., & Bentley, D. (2017). Impact of stretching on the performance and injury risk of long-distance runners. Research in Sports Medicine, 25(1), 78-90.
2. Saragiotto, B. T., Yamato, T. P., Junior, L. C. H., Rainbow, M. J., Davis, I. S., & Lopes, A. D. (2014). What are the main risk factors for running-related injuries?. Sports medicine, 44(8), 1153-1163.
3. Yeung, S. S., Yeung, E. W., & Gillespie, L. D. (2011). Interventions for preventing lower limb soft-tissue running injuries. Cochrane Database of Systematic Reviews.
4. Nelson, A. G., Kokkonen, J., Eldredge, C., Cornwell, A., & Glickman‐Weiss, E. (2001). Chronic stretching and running economy. Scandinavian journal of medicine & science in sports, 11(5), 260-265.
5. Bonnar, D., Bartel, K., Kakoschke, N., & Lang, C. (2018). Sleep interventions designed to improve athletic performance and recovery: a systematic review of current approaches. Sports medicine, 48(3), 683-703.

The important benefits of strength training for endurance runners have been well documented in numerous research publications(1,2,3,4). Resistance training is now considered a critical component to a well planned training program for runners of all levels.   

The key benefits runners can obtain from a strength-training program include: 

• Faster running performance
• Improved running economy 
• Reduced risk of injury

Faster running performances over 3 to 5km distances, and improved running economy (the amount of oxygen required to run at any given pace) are observed in endurance runners who complete a running specific heavy resistance strength training program twice weekly for 6 weeks or more(3,4). If strength training is then removed some loss of performance improvements are likely (3). Therefore staying consistent with strength training right up until a goal event will maximise performance.      

Strength training has also been demonstrated to reduce the risk of sustaining a running related overuse injury by up to 50% (5). Reduced injury risk results from the important adaptations that occur to our body’s tissues (i.e. bones, tendons and muscles), which results in improved tissue strength and resilience against the high loads experienced whilst running.  These adaptations can only be achieved with regular heavy resistance training (1).

There is a belief amongst some health professionals, running coaches and runners that strength training should be high rep, low resistance to mimic the endurance demands of running.  

This is incorrect.  

Improvements in muscular endurance are achieved specifically by running and should not be the goal of a strength training program.  Completing endurance circuit type exercises i.e. 3 sets of 20 reps or more has not been shown to achieve the benefits to running performance and reduced injury risk described above (6).

Runners should consider incorporating twice-weekly strength sessions into their current running routine. If just starting out chose 3-5 exercises that target key the hip, thigh, and calf muscles.  Key exercises to consider include deadlifts, squats, step-ups and calf raises. Complete 3-4 sets of 8-12 slow repetitions, ensuring sufficient resistance so that your muscles are fatiguing by the end of each set. Recovery between sets is important. Take 2-3 minutes.

It’s important to remember that there is no one size fits all approach when it comes to training strength for endurance runners.  Exercise selection, weight, sets and reps all depend on the individuals’ needs, injury history, goals, ability and experience.  A well-planned program shouldn’t negatively impact other running sessions.  If needed seek the assistance of a health professional or strength and conditioning coach who has experience working with runners to ensure you start out safely and get the most out of your strength training program.     

References: 

1. Rønnestad, B. R., & Mujika, I. (2014). Optimizing strength training for running and cycling endurance performance: A review. Scandinavian journal of medicine & science in sports, 24(4), 603-612.
2. Balsalobre-Fernández, C., Santos-Concejero, J., & Grivas, G. V. (2016). Effects of strength training on running economy in highly trained runners: a systematic review with meta-analysis of controlled trials. Journal of strength and conditioning research, 30(8), 2361-2368.
3. Karsten, B., Stevens, L., Colpus, M., Larumbe-Zabala, E., & Naclerio, F. (2016). The effects of sport-specific maximal strength and conditioning training on critical velocity, anaerobic running distance, and 5-km race performance. International journal of sports physiology and performance, 11(1), 80-85.
4. Yamamoto, L. M., Lopez, R. M., Klau, J. F., Casa, D. J., Kraemer, W. J., & Maresh, C. M. (2008). The effects of resistance training on endurance distance running performance among highly trained runners: a systematic review. The Journal of Strength & Conditioning Research, 22(6), 2036-2044.
5. Lauersen, J. B., Bertelsen, D. M., & Andersen, L. B. (2014). The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 48(11), 871-877.
6. Mikkola, J., Vesterinen, V., Taipale, R., Capostagno, B., Häkkinen, K., & Nummela, A. (2011). Effect of resistance training regimens on treadmill running and neuromuscular performance in recreational endurance runners. Journal of sports sciences, 29(13), 1359-1371.

KInetic Sports Physiotherapy welcome Cate Thomas to the team.

Cate holds a Masters of Musculoskeletal Physiotherapy and has recently enrolled in Diploma of Sports Medicine at the University of Melbourne. Cate is an experienced Clinical Pilates instructor. She has over 12 years experience, with extensive expertise in Musculoskeletal, Orthopaedic and Sports injury management.

In addition to her clinical roles, Cate has been involved in clinical research, contributing to the LEAP Study into lateral hip pain through The University of Melbourne.  She has lectured to both undergraduate and postgraduate Physiotherapy students.

She is passionate about injury prevention in children and adolescents, and has an overall interest in the role movement patterns have in injury and pain particularly in the sport.  

Cate has had the opportunity to work not only within Australia, but New Zealand and the UK, where she has furthered her skills and knowledge in both the musculoskeletal and sporting fields.