Integrating Runner, Practitioner and Coach Insights to inform Digital Running- Related Injury Prevention and Management: A Multi-Phase Qualitative Study

Running is one of the most accessible ways to move the human body. It requires no special equipment, no expensive gym membership, and no complex rules. For millions of people, it is a simple, free path to better health, offering protection against heart disease, diabetes, and other serious conditions. Yet, for all its benefits, running carries a significant cost: injury. When a runner hurts a leg or back, the pain often forces them to stop. This interruption is frustrating, but it also represents a lost opportunity for public health. If people could stay injury-free, they would keep running longer, reaping the rewards of physical activity for years.

The challenge is that preventing these injuries is not straightforward. While doctors and coaches have long offered advice on stretching, strengthening, and managing training loads, the results are often mixed. In recent years, the solution has seemed to lie in technology. Runners already carry smartphones and wear devices that track their speed and distance. It seemed logical that these tools could also guide them away from injury. However, the apps and digital tools currently available often fail to convince runners that they are useful. They may offer generic advice that feels disconnected from a runner's specific life, or they might provide information that feels unreliable. To build a tool that actually works, researchers needed to understand what runners and the professionals who treat them truly want and need.

A team of researchers at Cardiff University and the University of Southampton set out to solve this puzzle. They did not start by building an app or writing code. Instead, they started by listening. They gathered two distinct groups of people: recreational runners who run for fun and fitness, and practitioners, including physiotherapists, coaches, and trainers who work with these athletes. The researchers held a series of group discussions, known as focus groups, where they asked these participants to imagine a new digital tool designed to prevent running injuries and help manage them if they occur. The goal was to hear directly from the people who would use the tool and the people who would rely on its advice.

The discussions revealed a clear desire for a tool that lives on a smartphone. Both runners and practitioners agreed that an app would be the most practical platform because it is always in a runner's pocket and easy to open. However, the participants were quick to point out that simply having an app is not enough. The content inside must be trustworthy. Runners expressed a deep skepticism toward the vast amount of conflicting advice found on the internet. They wanted information that was backed by scientific evidence and vetted by medical professionals. They did not just want to know what exercise to do; they wanted to understand why it helped. This need for clarity and authority was a recurring theme. Runners felt that if the advice came from a credible source, they would be more confident in following it, even when it was difficult or required changing their habits.

Beyond the source of the information, the participants discussed how the tool should be organized. Runners wanted the advice to feel personal. They imagined an app that could ask about their age, their running history, or any past injuries and then provide specific guidance tailored to their situation. They hoped the tool could act as a guide, telling them exactly what to do if they felt a twinge in their knee or how to return to running after a break. Practitioners, however, offered a more cautious perspective on this idea of personalization. While they agreed that advice should be relevant to different groups, such as beginners or older runners, they warned against the tool trying to diagnose specific injuries on its own. They explained that an app cannot see a runner's body or feel the pain in the same way a human doctor can. They feared that if an app tried to tell a runner exactly what was wrong, it could lead to a misdiagnosis, causing the runner to ignore a serious problem or treat a minor one incorrectly.

This tension between the desire for a personalized, diagnostic tool and the need for safety was the central conflict in the study. Runners hoped for a "symptom checker" that could tell them if they had a stress fracture or a muscle strain. Practitioners insisted that the tool should instead act as a signpost. If a runner entered their symptoms, the app should not give a final answer but should instead suggest, "This sounds serious; please see a doctor," or "This looks like a common issue; here is some safe advice to try while you wait." The researchers found that both groups recognized the danger of getting it wrong. A digital tool that gives the wrong advice could lead to worse injuries, and the legal and ethical responsibility for such an error was a serious concern for the medical professionals involved.

The study also explored how to keep runners engaged with the tool. Even the best advice is useless if no one follows it. Participants suggested that the app could use gentle reminders to encourage runners to do their prevention exercises or to check in on how their body was feeling. Some suggested adding elements of fun, such as earning rewards or competing with friends, to make the process less of a chore. However, there was a fine line to walk. Practitioners noted that if the app became too intrusive, constantly demanding attention or nagging the runner, people might simply turn it off. The tool needed to be helpful without feeling like a manager.

Ultimately, the research painted a picture of a digital tool that is evidence-based, safe, and user-friendly. It should be an app that runners trust because it is built on solid science and involves real medical experts. It should offer clear, video-based instructions for exercises and advice on training loads, nutrition, and footwear. It should be smart enough to group runners by their experience level or age to give relevant advice, but it must stop short of trying to replace a doctor. The most important finding was that while runners want a tool that feels like it knows them, they also need to know that the tool will not lead them astray. The path forward is not to build a magic app that cures injuries, but to create a reliable companion that helps runners make better decisions, stay safe, and keep moving.