REF-924 · Toresdahl et al., 2019 · Sports Health, Vol. · Paper · PubMed

A Randomized Study of a Strength Training Program to Prevent Injuries in Runners of the New York City Marathon

A-fairly strong evidenceMeasured on recreational peopleWritten before October 2026, being re-checked

Twelve weeks before the New York City Marathon, first-time marathon runners were randomised to a strength training group or an observation group. The strength group was instructed, by written and video instruction, to perform a 10-minute programme 3 times weekly targeting the quadriceps, hip abductor and core muscle groups. Injuries were self-reported in biweekly surveys.

The incidence of overuse injury resulting in marathon noncompletion was 7.1% with strength training and 7.3% with observation, and finishing times did not differ. The authors conclude that injury is highly prevalent among first-time marathon runners but this self-directed programme did not reduce it.

Participants

n=720 first-time marathon runners age 18 years and older (mean age 35.9 ± 9.4 years; 69.4% female); 583 started the marathon and 579 completed it.

Protocol

Randomised 12 weeks before the race to a strength training group or an observation group.
Strength group: a 10-minute programme 3 times weekly, from written and video instruction, targeting the quadriceps, hip abductor and core muscle groups.
Injuries self-reported through biweekly surveys. Major injury: one that resulted in marathon noncompletion. Minor injury: one that impaired training or race performance.

Key Results

Overuse injury resulting in marathon noncompletion: 7.1% in the strength training group vs 7.3% in the observation group (risk ratio, 0.97; 95% CI, 0.57-1.63; P = 0.90).
Incidence of major injury 8.9%, of minor injury 48.5%, in the whole cohort.
Fifty two of 64 major injuries were overuse, of which 20 were bone stress injuries.
Mean finishing time: 5 hours 1 ± 60 minutes (strength) vs 4 hours 58 ± 55 minutes (observation), P = 0.35.

Practical Application

In 720 first-time New York City Marathon runners randomised 12 weeks before the race to a self-directed 10-minute strength programme 3 times weekly or to observation, overuse injury that stopped the runner from completing the marathon was equally common (7.1% vs 7.3%, risk ratio 0.97, 95% CI 0.57-1.63), and finishing times did not differ. To "will a short home strength routine keep me uninjured through my first marathon build?": this one did not.
The baseline risk is the message for a first-timer: 8.9% had an injury that kept them from completing the race, 48.5% had one that impaired training or racing, and 20 of the 64 major injuries were bone stress injuries.
Inference, not tested here: the result is about a light, unsupervised programme whose adherence the abstract does not report; it does not show that strength training in general fails to prevent running injuries.
Not from this paper; the base's own practice: the general-sport evidence that strength programmes reduce injuries is in REF-861, the runner's strength default in SYNTH-44; neither is a trial in first-time marathoners.

Limitations

Self-directed programme; adherence is not reported in the abstract.
Injuries were self-reported by survey, not clinically confirmed.
583 of the 720 enrolled runners started the marathon.
The primary outcome (noncompletion due to overuse injury) is infrequent, so the confidence interval is wide.
One race, one cohort, mostly women (69.4% female).
Written from the abstract and record metadata only (full text not read).
How this entry was checked and changed
Why this level

large parallel RCT (n=720), but pre-registration is not stated in the abstract, injuries were self-reported, adherence is not reported there, and 583 of the 720 started the race