Do Older Ultramarathon Runners Get Injured Less?

By Jason Koop,
Head Coach of CTS Ultrarunning

Injuries in ultramarathon training and racing are not going away. That’s a sobering fact, but the numbers don’t lie. On the training side, up to 70% of runners will become injured every year and lose at least one day of training. Racing is just as injurious. For every 1000 hours of ultramarathon racing, there are anywhere 20-65 injuries.

In preparation for a podcast interview with the authors of a narrative review on the subject, I took a data dive into the statistics, causes, and potential solutions for ultramarathon injuries. During that conversation, one thing stuck out: older and more experienced runners are injured less often. Sometimes the difference is significant, as this study indicates. In it, the authors found that for every 10 years of increasing age, ultrarunners were 50% less likely to get injured during an ultramarathon.

That’s right. Fifty-year-olds were half as likely to suffer an injury compared to 40-year-olds. Forty-year-olds were half as likely to get injured as 30-year-olds. But, why? Why do older and more seasoned ultrarunners experiencing far fewer injuries than their younger, less experienced (and perhaps more resilient) counterparts? I have a few ideas I think ultrarunners of all ages and experience levels should take to heart, and they relate to training volume.

Experienced athletes have more lifetime miles

Training volume matters. It matters for long term improvement, and it seems to also be an important factor in injury rates. Experienced runners generally have a larger lifetime volume of training time and miles. Why is this important in the injury prevention game? Because when you have a robust training history, your periods of peak volume are not as anomalous. You’ve been there, done that and your body knows how to cope with that stress.

As an example, if you normally train 10 hours-per-week, your peak volume weeks can be closer to double that (20 hours). You might have 3 of those a year, primarily from camps and longer long runs. Seems like a big jump, and it might be if that were your first time running a 20-hour week. However, for every decade of training, you have accumulated 30 of those 20-hour weeks. The 20^th or 25^th time you complete a double-volume week, it’s not that big of a deal.

Younger athletes have greater capacity (for harm)

There is no denying athletes lose some of their physiological capacity as they age. This is true even ultrarunning, where athletes tend to peak past their mid-30s. There is a robust body of literature that indicates that aerobic capacity, strength and power all decline after your 20s. So, it’s a conundrum that younger athletes, who should be physically superior, get injured more than their older counterparts.

I suggest younger athletes get injured more frequently precisely because of this physiological superiority. Younger athletes have the capacity to recover quickly, and thus have greater capacity to increase volume in the short term. They can increase training volume from 10 to 20 hours per week and not bat an eyelash. Then they can proceed to do another 20-hour week, and then another, until it’s too late.

Takeaways for ultrarunners of all ages

The takeaway here is that we need to reframe how we look at volume. I’ve written before about how trail and ultrarunners should use time instead of miles when tracking volume. In addition, we often evaluate volume on a weekly basis instead of zooming out and considering longer timeframes. Weekly volume is convenient and ubiquitous, but I’m not convinced it should be analyzed over such a short timeframe.

Most endurance adaptations take several weeks or months to manifest into something meaningful. Red blood cell count, bone density, and connective tissue strength don’t change easily (or much) in 7 days. Yet, we still scrutinize weekly mileage (and volume of time) as a means of trying to prevent injury.

The old 10% rule, whereby runners shouldn’t increase weekly volume by more than 10%, pays homage to this weekly analysis. The salient point for injury prevention is to evaluate volume ramps over months and years, not just weeks. Building total training volume consistently over long periods of time will likely be your most robust form of injury prevention.

Practical recommendations for ultramarathon injuries

From a practical standpoint, here’s what you can do:

• Compare months over a three-year period: Look at your previous 3 years of monthly training volume. If you successfully avoided injuries, pattern your next year of training around this volume pattern.
• Compare weeks to the average: Look at how many weeks your volume was more than 20% above your average. TrainingPeaks has a good tool for this in their dashboard section. If you were successful with that number of anomalies, pattern this year’s training similarly. If you got injured, try reducing the frequency of weeks at >20% above average training volume, but not necessarily your overall training volume.
• Zoom the volume lens out: Instead of observing volume by weeks, zoom out to a 42-day rolling average, similar to TrainingPeaks’ Chronic Training Load (CTL). Most athletes could honesty just use CTL to do this, as it tracks nicely with volume. If that 42-day rolling average is more than 10% different from year to year, consider dialing back.