Increase in the acute: chronic workload ratio relates to injury risk in competitive runners

Talko Bernhard Dijkhuis, Ruby Otter, Marco Aiello, Hugo Velthuijsen, Koen A.P.M. Lemmink

Research output: Contribution to journalArticleAcademicpeer-review


Injuries of runners reduce the ability to train and hinder competing. Literature shows that the relation between potential risk factors and injuries are not definitive, limited, and inconsistent. In team sports, workload derivatives were identified as risk factors. However, there is an absence of literature in running on workload derivatives. This study used the workload derivatives acute workload, chronic workload, and acute: chronic workload ratios to investigate the relation between workload and injury risk in running. Twenty-three competitive runners kept a daily training log for 24 months. The runners reported training duration, training intensity and injuries. One-week (acute) and 4-week (chronic) workloads were calculated as the average of training duration multiplied by training intensity. The acute:chronic workload ratio was determined dividing the acute and chronic workloads. Results show that a fortnightly low increase of the acute:chronic workload ratio (0.10-0.78) led to an increased risk of sustaining an injury (p<0.001). Besides, a low increase of the acute:chronic workload ratio (0.05-0.62) between the second week and third week before an injury showed an association with increased injury risk (p=0.013). These findings demonstrate that the acute:chronic workload ratio relates to injury risk.
Original languageEnglish
Pages (from-to)736-743
Number of pages8
JournalInternational Journal of Sports Medicine
Issue number11
Early online date2 Jun 2020
Publication statusPublished - Oct 2020


  • injury prevention
  • competitive runners
  • prediction
  • rating of perceived exertion


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