Prior Injury: The Greatest Risk Factor for Future Injury in Runners

As runners, we know that injuries are almost inevitable at some point in our training. Whether it’s a sprained ankle, runner’s knee, or a strained hamstring, these injuries can leave us sidelined for weeks, even months. The good news is that many runners recover and return to the sport they love. However, there’s an important factor that often goes unnoticed: a previous injury. 

While we may focus on new injuries, the reality is that prior injuries are one of the greatest risk factors for future injuries in runners. In fact, once you’ve been injured, your likelihood of suffering a similar or different injury increases significantly. Let’s dive into why this is the case, and how understanding this risk can help you avoid future setbacks.

The Connection Between Past and Future Injuries

Runners are often told to “listen to their bodies,” but it’s not always easy to identify the subtle signs of potential injury. When you’ve been injured in the past, your body doesn’t always fully return to its pre-injury state, even after you’ve healed. Here’s why prior injuries put you at a higher risk for re-injury:

1. Altered Movement Patterns

In response to an injury, your body compensates by changing how you move. For example, if you’ve had a knee injury, you may have subconsciously shifted your gait to avoid pain, which can put additional stress on other parts of your body, like your hips or lower back. Over time, these compensations can lead to imbalances that make you more susceptible to further injury.

2. Muscle Weakness and Imbalance

After an injury, certain muscles may weaken or stop firing correctly due to pain or disuse. For example, a sprained ankle may cause your lower leg muscles to become weaker or less coordinated. This muscular dysfunction can affect your entire kinetic chain, making you more vulnerable to compensatory injuries in other areas. Even after rehabilitation, weak muscles are often more prone to strain or overuse, especially when running.

3. Scar Tissue and Soft Tissue Changes

Once an injury heals, scar tissue can form at the site of the damage. While scar tissue serves an important purpose, it’s not as flexible or strong as healthy tissue. This can restrict movement and create tightness, affecting the efficiency of your stride. Over time, this limitation can lead to strain and injury in the surrounding tissues, especially when subjected to repetitive motion like running.

4. Psychological Factors

Fear of re-injury is a very real issue for many runners returning from an injury. This fear can lead to altered running mechanics, increased tension in the muscles, or even hesitation in pushing yourself as you did before the injury. This guarded approach can create a cycle of hesitation, weak performance, and ultimately, further injury. 

5. Chronic Inflammation and Joint Dysfunction

Sometimes, runners push through pain or continue running too soon after an injury, which can lead to chronic inflammation. Even when pain subsides, the underlying joint dysfunction or tissue damage may persist. Chronic inflammation can compromise the stability of joints and tissues, increasing the likelihood of re-injury. For example, a runner who has suffered from IT band syndrome or achilles tendinitis may develop lingering tissue tightness, making them more vulnerable to a flare-up of the same issue or something else entirely.

How to Break the Cycle: Prevention and Recovery Strategies

The good news is that prior injuries don't have to spell doom for your running future. While they do increase the risk of future injuries, there are steps you can take to minimize that risk and maximize your chances of staying injury-free.

1. Full Rehabilitation and Recovery

When you suffer an injury, it’s critical to go through the entire rehabilitation process. This means not just resting and then returning to running, but actively working on strengthening the muscles, improving range of motion, and restoring functional movement patterns. A physical therapist can guide you through a tailored rehab program that addresses your specific injury, any weaknesses, and other factors contributing to the risk of re-injury.

2. Addressing Imbalances and Weaknesses

Injury recovery is an opportunity to evaluate your body’s weaknesses and imbalances. A thorough evaluation by a physical therapist can help identify muscle imbalances, areas of tightness, and dysfunctional movement patterns. From there, you can work on corrective exercises to strengthen weak muscles and improve alignment, reducing the risk of another injury. Targeted strength training, especially for your core and legs, is crucial for any runner.

3. Gradual Return to Running

If you have stopped running (check out our blog post on how this isn’t usually the answer), then returning to running too quickly can often lead to a re-injury. A slow and gradual return-to-running program that builds strength and endurance progressively can help you regain your fitness while minimizing stress on your recovering tissues. This process is best done under the guidance of a physical therapist or coach who understands the demands of running and injury prevention.

4. Cross-Training

Engage in cross-training activities like strength training, swimming, cycling, etc to maintain your fitness without overloading the injured area. Cross-training also helps maintain overall muscle balance and prevents overuse injuries from the repetitive nature of running.

5. Proper Footwear and Running Form

Sometimes a previous injury can be related to improper footwear or running mechanics. A physical therapist or running specialist can help assess your form. There are running shoes stores that can analyze your foot and gait and recommend a shoe that better supports your body’s needs. Custom orthotics may be helpful in the short term to relieve stress to injured tissues.

6. Regular Maintenance and Stretching

Incorporating regular maintenance practices like foam rolling, dynamic stretching, and mobility exercises can keep your muscles and joints flexible, reducing the chances of tightness leading to an injury. Consistent flexibility work is essential for runners, as it can keep you limber and ensure that your muscles move through their full range of motion.

Conclusion: Prevention Is Key

While you can’t completely eliminate the risk of injury as a runner, being aware of the impact that prior injuries can have on future ones is essential. By addressing muscle imbalances, improving your running mechanics, and allowing adequate time for recovery, you can break the cycle of recurring injuries. The key is a holistic approach to injury prevention that goes beyond simply recovering from an injury, but also actively strengthening and correcting potential weaknesses.

We understand how important it is to get runners back to their best, but more importantly, to help them stay healthy and injury-free. If you’ve dealt with a running injury in the past or are currently recovering from one, don’t wait for the next setback to occur—take proactive steps today to ensure a strong, injury-resistant future in running.