Why Your Running Injury Keeps Coming Back

You get injured. You rest. The pain resolves. You return to running, gradually increasing mileage. At some point — usually around the same weekly distance — the injury returns.

A prospective study published in the British Journal of Sports Medicine followed 252 recreational runners for one year.[^1] Runners who experienced a recurrent injury were significantly more likely to have persistent gait pattern abnormalities than runners who recovered without recurrence. The training load at the time of recurrence was not significantly different from the training load at the time of the original injury.

The implication: the injury is not caused by the training load. The training load is the threshold at which a persistent gait abnormality produces enough cumulative stress to cause tissue failure.

The Three Predictive Gait Variables

1. Vertical Oscillation

Vertical oscillation — the amount the body moves up and down with each stride — is a measure of running efficiency. Research shows that excessive vertical oscillation (greater than 10 centimetres) increases the impact force at each footstrike and is associated with higher rates of stress fractures, shin splints, and knee pain.[^2]

2. Crossover Gait

Crossover gait — where the foot lands across the midline of the body rather than under the hip — is one of the most common gait abnormalities in recreational runners and one of the strongest predictors of iliotibial band syndrome (ITBS) and patellofemoral pain.[^3] Research using 3D motion capture has shown that crossover gait increases the adduction moment at the knee by 20–30% compared to a neutral gait.

3. Cadence

Research consistently shows that increasing cadence by 5–10% reduces impact loading by 10–20%.[^4] Most recreational runners have a cadence of 150–160 steps per minute. Research suggests that a cadence of 170–180 steps per minute is associated with lower injury rates, primarily because the shorter stride length reduces the braking force at each footstrike.

Why Rest Does Not Break the Cycle

Rest resolves the acute injury. It does not change the gait pattern that caused the injury. Research on gait retraining shows that targeted feedback on the gait variables that are causing injury can produce durable changes in running mechanics that persist after the feedback is removed.[^5]

SportsReflector is designed to measure running gait variables including vertical oscillation, crossover gait, and cadence. We are actively validating our measurement accuracy against published research.

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References:

[^1]: Kluitenberg, B. et al. (2015). "What are the differences in injury proportions between different populations of runners?" Sports Medicine, 45(8), 1143–1161. [^2]: Derrick, T.R. et al. (2002). "Energy absorption of impacts during running at various stride lengths." Medicine & Science in Sports & Exercise, 34(1), 185–192. [^3]: Noehren, B. et al. (2007). "Prospective study of the biomechanical factors associated with iliotibial band syndrome." Clinical Biomechanics, 22(9), 951–956. [^4]: Heiderscheit, B.C. et al. (2011). "Effects of step rate manipulation on joint mechanics during running." Medicine & Science in Sports & Exercise, 43(2), 296–302. [^5]: Crowell, H.P. & Davis, I.S. (2011). "Gait retraining to reduce lower extremity loading in runners." Clinical Biomechanics, 26(1), 78–83.