Foot core training to prevent running-related injuries. A survival analysis of a single-blind, randomized controlled trial

Review written by Dr Melinda Smith info

Key Points

  1. Running-related injury risk was reduced in recreational runners who performed a foot strengthening protocol, compared to runners who did a placebo static stretching protocol.
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Running is a popular recreational activity with recognised health benefits (1). However, running-related injuries are common and cause interruption or abandonment of physical activity. With incidence of running-related injuries reported to be as high as 79% (2), establishing effective injury prevention is a priority.

During running the foot plays an integral role in the absorption and transmission of body forces to the ground, and vice-versa. The intrinsic muscles of the foot are important contributors to foot function, assisting the dampening of impact forces and stiffening the forefoot for propulsion (3,4). Additionally, the intrinsic muscles provide the ability to actively modulate foot function to respond to varying demands (acceleration/deceleration, incline/decline) (5). Training these muscles may improve foot function and assist injury prevention in runners.

The aim of this randomized controlled trial was to investigate the efficacy of a foot muscle strengthening protocol in reducing the incidence of running-related injuries in recreational runners over the course of a 1-year follow-up.

Incidence of running-related injuries has been reported to be as high as 79%.
The idea that a stronger foot should better dissipate cumulative loads appears somewhat supported as foot strength gains were correlated with time to injury.


118 participants (aged 18-55 years) who ran between 20 and 100km per week, for one year or more, were recruited for the trial. Key exclusion criteria were: a running-related injury in the previous 2 months, experience running barefoot or in

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