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Predicting Future Injuries & Early Detection with Prof. Eric Hegedus

In today’s rerun episode, Brodie sits down once again with Professor Eric Hegedus—physical therapist, clinician, researcher, and one of the podcast’s favourite returning guests. Eric previously joined us in Episode 186 to dive into return-to-running principles. Today, he’s back to explore one of the hardest and most misunderstood topics in running science:

Can we actually predict running injuries?
If so, how? And what should runners do with that information?

Using insights from his 3-year prospective cohort study, Eric walks us through what physical performance tests can and cannot tell us about injury risk—and why simple movement screens like single-leg squats may be more powerful than we ever realised.

We also dive into psychosocial risk factors, early warning signs, modern wearable data, and why injury prediction research is evolving rapidly.

What This Episode Covers

• Why Eric designed a study to challenge the Functional Movement Screen (FMS)
• The 15 bodyweight performance tests studied across 360 athletes
• Which movement patterns actually mattered for overuse injuries
• The shocking finding: when motor control was considered, past injury stopped predicting future injury
• Why weak glute medius and poor ankle mobility show up repeatedly in injured runners
• How poor movement gives you “less wiggle room” before overload
• Why injury prediction today is no longer just movement → injury, but a multifactorial real-time model
• The four early warning signs of an upcoming injury episode
• Practical takeaways all runners can apply immediately

Key Insights & Takeaways

1. Movement Quality Matters More Than We Thought

Eric’s research found that poor single-leg or double-leg squat control was strongly associated with future overuse injuries—even more than past injury history.
When movement quality was poor, “past injury” no longer predicted new injury. This indicates:

• Poor motor control = major vulnerability
• Runners with poor control have less buffer when workloads fluctuate
• Runners who move well have a much larger margin for error

Symptoms of poor control during squats include:

• Knees collapsing inward
• Trunk rotating
• Heels lifting
• Using the spine instead of hips/knees to descend

These often reflect:

• Weak glute medius
• Poor ankle mobility
• Poor neuromuscular coordination after prior injury

2. The Tests That Truly Matter

Eric’s study grouped bodyweight tests into:

• Active motion
• Motor control
• Hip stability
• Flexibility
• Power

But the only category that consistently correlated with overuse injury was:

Motor Control: quality of double-leg and single-leg squat

These tests are simple, take 20 seconds, and anyone can self-assess in front of a mirror.

3. Early Warning Signs of an Injury (Clear Red Flags)

Eric highlights four factors runners should monitor weekly:

• Fatigue
• Stress levels
• Sleep quality
• Muscle soreness

When all four trend in the wrong direction, an injury is often imminent.

4. Wearables Are Changing Injury Prediction

Unlike old studies that tested athletes once per year, modern tech (Garmin, Whoop, Oura, etc.) collects real-time data—giving much stronger prediction models.

Right now, Eric estimates we can predict injury with:

👉 30–50% confidence
Already far better than the past, and improving rapidly.

5. Runners Must See Themselves as Whole Humans

Mechanical load alone doesn't explain injuries. Psychological and lifestyle factors matter just as much:

• Travel
• Stress
• Poor sleep
• Relationship/social strain
• High soreness
• Reduced recovery behaviors

Ignoring these variables leads runners into repeated injury cycles.

🧠 Practical Tips for Runners

• Film yourself doing a single-leg and double-leg squat → check knee control, trunk alignment, ankle mobility
• Avoid running when fatigued, highly stressed, poorly slept, or extremely sore
• Build glute medius strength (side planks, hip abduction variations)
• Improve ankle mobility if squats improve with heels elevated
• Consider cross-training to break unidirectional overload
• Take easy days without guilt—they prevent injury, not reflect weakness
• Look at yourself as a whole athlete: body + mind + lifestyle

📚 Related Research Mentioned

• Hegedus et al. Physical performance tests predict injury in NCAA athletes
• Chris Bramah: Hip drop & knee mechanics associated with running injury
  (Referenced within conversation)

👤 About Today’s Guest: Prof. Eric Hegedus

Eric Hegedus is a professor, clinician, researcher, and highly respected physiotherapist whose body of work spans biomechanics, injury risk, and clinical reasoning. His research is widely used globally in sports rehabilitation and athlete screening.