The Two Reasons Runners Need Strength Training

Many of our patients come to us for help with for injuries, aches, and pains related to running. We place an initial focus on reducing pain and helping them get back to running as soon as possible. Towards the end-stages of injury rehabilitation, we gradually shift gears and begin to focus on long-term strategies to reduce the risk of future injuries.

While each treatment plan is individualized, perhaps the most universal recommendation we make in the later stages of running injury rehabilitation is to begin a long-term strength and movement training program that complements the patient’s running program. Many runners often find this surprising, as for a long time, conventional wisdom was that endurance and strength training are not compatible, that the gains in one area would offset progress in the other.

However, my goal today is to convince you that this just isn’t true. Runners need to be performing strength training for two big reasons: 1) Improve performance, and 2) Decrease injury risk. 

Both peer-reviewed research and our clinical experience clearly show that a focused strength training routine can improve both endurance performance and injury risk factors. It’s truly a win-win situation.

Running Performance: We’ll start with the exciting stuff. There’s good evidence to show that a focused strength training program can improve endurance performance. I’ll link to three studies, but there are many others:

  • Maximal strength training with a squat program improves running economy and time to exhaustion at maximal aerobic speed. No changes in body weight were associated with this training. (Link) Running economy is a measure of the energy demand to run at a given submaximal speed. So if you improve it, running at the same pace will feel easier. And I think it’s obvious that improving time to exhaustion is a worthwhile goal.

  • Strength training improves time to exhaustion and increases peak blood lactate levels during a treadmill test. (Link) Again, we see time to exhaustion showing up, as well as blood lactate. The link between lactate and endurance performance has been the subject of some debate, but increasing the body’s ability to tolerate lactate is probably helpful. (Read more about blood lactate here).

  • A systematic review of the literature concludes that strength training can improve performance and running economy (Link).

I find the first study exciting for a few reasons. First, it demonstrated improvements with very small programs of just a few exercises. That means that if performed correctly, strength programs for runners can be short and focused.

Second, there were no changes in body weight noted. This addresses perhaps the most common objection I get from runners about strength training: that it’ll make them gain unnecessary mass or get “bulky.” To be blunt, this simply will not happen. Bodybuilders follow very specific high-volume muscle hypertrophy programs, coupled with high calorie diets and often complex supplement regimens, in an attempt to gain mass, and it’s often stiff difficult for them. For a runner following an endurance training program, the addition of a few strength training exercises, at fairly low volume, will not cause a significant change in body weight.

Additionally, the conclusions of the systematic review are exciting because in these large-scale reviews of literature, the conclusion is almost always “More research is needed.” However, this article clearly states in the abstract, “...coaches should not hesitate to implement a well-planned, periodized [concurrent resistance resistance and endurance training] program for their endurance runners.”

Interested in incorporating strength training into your running program, but not sure where to start? Or are you struggling with a running injury? Click the button below to schedule to talk about your issues and questions with a Doctor of Physical Therapy. We'll develop a strategy together to help you reach and exceed your goals.

Reduce Injury Risk: Let’s move on to injuries. The potential for strength training to mitigate running injury risk factors is a major reason why I recommend it to most of my patients.

Running injuries tend to fall into three categories: Tendon, muscle, and bone. Strength training has a positive effect on each of these areas.

Tendon injuries: These are among the most common running injuries (anterior knee pain, Achilles tendon pain). After we control pain, the goal of treatment is to improve the durability of the tendon. The role of a tendon is to transmit the force from a muscle to a bone, and then absorb the load of impact force.

  • Studies show that resistence training can increase tendon stiffness (this is good), and decrease hysteresis (also good). This means that the tendon can better and more efficiently absorb load. (This article is a good primer on what tendon stiffness and hysteresis mean.)

  • Decreased calf muscle strength associated with Achilles tendon injury (link). So, if we can increase strength, we might decrease injury risk.

Muscle injuries: These are usually strains or overuse injuries, often of the calf or hamstrings. Aside from gradually increasing volume, the best way to prevent muscle injuries is to make the muscles more robust and durable. This is the classic role of strength training. There are numerous studies recommending strength training as a component of muscle strain rehabilitation (see this study on hamstring strains), and I think it makes logical sense: A stronger muscle is less vulnerable to injury.

Bone injuries: Perhaps the most troubling running injuries are stress fractures, as they require a long healing time, usually require a total rest from running, and if not treated appropriately, can progress to requiring surgical repair. Every runner should be concerned with reducing stress fracture risk. In addition to gradual training load increases, strength training is crucial here. Here are two relevant studies:

  • Strength training increases bone mineral density of femoral neck - one of the highest-risk stress fracture sites. (link)
  • Muscle weakness is among the risk factors for stress fractures (link)

We could spend years digging into the research on strength training, running performance, and running injuries. Some researchers spend their entire careers focused on these questions. While there are definitely still some questions, I think we have enough information to conclude that strength training is important for runners from both a performance and an injury perspective.

I also believe that combining strength training with a program to improve muscle activation, movement mechanics and movement patterns, and ability of the system absorb force, can even further improve performance and reduce injury risk. (Discussion of research in these areas is a topic for another article, but as a primer, the article above on hamstring strains discusses some components of a comprehensive program.)

To help runners incorporate this type of training, EVOLVE Flagstaff now offers a running-specific strength and movement program, designed and led by a Doctor of Physical Therapy. It addresses all of these elements to help runners reduce injury risk and improve performance. Click here to learn more, or schedule a free 15-minute call to discuss how we can help you meet your running goals.