Injury Onset Timeline: What to Know

Cat Fitzgerald PT, DPT, CSCS

“__________ just started hurting! It doesn’t make any sense, I didn’t go up in mileage this week or have any harder than usual workouts!”

Does that sound familiar? It certainly does to me! This is what we hear a lot of at first sessions – the timeline of injury and running volume increases seems like it doesn’t line up. This is because runners are generally looking for immediate cause and effect. If I ran my highest mileage week this week, surely the injury would pop up during that time? Or during my hardest workout of the training cycle?

But this is not how injuries behave!

Generally, the injuries will show up after 3-4 weeks of increased running volume. Running volume includes mileage, frequency of runs, and intensity.

This is why we’ll see an influx of runners coming into Custom Performance during certain periods of training cycles. There’s one group that shows up about 4-8 weeks after starting training. So for the NYC marathon, that’s typically in August and early September. The injury pops up, and then the runner typically has a period of resting and trying to run, sometimes through a few cycles before getting the injury looked at. This group typically had a jump in what they’re doing before training and when training “officially” started.

The second is the group that comes in during the last 6 weeks of training – this is the one where higher mileage and harder workouts are pushing them over the edge into injury territory.

The key to remember is that these injuries will show up in that 3-4 week window after the increase in running volume.

Because of this, I highly recommend getting ahead of things! May, June and July are good months to be proactive and figure out how to progress in a smart way and what you’re missing. (Ahem, strength training, anyone?) This is one of my favorite things when someone comes in with this goal and timeframe! We get to be proactive and focus on injury prevention and performance goals.

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