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Youth Distance Running

Strategies for Training and Injury Reduction

Krabak, Brian J., MD, MBA, FACSM1; Tenforde, Adam S., MD2; Davis, Irene S., PT, PhD, FACSM3,4; Fredericson, Michael, MD, FACSM5; Harrast, Mark A., MD6; d’Hemecourt, Pierre, MD, FACSM7; Luke, Anthony C., MD, FACSM8; Roberts, William O., MD, MS, FACSM9

Current Sports Medicine Reports: February 2019 - Volume 18 - Issue 2 - p 53–59
doi: 10.1249/JSR.0000000000000564
Special Communication

Running is a popular sport for children in the United States. However, review of available literature on health effects and safety recommendations for youth running has not been previously conducted. Unique factors for injury include periods of growth during puberty and potential for growth plate injury. Youth runners may benefit from activities that incorporate high-impact loading and multidirectional movement for optimal bone maturation, exercises to strengthen tendons and muscles, and strategies aimed at improving running biomechanics to reduce risk of injury. In addition, addressing lifestyle factors, including nutrition and sleep is essential for a runner’s general health. Similar to other sports, sports specialization should not be encouraged in youth runners. Reducing running-related injury in growing children and assessing readiness for running should be based on a combination of physical, emotional, psychological, social, and cognitive factors. Youth runners require individualized training and competition to safely participate in the sport.

1Rehabilitation, Orthopedics, and Sports Medicine, University of Washington and Seattle Children’s Sports Medicine, Seattle, WA;

2Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Cambridge, MA;

3Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, MA;

4Spaulding National Running Center, Cambridge, MA;

5Department of Orthopedic Surgery, Stanford University School of Medicine, Stanford, CA;

6Rehabilitation, Orthopedics, and Sports Medicine, University of Washington, Seattle, WA;

7Primary Care Sports Medicine, Boston Children’s Hospital, Boston, MA;

8UCSF Primary Care Sports Medicine, UCSF Department of Orthopaedics, UCSF Department of Family and Community Medicine, San Francisco, CA; and

9Department of Family Medicine, University of Minnesota Medical School, Minneapolis, MN

Address for correspondence: Brian J. Krabak, MD, MBA, FACSM, University of Washington Sports Medicine, 3800 Montlake Blvd NE, Seattle, WA 98195; E-mail:

Copyright © 2019 by the American College of Sports Medicine.