Dr. Kate Mihevc Edwards Explains Why Injury Prevention Cannot Be Reduced to One Rule

Every few years, the running world discovers a new study and treats it like permission to burn an old rule to the ground.

This year's target is the 10% rule, the long-standing guideline that runners should not increase weekly mileage by more than ten percent at a time. A recent Garmin-backed study has been widely circulated as proof that the rule is outdated, overly conservative, or simply wrong. Coaches and commentators have rushed to declare it dead, replacing it with a more provocative takeaway: mileage increases are not the real problem. One big workout is.

Dr. Kate Mihevc Edwards, founder of Precision Performance and Physical Therapy and RunSource, does not disagree with the data. What concerns her is how quickly nuance disappears once research hits social media.

"The study is not wrong," she says. "But it is incomplete. And treating it as a universal answer is how people get hurt."

Edwards, a physical therapist and running specialist who works with athletes across performance levels, has spent years watching injury rates stubbornly refuse to decline. Despite advances in footwear, tracking technology, and training theory, as many as 80 percent of runners still experience an injury each year. That number has barely moved in decades.

For Edwards, the reason is not mysterious. Injury is not caused by a single variable. It never has been.

The Problem with Declaring Rules Dead

The Garmin study highlighted a real and important finding: runners are at higher risk when one workout in a given week is dramatically larger than the rest. A single spike in volume or intensity can overwhelm tissues that are otherwise tolerating a gradual progression just fine.

What the study does not say is that overall progression no longer matters, or that athletes can safely ignore how their training fits into the rest of their lives.

"That leap is happening outside the data," Edwards explains. "And it is a dangerous one."

The 10% rule was never meant to be a law. It was a heuristic, a simple guardrail designed to slow people down in a culture that rewards doing more. Its flaw was not that it existed, but that it was often applied without context.

The current backlash risks repeating the same mistake in reverse. By focusing narrowly on workout size, the conversation collapses a complex system into a single metric that is easier to explain and easier to market.

Injury Is Multifactorial, Whether We Like It or Not

In Edwards's clinical practice, training load is only one piece of a much larger picture. Sleep quality. Nutrition and energy availability. Psychological stress. Hormonal status. Life transitions like pregnancy, postpartum recovery, and menopause. All of these variables shape how much stress an athlete can tolerate at any given moment.

Two runners can complete the same training plan and have entirely different outcomes. One adapts. The other breaks down.

"That is not bad luck," Edwards says. "That is biology responding to context."

This is why black-and-white rules persist. They offer certainty in a space that is fundamentally uncertain. Athletes want to know exactly how much they can do without crossing a line. Coaches want clean frameworks they can apply at scale. Algorithms reward confidence over caveats.

But bodies do not care about simplicity.

What Edwards Actually Does in Practice

Rather than abandoning the 10% rule, Edwards reframes it. In her work with runners, weekly increases typically range from 10 to 25 percent, depending on the athlete's full life picture.

An athlete sleeping eight hours a night, fueling well, managing stress, and maintaining hormonal stability may tolerate a higher increase safely. Someone dealing with disrupted sleep, caloric restriction, high life stress, or recent illness may need a far more conservative approach.

This individualized progression has been remarkably effective, not because the percentages are magic, but because they are chosen deliberately.

"It is not about the number," Edwards says. "It is about whether the body has the resources to absorb the load."

Crucially, Edwards also pays close attention to workout distribution. Avoiding a single outlier session that dwarfs the rest of the week remains a priority. The Garmin study reinforces this point. Where things go wrong is when that insight is treated as the only variable that matters.

The Cost of Oversimplification

When research findings are stripped of context, athletes are left chasing partial truths. A runner might feel justified in ramping volume aggressively as long as no single workout stands out. Another might ignore mounting fatigue, poor sleep, or disordered fueling because their mileage progression appears reasonable on paper.

This is how details get lost in translation. And it is why injury rates remain stubbornly high.

Edwards sees the downstream effects daily. Frustrated athletes cycling through providers. Persistent injuries that do not respond to standard protocols. A growing mistrust of medical advice among runners who fear being told to stop altogether.

That mistrust, Edwards argues, is not unfounded. Too often, athletes are placed into rigid boxes rather than engaged as whole people.

Changing the Narrative, One System at a Time

Edwards's broader mission is to close the gap between research, medicine, and the running community. She speaks regularly at medical conferences, works with coaches and specialty running stores, and collaborates across disciplines to help athletes stay active rather than sidelined.

Her message is consistent: injury prevention is not about choosing the right rule. It is about understanding the system.

The 10% rule still has value, not as a prescription, but as a reminder. Progression matters. Gradual change is safer than sudden stress. And no single study can replace clinical judgment informed by sleep, fuel, hormones, stress, and lived experience.

In an era obsessed with decisive takes, Edwards offers something quieter and far more useful. A refusal to flatten complexity for clicks.

"If one new study could solve running injuries," she says, "we would not still be having this conversation forty years later."

The work now is not to declare old rules obsolete, but to grow beyond the idea that rules alone can keep us safe.

For runners and coaches who want a more individualized, evidence-informed approach to help athletes make decisions that support both performance and longevity, reach out to Dr. Kate Mihevc Edwards at https://www.katemihevcedwards.com/.