Run Smart, Run Strong: Exploring the Role of Physiotherapy in Running Load Management and Injury Prevention Among Recreational Runners

Background: Running is a widely practiced form of physical activity among recreational runners; however, inappropriate training load and inadequate progression may contribute to running-related injuries. Physiotherapy may play an important role in optimizing running load, improving physical capacity, and preventing running-related injuries through strengthening, flexibility, neuromuscular, and load-management strategies. Therefore, this narrative review aimed to explore the role of physiotherapy in running load management and injury prevention among recreational runners. Methodology A narrative review was conducted using literature identified from PubMed and Google Scholar. The search strategy incorporated keywords related to running, recreational runners, running load, training load, running-related injuries, injury prevention, and physiotherapy using Boolean operators such as AND and OR. Studies were screened according to predefined inclusion and exclusion criteria. Randomized controlled trials involving recreational or novice recreational runners and investigating running load, training interventions, injury prevention, or related functional outcomes were considered. Data regarding study methodology, participants, interventions, outcome measures, and major

Findings: were extracted and synthesized narratively.

Results: Six studies were included in the final narrative synthesis. The

findings demonstrated that structured exercise interventions can positively influence several outcomes in recreational runners. A multi-component exercise programme significantly reduced overall running-related injuries and overuse injuries. Lower-leg exercises improved quality of life and foot posture in runners with medial tibial stress syndrome, although significant improvements in pain and injury severity were not observed. HIIT and plyometric training improved agility, lower-limb power, sprint speed, and functional performance. Training intensity distribution was also associated with endurance performance. However, hip/core and ankle/foot interventions produced only small biomechanical changes without clinically meaningful improvements in running kinematics or strength. One included study was a protocol comparing moderate- and high-load exercise for Achilles tendinopathy and therefore did not provide clinical outcome data.

Conclusion: The available evidence suggests that physiotherapy-based exercise and appropriate training-load management may contribute to injury prevention and improved physical and functional outcomes in recreational runners. However, the relationship between running load and injury is complex and cannot be explained by a single training variable. Individual factors, training progression, physical capacity, strength, and biomechanics should be considered when developing physiotherapy-based running programmes. Further high-quality studies using standardized measures of running load and running-related injury are required to establish clearer evidence-based recommendations.