Effectiveness of an online multi-component exercise-based injury prevention program on running-related injury risk in recreational runners: a randomized controlled trial

Exercise-based injury prevention programmes for runners often show inconsistent results, potentially due to inadequate targeting of modifiable intrinsic risk factors. This randomized controlled trial assessed the effectiveness of an online, multi-component exercise programme in reducing running-related injuries (RRIs) among recreational runners over nine months. A total of 264 runners (mean age 35.9 ± 13.1 years) were randomly assigned to an intervention (<i>n</i> = 135) or control group (<i>n</i> = 129). The intervention included 11 exercises focusing on core strength, flexibility, and neuromuscular control, performed 2-4 times weekly for 15-30 minutes. The control group maintained their usual running routine. Injuries were self-reported every two weeks. During the study, 30.3% of participants reported at least one new injury, with an overall incidence rate of 6.52 injuries per 1000 running hours. The intervention group had significantly lower rates of overall RRIs (4.62 vs. 8.71 per 1000 hours; IRR = 0.53, 95% CI: 0.37-0.77, <i>p</i> = 0.004) and overuse injuries (4.04 vs. 7.61; <i>p</i> = 0.001), representing 47% and 54% risk reductions, respectively. No significant difference was observed for acute injuries. These findings indicate that a structured, online, multi-component programme targeting key intrinsic risk factors can significantly reduce the incidence of running-related and overuse injuries. This scalable approach supports safer and more sustainable running practices among recreational athletes.