Injury Prevention in Trail-running

Injury prevention may well be a misnomer, injury risk reduction is probably a more apt name. None the less, there is an action that can be taken to limit injury risk in both runners in general and trail runners specifically. This is particularly important due to the relatively high injury rate of running as a sport and the association of injury-free time and success in the medium and long term.

Strength work

A growing body of evidence suggests strength training is helpful to both performance and injury prevention. Gone are the days of concerns regarding bulking up for runners preventing them from doing strength work. For more information on the detail of strength training, see this article “Strength Training for Trail running”. Focusing any program around specific areas of need or weaknesses is important, this is no different for strength training. 

Track your training load

In the article “Fitting Trail running into a Fitness Program”, the means for tracking your training load in trail running is discussed. The crucial component of this is about the rate of change of load rather than the load itself. In this regard, there is a growing body of research focusing on “acute to chronic workload ratio” (ACWR). ACWR is the ratio of the previous week’s workload to the previous 4-week average workload.

There is no magic number but there seems to be a reduced risk of injury in the realm of an ACWR of 0.8-1.3. That said, an ACWR outside of this is an increased risk only and should be modulated by how the athlete is feeling. Despite significant advances in science, subjective feelings of wellbeing, fatigue, and soreness seem to indicate the state of the athlete better than anything that can be measured objectively.

 The take away from this is probably more about avoiding huge peaks and troughs in loading than any magic numbers.


As previously discussed, elevation needs to be considered in tracking training. This is because it can modify load for a given distance significantly! So do not ignore it in planning or tracking of loading.

The Major Stuff aka the Basics

Despite the lack of appeal of doing the basic things, these are considered basic because they should be done as the first step and comprise the bulk of what is needed for benefits associated with the goal in question. So, ensuring your loading is appropriate and consistent, as covered above, needs to be paired with the basics of recovery.

These basics include; sleep and nutrition. Having a good sleep routine, including optimal sleep hygiene is crucial to recovery. In addition to this, in periods of higher stress (of any source, including training), napping can be very helpful in recovery.

Nutrition is quite varied in terms of the composition of diets, but consistencies exist. Good quality, unprocessed food is crucial. Eating enough of this and avoiding other foods is crucial to being able to adapt to training. More specifically ensuring protein intake is adequate to facilitate recovery from training is particularly important. In the ideal world, this would be relatively close to the cessation of training unless specifically avoiding this for training stimulus is the goal.

It would be remiss not to mention hydration when discussing nutrition. Ultimately, adequate hydration should be maintained. Deprivation of fluid in longer and hotter training runs can be very stressful to the body (and dangerous) so it should be considered in terms of loading and avoided if the goal is to allow optimal recovery.

Injury risk reduction is a product of appropriate stress being applied to the athlete, this includes strength and should be relatively consistent rather than have large fluctuations. In addition to this, optimization of recovery from this stress should be the goal, ensuring adequate nutrition, hydration and sleep are a priority.

Written by: Dr. David Lipman, Podiatrist and Exercise Physiologist

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