Detailed guides to painful problems, treatments & more

Can strength training prevent overuse injuries?

 •  • by Paul Ingraham
Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Repetitive strain injuries like plantar fasciitis and iliotibial band syndrome are often seen as a price that active people pay for being weak in some way. Although this has always been a popular view, it’s been given new life since the early 2000s by a lot of hype about hip weakness specifically, which supposedly causes runner’s knee (and maybe other overuse injuries in the lower body). If it’s true, then surely strength training the hips can prevent runner’s knee? Unfortunately, this is just a pet theory that got out of hand, and still isn’t supported by any credible evidence.

A 2014 meta-analysis (Lauersen et al) is the best reference available to support a more general claim that resistance training will prevent overuse injuries. Unfortunately, “the best” is not very good: the authors’ conclusion about injury prevention is based on data from just four studies of questionable/limited relevance …+All the 4 studies are of the lower limb, two of them about hamstrings and eccentric training, both of which have limited applicability to the question of preventing overuse injuries (most injuries of the hamstrings are not overuse injuries, and eccentric training is not typical resistance training). The third was a study of ACL injuries, which are traumatic, not overuse, so that doesn’t contribute to the case for preventing overuse injuries. And the final one was for patellofemoral pain, which does count, but its results are hardly decisive (see Coppack et al). and there is definitely some contrary evidence as well (see Brushøj et al).

Strengthening might prevent some overuse injuries, but that’s an untested hypothesis, and Lauersen et al simply does not provide meaningful support for it—not even remotely.

There are all kinds of other reasons to train your muscles. Use those reasons. You don’t need this one.

End of post marker

Last post: Prescribing opioids is a huge bummer

Next post: Many nuggets of wisdom about back pain