Exploring the relations between running variability and injury susceptibility: A scoping review

Background: Variability in running mechanics, termed running variability, reflects the adaptability of the locomotor system to dynamic environments. Due to inconsistent findings in the literature, there is a research gap in understanding its role in injury. Objectives: This scoping review explores running variability’s influence on injury susceptibility, examining studies across various injury types, skill levels, methods, and analysis adhering to the guidelines outlined in the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist (PRISMA-ScR). Eligibility criteria and sources of evidence: Twenty-one studies illustrating the complexity of running variability in relation to running-related injuries were selected from Web of Science, ScienceDirect, Google Scholar, and PubMed databases during December 2022 to June 2024. Results: There are significant differences in running variability between injured and healthy runners, with variability influenced by injury type, stage, and individual differences with varying levels of evidence. Out of 21 studies, 8 (38%) found no group differences, 11 (52%) noted higher running variability in injured participants, and 5 (24%) reported lower variability in injured than healthy subjects. The review was constrained by the diverse subjects, methods, tasks, and outcome variables across the studies. Conclusions: Currently, there is no standard normal range for running variability and abnormal variability is defined relative to control groups, though healthy controls can also show abnormal variability without injury in some study designs. Despite the absence of standardized running variability norms, wearable sensors offer insights into real-world running mechanics, presenting running variability as a potential predictor of running-related injuries. The review highlights the need for standardized protocols and further research to clarify running variability’s role in injury prediction and prevention, emphasizing the necessity of individualized approaches in training and rehabilitation. Future studies should aim to establish a causal relationship between running variability and injury susceptibility, focusing on identifying variability patterns that precede or follow an injury. This review sets the stage for developing evidence-based strategies to optimize running performance and minimize injury risks. Copyright © 2025 by the authors.