Injury prevention in endurance athletes

As athletes, it's fair to say that we generally don't deal with injuries very well. Injuries hinder our performance improvements and can cause us to withdraw from key races. We define an injury as any musculoskeletal problem that causes an athlete to stop training for at least one day, reduce mileage, seek treatment or medical aid.  In long distance triathletes, injuries are frightfully common with studies reporting that 87% of triathletes sustain a form of injury in the lead up to a race. Of these injuries, 78% caused the athlete to take time off training and 64% prevent the athlete from competing in their next race.

The majority of injuries in triathletes are overuse injuries, which are caused by repetitive movements. In long distance triathlons, we can think of these repetitive movements as the arms completing the same stroke pattern thousands of times during the swim and the legs going through thousands of pedal revolutions and strides during the bike and run. Our bodies may get away with abnormal and/or excessive loads and movements after a few repetitions, but over time the body may struggle to tolerate these repetitive loads and it begins to breakdown, resulting in injury. Injuries occur when we overload the body from training and it is simply not strong enough to handle the load. In long distance triathletes, the most prevalent sites of overuse injuries are the knees (25%), lower leg (23%) and lower back (23%). 

I always like to use the simple analogy of a bridge when it comes to injuries. If a bridge is overloaded with cars, eventually it will break if it isn't strong enough. The solution is either to reduce the number of cars or build a stronger bridge to handle a larger number of cars. Think of our bodies as the bridge and the cars as the training load. It's also important that we are biomechanically sound.  This includes having an appropriate swim stroke for you, a suitable bike fit, as well as running shoes that are best suited to your gait.

To enable our bodies to handle a larger load, strength training is a great addition to a training programme. A study examining over 26,000 athletes who trialed varying injury prevention programmes (such as strength training, stretching and proprioception training) found that strength training reduced overuse sports injury occurrence by half.  Strength training can include light weights, heavy weights, plyometrics or control exercises. Interestingly, stretching showed no correlation with injury prevention.

There is a lot of information out there regarding injury management protocols which can sometimes be confusing. When creating a strength training programme to prevent and manage injuries, it's important to design a specific programme to suit your individual needs, taking into account your injury history, strengths and weaknesses. If you are unsure how to structure and integrate a strength training programme to your routine, we always recommend the assistance of a qualified physiotherapist or strength and conditioning coach.

Over time through our social media pages, we will illustrate some of the exercises which we commonly incorporate into our programmes for injury prevention. To book your one on one strength & conditioning assessment, please click here.

Kate Luckin



Andersen, C. A., Clarsen, B., Johansen, T. V., & Engebretsen, L. (2013). High prevalence of overuse injury among iron-distance triathletes. Br J Sports Med, 47(13), 857-861. doi:10.1136/bjsports-2013-092397

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. doi:10.1136/bjsports-2013-092538

Vleck, V. E., Bentley, D. J., Millet, G. P., & Cochrane, T. (2010). Triathlon event distance specialization: training and injury effects. J Strength Cond Res, 24(1), 30-36. doi:10.1519/JSC.0b013e3181bd4cc8