Evidence map›Paper›PMID 40623829›Full record

ArticleBritish journal of sports medicine2025

How much running is too much? Identifying high-risk running sessions in a 5200-person cohort study.

Jesper Schuster Brandt Frandsen, Adam Hulme, Erik Thorlund Parner, Merete Møller, Ida Lindman, Josefin Abrahamson, Nina Sjørup Simonsen, Julie Sandell Jacobsen, Daniel Ramskov, Sebastian Skejø and 3 more

Abstract read
In one paragraph

Article in British journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Jesper Schuster Brandt FrandsenBig Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark.
Adam HulmeSouthern Queensland Rural Health, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia.
Erik Thorlund ParnerDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Merete MøllerDepartment of Sports Science and Clinical Biomechanics, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.ORCID http://orcid.org/0000-0001-7514-0399
Ida LindmanGeneral Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID http://orcid.org/0000-0003-1450-4114
Josefin AbrahamsonOrthopaedic Research Unit, Sahlgrenska University Hospital, Gothenburg, Sweden.ORCID http://orcid.org/0000-0003-3949-0425
Nina Sjørup SimonsenDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Julie Sandell JacobsenDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Daniel RamskovDepartment of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark.
Sebastian SkejøDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Laurent MalisouxDepartment of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg.ORCID http://orcid.org/0000-0002-6601-5630
Michael Lejbach BertelsenDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Rasmus Oestergaard NielsenDepartment of Public Health, Aarhus University, Aarhus, Denmark roen@ph.au.dk.ORCID http://orcid.org/0000-0001-5757-1806

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWe explored whether a spike in running distance during a single session or over 1 week, compared with the preceding period, was associated with increased risk of running-related overuse injury.

methodsAdult runners were recruited for an 18-month cohort study. Three training-related exposures were defined based on a relative change in running distance, using data collected via Garmin devices: (1) session-specific running distance relative to the longest distance run in the past 30 days; (2) 1-week period relative to the preceding 3 weeks using the acute:chronic workload ratio (ACWR); (3) 1-week period using a week-to-week ratio. Runners were categorised into one of four time-varying states: (1) regression, or up to 10% increase (reference); (2) 'small spike' between >10% and 30% increase; (3) 'moderate spike' between >30% and 100% increase; and (4) 'large spike' >100% increase. Outcome was self-reported overuse running-related injury. A multistate Cox regression model was used to estimate adjusted hazard rate ratios (HRR).

resultsAmong 5205 runners (mean age 45.8 years, SD=10.4; 22% female), a total of 1820 (35%) sustained a running-related injury during 588 071 sessions. Significantly increased rates were identified for small spikes (HRR=1.64 (95% CI: 1.31 to 2.05, p=0.01)), moderate spikes (HRR=1.52 (95% CI: 1.16 to 2.00, p<0.01)) and large spikes (HRR=2.28 (95% CI: 1.50 to 3.48, p<0.01)) in single-session running distance. A negative dose-response relationship was observed for the ACWR. No relationship was identified for the week-to-week ratio.

conclusionA significant increase in the rate of running-related overuse injury was found when the distance of a single running session exceeded 10% of the longest run undertaken in the last 30 days.

Indexed as

Athletic InjuriesCumulative Trauma DisordersPhysical Conditioning, HumanRunningAdultCohort StudiesFemaleHumansMaleMiddle AgedProportional Hazards ModelsRisk FactorsTime FactorsAthletic InjuriesRunningSporting injuriesSports medicine

Identifiers

PMID40623829
PMCPMC12421110

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.