Strength training is one of the few injury-prevention measures with a large body of randomised evidence behind it. It is also one where the evidence for runners specifically is thinner than the evidence for athletes in general — and most articles on the subject quietly borrow the second to talk about the first. Here is what each actually shows.
Across sports: the evidence is strong
A 2014 systematic review and meta-analysis pooled 25 randomised trials of exercise-based injury prevention, covering 26,610 people. Strength training reduced sports injuries to less than a third, and overuse injuries by roughly half. Stretching, notably, showed no protective effect.1 A 2018 follow-up by the same group found the effect was dose-dependent: more strength training, fewer injuries.2
Those are large, well-conducted reviews. They are also reviews of athletes across many sports — team sports, military recruits, adolescents — not reviews of runners.
In runners: the evidence is weaker, and it is worth knowing why
A 2024 systematic review and meta-analysis in Sports Medicine asked the runner-specific question directly: do exercise-based prevention programmes reduce injury in endurance runners? Pooling the available trials, the overall answer was not significant — no clear difference in injury risk or injury rate between runners who did the programmes and runners who didn't.3
A post-hoc analysis found something more useful: the trials where the programme was supervised looked better than the trials where runners were handed a routine and left to it. That fits with what anyone who has tried to keep up a strength routine on their own already knows. The exercise probably works. The problem is doing it.
So when you read that strength training "cuts running injuries by 50%", the 50% is borrowed from the all-sports data. The runner-specific data says: it may, if you actually do it, consistently, and ideally with someone checking your form.
Where the runner-specific evidence is strong: running economy
Here the picture flips. For performance rather than injury, the evidence in runners specifically is about as good as it gets in this field.
A 2008 systematic review of resistance training in highly trained distance runners found running economy improved by 3–8.1% across five studies, an average of 4.6%, with 3 km and 5 km performance improving by around 2.9%.5 A 2016 meta-analysis of controlled trials in highly trained runners found a large effect on running economy — five studies, 93 runners, programmes of two to three sessions a week for eight to twelve weeks.6 Later work has refined the dose: heavy resistance training outperformed plyometrics in a 2022 meta-analysis, and a 2024 meta-analysis found the effect held across running speeds and grew with more sessions.7,8
Running economy is how much oxygen you use at a given pace. Improving it by 4–5% without adding a single mile is a large return. If you want one evidence-based reason to lift, this is it — and it is a performance reason, not a protection one.
One caveat the 2008 review raised itself: several of the underlying studies used untrained subjects, who improve at almost anything. In well-trained runners the gains are likely smaller than the headline range.
Hips and runner's knee
One relationship that does hold up in runners: people with patellofemoral pain — the diffuse pain around and behind the kneecap that runners call runner's knee — tend to have weaker hip abductors and external rotators than people without it. That has been shown in more than one systematic review.4
Two cautions. First, "people with the condition have weaker hips" is not the same as "weak hips cause the condition"; the prospective evidence on causation is more mixed than the cross-sectional evidence on association. Second, the existence of an association does not tell you how much strengthening helps, or how fast. Hip and core strengthening is a standard part of runner's knee rehabilitation and there is trial evidence for it, but we are not going to put a percentage on it that we cannot source.
A routine to start with
This is standard practice rather than a research protocol, but it covers the muscles the literature keeps pointing at. Two or three times a week, three sets, slow and controlled:
- Squats — bodyweight to start. 10–15 reps.
- Lunges — forward and reverse. 10–12 each leg.
- Glute bridge, progressing to single-leg. 12–15 reps.
- Side-lying hip abduction or clamshells. 15 each side.
- Plank — forearm or high. 30–60 seconds.
If the runner-specific evidence has a lesson, it is that the routine you do matters less than whether you keep doing it. Pick a version you will still be doing in three months. And if you can get a physio or coach to watch you once, do — that is the version of this that had the best results.
The feet
Strength work for runners usually stops at the hips. One randomised trial did not: it took recreational runners through eight weeks of foot and ankle strengthening, kept them going for a year, and found they were 2.4 times less likely to be injured than a comparison group doing stretching. It was supervised, which fits the pattern above. The trial, what it shows, and what it doesn't, is written up on the runners' page. We make a tool for that kind of foot work; it is not a substitute for anything in this article.
A note on this article
An earlier version of this post cited two studies in support of its hip and core claims. When we checked them, one was a case report on nocturnal leg cramps and the other was a mouse genetics paper. Neither had anything to do with runners. We have rebuilt the article using only sources we have read, and we would rather tell you that than hope nobody clicked.
References
- Lauersen JB, Bertelsen DM, Andersen LB. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine. 2014;48(11):871–877. doi:10.1136/bjsports-2013-092538. Read it
25 RCTs, 26,610 participants, all sports. Overuse injury RR 0.527. Stretching: no effect. - Lauersen JB, Andersen TE, Andersen LB. Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis. British Journal of Sports Medicine. 2018;52(24):1557–1563. doi:10.1136/bjsports-2018-099078. PMID: 30131332. Read it
- Do exercise-based prevention programs reduce injury in endurance runners? A systematic review and meta-analysis. Sports Medicine. 2024. doi:10.1007/s40279-024-01993-7. Read it
Authors to be added — see notes. Pooled injury risk p = 0.110, injury rate p = 0.329; post-hoc analysis favoured supervised programmes. - Rathleff MS, Rathleff CR, Crossley KM, Barton CJ. Is hip strength a risk factor for patellofemoral pain? A systematic review and meta-analysis. British Journal of Sports Medicine. 2014;48(14):1088.
CONFIRM BEFORE PUBLISHING — see notes. Cited from knowledge of the literature, not read in this session. - Yamamoto LM, Lopez RM, Klau JF, Casa DJ, Kraemer WJ, Maresh CM. The effects of resistance training on endurance distance running performance among highly trained runners: a systematic review. Journal of Strength and Conditioning Research. 2008;22(6):2036–2044. doi:10.1519/JSC.0b013e318185f2f0. PMID: 18978605. Read it
Five studies. The review notes several used untrained subjects. - Balsalobre-Fernández C, Santos-Concejero J, Grivas GV. Effects of strength training on running economy in highly trained runners: a systematic review with meta-analysis of controlled trials. Journal of Strength and Conditioning Research. 2016;30(8):2361–2368. doi:10.1519/JSC.0000000000001316.
Five studies, 93 participants, SMD −1.42. Confirm PMID (26694507 per the original article) before publishing. - Eihara Y, Takao K, Sugiyama T, Maeo S, Terada M, Kanehisa H, Isaka T. Heavy resistance training versus plyometric training for improving running economy and running time trial performance: a systematic review and meta-analysis. Sports Medicine – Open. 2022;8:138. doi:10.1186/s40798-022-00511-1. Read it
- Llanos-Lagos C, Ramirez-Campillo R, Moran J, Sáez de Villarreal E. Effect of strength training programs in middle- and long-distance runners' economy at different running speeds: a systematic review with meta-analysis. Sports Medicine. 2024. doi:10.1007/s40279-023-01978-y. Read it
Confirm author list before publishing.
*These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.
