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Running Injuries and Nutrition

I treat a number of running athletes ranging from recreational runners to competitive tri-athletes/marathoners. Often I am treating them for repetitive strain injuries.  Many of these runners are female.  I can often explain their injuries due to poor running mechanics, muscular imbalances, previous injuries, volume of training etc.  Often I can successfully treat them using Active Release Techniques, acupuncture, manipulation and appropriate stretches or corrective exercises but sometimes they just keep getting injured throughout their training season.  What is causing this?


When reviewing the research on running injuries I stumbled upon this research paper, Fat Intake and Injury in Female Runners, which may be one reason for injuries in female runners who run greater than 20 miles/week.  Here are the highlights of what I learned from reading this research paper:

  • Energy availability between 20–30 kcal/kgFFM/d has been found to impair bone formation due to a sharp decline in the osteocalcin. This increases the chance of stress fractures.
  • 2 previous studies have found an association between fat intake and stress fractures.
  • A study that followed elite adolescent runners for a period of 3 years found that mean energy intake and fat intake decreased over the follow-up period while stress fracture incidence increased.
  • In the study they found that the foot/ankle the most common site (40 % of injuries), followed by the knee (19 %) and the hip (16 %). 
  • Stress fractures/stress reactions, iliotibial band problems, and tendonitis were the most common injuries.
  • Injured runners consume significantly (p < .05) less total fat and obtain a lower percentage of total calories from fat than non-injured runners and consumed significantly lower amounts of the fat soluble vitamins A and K
  • Daily fat intake in grams was the single best dietary predictor of injury 
  • Using daily fat intake they were successfully able to classify 64% of the subjects as subsequently injured (1) or not injured.
  • The odds ratios revealed that runners consuming less than the commonly recommended 30% of total calories from fat were 2.5 times as likely to sustain an injury compared with runners consuming 30% or more.
  • Another intriguing explanation for the correlation between fat and injury involves polyunsaturated fatty acids (PUFA), which are know to play a role in inflammation.  Deficient intake of n-3 PUFA could contribute to an enhanced inflammatory response and increase injury severity (injured runners did consume significantly less PUFA in this study

This is a very enlightening research study. It may explain why I see many of my clients having re-occurring injuries.   So if you are a female runner, and you get injured often, one possible ways of preventing injury is to analyze your diet. Are you getting enough healthy fats in your diet? Are you getting around 30% of your calories from fat?  

I had a curious thought about this research, “Could a woman who is attempting to lose weight be increasing her chance of injury, especially if she is reducing her fat intake?”
I hope you found this interesting

Originally posted on May 17, 2022 @ 4:40 pm