Strength Training for Runners Part 1: A Detailed Look at the Evidence

Strength training has long been overlooked as a key part of a runner’s training. As the evidence base for the value of strength (resistance) training grows, here we examine comprehensively some key studies and their findings. We dive into the implications this has not only on performance but prevention and rehabilitation from injury.

You will seldom come across a rehabilitation program that doesn’t include strength training. Despite common beliefs this isn’t just because us Physios’ like giving out exercises and homework. It is to minimise imbalances and weaknesses, to improve the body’s capacity to endure whatever training and competitive loads we throw at it, enabling us to perform harder, better, faster longer before we find a weak link and something is overloaded. To avoid injury we really have two options we keep ‘safe’ moderate training loads or gradually increase capacity. We can do this in two ways by slowly increasing volume and adapting; and/or by using resistance training.

The Evidence for Running Economy and Performance

Numerous studies have looked at the addition strength training has on running performance, maximal strength, power, running economy and time to exhaustion. One study added 4 sets of 4 repetition maximum (4 reps of the heaviest weight they could manage safely) squats 3x a week for 8 weeks to subjects normal training. The intervention manifested significant improvements in 1RM (33.2%), rate of force development or power (26.0%), running economy (5.0%), and time to exhaustion at maximal aerobic speed (21.3%). The control group completed the same running without any changes in test parameters. Therefore the authors concluded that maximal strength training for 8 weeks improved running economy (RE) and increased time to exhaustion among well trained, long-distance runners, without change in maximal oxygen uptake or body weight (1).

These results have been repeated numerous times in different experiments. One study compared the effects of 8 weeks of either; heavy resistance, explosive resistance,or muscle endurance training on neuromuscular, endurance, and high-intensity running performance in recreational endurance runners. All three modes of strength training used concurrently with endurance training were effective in improving treadmill running endurance performance. However, both heavy and explosive strength training were beneficial in improving neuromuscular characteristics, and heavy resistance training in particular contributed to improvements in high-intensity running characteristics (2).

It is not just running efficiency that increases as a result of resistance training. A study in 2017 (3) looked at long term (40 weeks) strength training on strength (maximal and reactive strength), speed at VO₂max, economy, and body composition (body mass, fat, and lean mass) in competitive distance runners.  The intervention group showed significant improvements in maximal and reactive strength qualities, RE, and speed at VO₂max. The control group showed no significant changes at either time point. There were no significant changes in body composition variables between or within groups, and no changes in this between time points. This highlighted that through strength training runners improved efficiency, speed and strength without ‘bulking up’ or putting on additional muscle.

Perhaps the most comprehensive study of all things strength training for runners comes from a recent 2017 systematic review.  The research reviewed suggests that supplementing the training of a distance runner with strength training is likely to provide improvements to RE, time trial performance and anaerobic parameters such as maximal sprint speed. Additionally it was clear that the inclusion of strength training does not adversely affect VO2max or blood lactate markers. The addition of two to three supervised ST sessions per week is likely to provide a sufficient stimulus to augment parameters within a 6- to 14-week period, and benefits are likely to be larger for interventions of a longer duration (4).

Strength Training for Reducing Injury Risk

Having strong and stable hips are a staple for efficient and injury free running. Other than drills and running which use these muscle this can be greatly improved through targeted strength training. The effect of a deficit in hip stability and strength is a collapsing of the thigh (femur) in towards the midline of the body. This is termed hip adduction. Hip adduction in the frontal plane had been shown to be contributory for a combination of lower limb running injuries including: patello-femoral knee pain, tibial stress fractures, and also ITB syndrome. If we look at the research individuals with patellofemoral pain demonstrated 26% less hip abduction strength and 36% less hip external rotation strength than their matched controls (5).

Hip adduction is often also coupled with increased femoral internal rotation forming what is known as a dynamic valgus. This creates an increase in stress on the knee joint and can be a factor involved in patellofemoral pain, ITBP and ankle and shin pain (due to increased load on the supporting structures of the foot).  A 2016 systematic review of the literature looked at the role of the hip abductors (muscles on side of hip) in the development of lower limb running injuries including ITB friction syndrome, patello-femoral pain, medial tibial stress syndrome, tibial stress fractures, and  (6). The papers included in the review compared hip abductor strength scores for injured and non-injured runners.

Hip abductor weakness was found to be a significant factor in the development of ITB friction syndrome. While the literature wasn’t conclusive on the association of hip abduction strength on the other injuries, clinically it used in the rehabilitation of patellofemoral pain (alongside gluteus maximus and quadriceps strength).

Putting It All Together

With all available evidence regarding the benefits of strength training, it is best illustrated in a 2017 systematic review. It evaluated the effect of concurrent training on RE in endurance running athletes and identified the effects of subject characteristics and concurrent training variables on the magnitude of RE improvement. Explosive training and heavy weight training are effective concurrent training methods aiming to improve RE within a few weeks. However, long-term training programs seem to be necessary when the largest possible improvement in RE is desired (7). This has been similarly reported in a 2016 systematic review which found a strength training program including low to high intensity resistance exercises and plyometric exercises performed 2–3 times per week for 8–12 weeks is an appropriate strategy to improve RE in highly trained middle- and long-distance runners (8).

Finally a systematic review on the effectiveness of exercise interventions to prevent sports injuries: found that strength training reduced sports injuries to less than 1/3 and overuse injuries could be almost halved (9). For a sport in which there is a very high percentage of overuse injuries this injury risk reduction is extremely valuable. Despite all these benefits of strength training there are many runners and coaches who don’t include strength training for runners. Stay tuned for the next blog on unpacking (and overcoming) the barriers against strength training, so you can enjoy the benefits of strong, efficient, injury minimised running.

Lewis Craig (APAM)
POGO Physiotherapist
Masters of Physiotherapy

Featured in the Top 50 Physical Therapy Blog

References:

• STØREN, Ø., Helgerud, J. A. N., Støa, E. M., & Hoff, J. A. N. (2008). Maximal strength training improves running economy in distance runners. Medicine & Science in Sports & Exercise, 40(6), 1087-1092.
• Mikkola, J., Vesterinen, V., Taipale, R., Capostagno, B., Häkkinen, K., & Nummela, A. (2011). Effect of resistance training regimens on treadmill running and neuromuscular performance in recreational endurance runners. Journal of Sports Sciences, 29(13), 1359-1371.
• Beattie, K, Carson, BP, Lyons, M, Rossiter, A, and Kenny, IC (2017). The effect of strength training on performance indicators in distance runners. J Strength Cond Res 31(1): 9–23.
• Blagrove, R.C., Howatson, G. & Hayes, P.R. (2017). Effects of Strength Training on the Physiological Determinants of Middle- and Long-Distance Running Performance: A Systematic Review. Sports Med. https://doi.org/10.1007/s40279-017-0835-7
• Davis, I et al (2003). Hip strength in females with and without patellofemoral pain. Journal of Orthopaedic & Sports Physical Therapy, 2003 Volume:33 Issue:11 Pages:671–676 DOI:10.2519/jospt.2003.33.11.671
• Mucha, M. D., Caldwell, W., Schlueter, E. L., Walters, C., & Hassen, A. (2016). Hip abductor strength and lower extremity running related injury in distance runners: A systematic review. Journal of science and medicine in sport.
• Denadai, B. S., de Aguiar, R. A., de Lima, L. C. R., Greco, C. C., & Caputo, F. (2017). Explosive training and heavy weight training are effective for improving running economy in endurance athletes: A systematic review and meta-analysis. Sports Medicine, 47(3), 545-554.
• Balsalobre-Fernández, C, Santos-Concejero, J, and Grivas, GV. Effects of strength training on running economy in highly trained runners: a systematic review with meta-analysis of controlled trials. J Strength Cond Res 30(8): 2361–2368, 2016
• Lauersen, J. B., Bertelsen, D. M., & Andersen, L. B. (2014). The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med, 48(11), 871-877.

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