Athletic therapist Reed Ferber, Ph.D., has a nickname for injury-free runners: “golden unicorns.” Yes, they are that elusive. In fact, Ferber, who is professor of kinesiology and director of The University of Calgary’s Running Injury Clinic, says that as many as 80 percent of runners develop running-related complaints each year. His job, of course, is to fix those aches and pains. But his ultimate goal—and the focus of his current research—is to identify the biomechanical and lifestyle habits of the so-called golden unicorns. By doing so, Ferber hopes to create a blueprint of a healthy runner for others to follow.
His work adds to that of other researchers aiming to better understand the cause of overuse injuries. Some influences lie beyond your control, such as the way your body is built. But in other cases, there are identifiable risk factors that can be addressed, potentially warding off injuries.
So we asked Ferber and other experts—physicians, biomechanics researchers, and physical therapists—to identify common weaknesses in runners’ bodies, training programs, and lifestyles. We compiled these factors into an injury-risk scorecard to help you gauge your likelihood of getting hurt. Next to each risk factor, you’ll find strategies from our panel of experts to mitigate the danger. Combine the specific recommendations that apply to you, and you’ll have a targeted injury-prevention program.Put that advice into practice to take a big step toward becoming a golden unicorn.
To get your injury risk score, scroll through the 15 questions below and respond to each by clicking on your selected answer. Your score will be calculated automatically when you have finished.
1. Have you started (or resumed) running in the past six months?
Yes, 1 point · No, 0 points
Why it matters: Novice runners face about double the injury risk of more experienced runners. “Injuries start when distances increase,” says Colleen Brough, D.P.T., O.C.S., physical therapist at Columbia University.
Reduce the risk: Make changes gradually. The slower you proceed with an alteration to your training, the more time your body has to adapt without strain. A rule of thumb: Increase your weekly mileage total by no more than the number of days you run per week—so five miles if you run five days.
2. Do you run more than 30 miles a week?
Yes, 1 point · No, 0 points
Why it matters: The more you run, the greater the stress on your bones and joints—plus, you amplify all your other risk factors. While some people log more miles without incident, research shows an increase in injury rate once weekly totals surpass 30 miles.
Reduce the risk: If you’re healthy, you may be able to handle higher mileage. But if you’re injury-prone with several other risk factors here, consider being conservative with your mileage and supplementing with cross-training.
3. How many days a week do you run?
7 days, 1 point · 1-2 days, 1 point · 3-6 days, 0 points
Why it matters: Failing to take rest days doesn’t let your body recover, increasing the ODDS that a small tweak progresses into an injury, says Jeff Gaudette, head coach at RunnersConnect in Boston. On the flip side, if you only run once or twice a week, your body never adapts to the training to become more efficient and injury resistant.
Reduce the risk: Train consistently. Using a log to track how often and how far and fast you run—and how you feel—can offer insights into your injury risk. “It helps you see a pattern—‘I felt good when I did this, not when I did that,’” says Kevin Vincent, M.D., Ph.D., director of the University of Florida Running Medicine Clinic. Review it to check for too many hard days, too few rest days, or lack of consistency. Nip injuries by cutting back when you note a few days of aches.
4. Do you strength-train at least twice a week?
Yes, 0 points · No, 1 point
Why it matters: In a research review, strength-training reduced the risk of overuse injuries by about half. A strengthening program helps you maintain good form even when fatigued, and builds strong muscles that absorb impact from running, says running coach and personal trainer Jeff Horowitz, author of Quick Strength for Runners.
Reduce the risk: Strength-train.
5. How many marathons do you race a year?
3 or more, 1 point · 2 or less, 0 points
Why it matters: “Races are absolutely the hardest efforts that we put our bodies through, and marathons are especially demanding,” Gaudette says.
Reduce the risk: Know your limits. While some runners can race long distances more often, those whose main goal is reducing injury would be best off limiting the number of hard, long races done in a year.
6. Have you reduced mileage or received treatment for an injury in the past year?
Yes, 1 point · No, 0 points
Why it matters: Many runners fail to address underlying causes of injury, making relapse likely. Even after you’re better, “every injury leaves crumbs,” Brough says. Leftover dysfunctions can increase your chance of developing a different injury.
Reduce the risk: Strength-train. Seek medical advice if you’ve had multiple injuries over the past three years.
7. Do you overstride?
Your foot falls far in front of the line, 1 point · Your foot falls nearly in line, 0 points
Why it matters: If your foot hits the ground far from your center of gravity, greater impact forces travel up through your leg, increasing your risk of stress fractures, plantar fasciitis, patello-femoral syndrome, and Achilles tendinopathy, Brough says.
Reduce the risk: Runners who overstride often have a slow cadence—less than 160 steps per minute. According to recent studies, increasing your step count by about 10 percent reduces the impact on your hips, knees, and ankles, likely reducing injury risk. Multiply your starting cadence by .1, then add it to the original count for your new target. For example, say you started out at 160 steps per minute—10 percent of that is 16. So you should aim to move your feet more quickly until you’re taking 176 steps per minute.
8. Are your hips weak?
Your pelvis slants down, 1 point · Your knee drifts in, 1 point · Perfect form, 0 points
Why it matters: Weakness or a faulty firing pattern leads your hip to dip and your knees to shift inward. This poor alignment could cause runner’s knee or IT-band syndrome. Other muscles, such as your hip flexors and hamstrings, compensate for the weaknesses, increasing your risk of strains in these areas.
Reduce the risk: Strength-train two or three times a week.
9. Have you recently gone through a major negative life event? Are you in the midst of a trying period at work or home?
Yes, 1 point · No, 0 points
Why it matters: Stress increases tension in your muscles and hampers coordination. This puts you at greater risk for an acute injury and also impairs recovery.
Reduce the risk: Reserve ambitious running goals for a period when you are experiencing less turmoil. Keep your running easy and low-key so it relieves stress.
10. Do you sleep fewer than seven hours a night?
Yes, 1 point · No, 0 points
Why it matters: Sleep-deprived runners fall short on human growth hormone, a compound needed to repair muscles and bones, says neurologist W. Christopher Winter, M.D.
Reduce the risk: Aim for at least seven hours of sleep per night. Work back from the time you need to get up to calculate your bedtime. Power down electronics an hour before you hit the sack.
11. Have you started running in a new make or model of shoe recently?
Yes, 1 point · No, 0 points
Why it matters: A sudden change in shoes can alter your gait, boosting your ODDS of injury.
Reduce the risk: Don’t go from one extreme to another (stability shoe to a cushioned shoe). Choose a transitional shoe that moves you toward the shoe you ultimately wish to be in, says RW Shoe Editor Jonathan Beverly. “Run in new shoes on an easy day, then return to the old pair. Keep rotating, adding more days per week in the new pair.”
12. Do you have lofty time goals—and are you inflexible about adjusting them?
Yes, 1 point · No, 0 points
Why it matters: Locking in on a big goal could cause you to train too intensely and to ignore red flags.
Reduce the risk: Gaudette advises runners with big goals to focus less on the outcome and more on the process, or the steps needed to improve running performance every day.
13. Are you a woman?
Yes, 1 point · No, 0 points
Why it matters: In part because of differences in body shape and type, women may face more injuries, Brough says. Plus, they’re prone to unique risk factors.
Reduce the risk: Strength-training helps keep bones strong to protect against osteoporosis and fractures as well as correct common muscle imbalances.
14. Have you gone six months without a period?
Yes, 1 point · No, 0 points
Why it matters: Training too hard, especially without eating properly, causes hormonal shifts that can stop your periods, weaken your bones, and impair your recovery.
Reduce the risk: Talk to your doctor, who may recommend nutrition therapy or counseling.
15. Do you leak urine when you run?
Yes, 1 point · No, 0 points
Why it matters: It’s a sign of pelvic floor dysfunction—weakness in the deep muscles of the abdomen, says Kara Vormittag, M.D., a sports-medicine specialist in Park Ridge, Illinois.
Reduce the risk: Seek medical advice. Specialized physical therapy can resolve this.
To get your score, answer all of the questions above.
