Epidemiology, Clinical Characteristics, and Risk Factors for Running-Related Injuries among South African Trail Runners.
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ABSTRACT:
SUBMITTER: Viljoen CT
PROVIDER: S-EPMC8656810 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveRunning-related musculoskeletal injuries (RRMIs), especially stemming from overuse, frequently occur in runners. This study aimed to systematically review the literature and determine the incidence and prevalence proportion of RRMIs by anatomic location and specific pathology.MethodsAn electronic database search with no date beginning restrictions was performed in SPORTDiscus, PubMed, and MEDLINE up to June 2020. Prospective studies were used to find the anatomic location and the incidence proportion of each RRMI, whereas retrospective or cross-sectional studies were used to find the prevalence proportion of each RRMI. A separate analysis for ultramarathon runners was performed.ResultsThe overall injury incidence and prevalence were 40.2% ± 18.8% and 44.6% ± 18.4% (mean ± SD), respectively. The knee, ankle, and lower leg accounted for the highest proportion of injury incidence, whereas the knee, lower leg, and foot/toes had the highest proportion of injury prevalence. Achilles tendinopathy (10.3%), medial tibial stress syndrome (9.4%), patellofemoral pain syndrome (6.3%), plantar fasciitis (6.1%), and ankle sprains (5.8%) accounted for the highest proportion of injury incidence, whereas patellofemoral pain syndrome (16.7%), medial tibial stress syndrome (9.1%), plantar fasciitis (7.9%), iliotibial band syndrome (7.9%), and Achilles tendinopathy (6.6%) had the highest proportion of injury prevalence. The ankle (34.5%), knee (28.1%), and lower leg (12.9%) were the 3 most frequently injured sites among ultramarathoners.ConclusionThe injury incidence proportions by anatomic location between ultramarathoners and non-ultramarathoners were not significantly different (p = 0.798). The pathologies with the highest incidence proportion of injuries were anterior compartment tendinopathy (19.4%), patellofemoral pain syndrome (15.8%), and Achilles tendinopathy (13.7%). The interpretation of epidemiological data in RRMIs is limited due to several methodological issues encountered.
| S-EPMC8500811 | biostudies-literature
Project description:BackgroundThe purpose of this exploratory study was to investigate whether runners with certain biomechanical or clinical/anthropometrical characteristics sustain more running-related injuries than runners with other biomechanical or clinical/anthropometrical characteristics.MethodsThe study was designed as a prospective cohort with 52-weeks follow-up. A total of 224 injury-free, recreational runners were recruited from the Gothenburg Half Marathon and tested at baseline. The primary exposure variables were biomechanical and clinical/anthropometrical measures, including strength, lower extremity kinematics, joint range of motion, muscle flexibility, and trigger points. The primary outcome measure was any running-related injury diagnosed by a medical practitioner. Cumulative risk difference was used as measure of association. A shared frailty approach was used with legs as the unit of interest. A total of 448 legs were included in the analyses.ResultsThe cumulative injury incidence proportion for legs was 29.0% (95%CI = 24.0%; 34.8%). A few biomechanical and clinical/anthropometrical factors influence the number of running-related injuries sustained in recreational runners. Runners with a late timing of maximal eversion sustained 20.7% (95%CI = 1.3; 40.0) more injuries, and runners with weak abductors in relation to adductors sustained 17.3% (95%CI = 0.8; 33.7) more injuries, compared with the corresponding reference group.ConclusionsMore injuries are likely to occur in runners with late timing of maximal eversion or weak hip abductors in relation to hip adductors.
| S-EPMC7110719 | biostudies-literature
Project description:ObjectiveRecreational running is one of the most common physical leisure activities worldwide and is associated with high rates of running related injury (RRI). Little is known of the perceptions of male recreational runners regarding the aetiology and management of RRI.DesignUtilising an interpretive phenomenological analysis framework, qualitative data was gathered from participants via interview, and reflexive thematic analysis was used to develop insights into the experiences and perceptions of the participants in relation to RRI.Materials and methodsTwo focus groups with a total of six (mean age 37.8 ± 9.5 years, 16.5 ± 13.1 years running experience) male recreational runners were used to obtain data regarding their understanding of RRI causation, prevention and management. Interviews were evaluated using a six-phase reflexive thematic analysis approach to generate and interpret themes within the data.ResultsThree themes (Mind, Body and Education) were identified by the analysis as critical to RRI avoidance. Mind refers to the self-understanding and self-management of personal limits required for RRI prevention. Body reflects a degree of physical conditioning necessary for injury free running, while Education indicates an understanding of how to correctly structure a running program. When viewed together these themes can be seen to form an 'internal locus of injury' model which highlights the runners' beliefs that RRI are related to their decisions regarding training and running, and that avoidance of injury lies within their personal control.ConclusionRecreational runners rely on self-management, in preference to professional advice, to manage training loads, fitness and RRI. Health care professionals involved with this population may consider the use of online resources, a preferred option of runners, to assist runners to build their knowledge base and support their development to experienced runners.
| S-EPMC9409521 | biostudies-literature
Project description:BackgroundNo systematic review has identified the incidence of running-related injuries per 1000 h of running in different types of runners.ObjectiveThe purpose of the present review was to systematically search the literature for the incidence of running-related injuries per 1000 h of running in different types of runners, and to include the data in meta-analyses.Data sourcesA search of the PubMed, Scopus, SPORTDiscus, PEDro and Web of Science databases was conducted.Study selectionTitles, abstracts, and full-text articles were screened by two blinded reviewers to identify prospective cohort studies and randomized controlled trials reporting the incidence of running-related injuries in novice runners, recreational runners, ultra-marathon runners, and track and field athletes.Study appraisal and synthesis methodsData were extracted from all studies and comprised for further analysis. An adapted scale was applied to assess the risk of bias.ResultsAfter screening 815 abstracts, 13 original articles were included in the main analysis. Running-related injuries per 1000 h of running ranged from a minimum of 2.5 in a study of long-distance track and field athletes to a maximum of 33.0 in a study of novice runners. The meta-analyses revealed a weighted injury incidence of 17.8 (95% confidence interval [CI] 16.7-19.1) in novice runners and 7.7 (95% CI 6.9-8.7) in recreational runners.LimitationsHeterogeneity in definitions of injury, definition of type of runner, and outcome measures in the included full-text articles challenged comparison across studies.ConclusionNovice runners seem to face a significantly greater risk of injury per 1000 h of running than recreational runners.
| S-EPMC4473093 | biostudies-literature
Project description:Using an enactive approach to trail runners' activity, this study sought to identify and characterize runners' phenomenological gestalts, which are forms of experience that synthesize the heterogeneous sensorimotor, cognitive and emotional information that emerges in race situations. By an in-depth examination of their meaningful experiences, we were able to highlight the different typologies of interactions between bodily processes (e.g., sensations and pains), behaviors (e.g., actions and strategies), and environment (e.g., meteorological conditions and route profile). Ten non-professional runners who ran an ultra-trail running race (330 km, 24,000 m of elevation gain) volunteered to participate in the study. Data were collected in two steps: (1) collection of past activity traces (i.e., race maps, field notes, and self-assessment scales) and (2) enactive interviews using the past activity traces in which the runners were invited to relive their experience and describe their activity. The enactive interviews were coded using the course-of-experience methodology to identify the phenomenological gestalts that emerged from activity and scaffolded the runners' courses of experience. The results revealed that runners typically enact three phenomenological gestalts: controlling global ease, enduring general fatigue and experiencing difficult situations, and feeling freedom in the running pace. These phenomenological gestalts were made up of specific behaviors, involvements, and meaningful situated elements that portrayed various ways of achieving an ultra-endurance performance in the race situation. They also highlighted how runners enact a meaningful world by acting in relation to the fluctuations in physical sensations and environmental conditions during an ultra-trail race. Practical applications for preparation, race management and sports psychology interventions are proposed to enrich the existing recommendations. In conclusion, this approach provides new research perspectives by offering a more holistic grasp of activity in trail running through an in-depth analysis of athletes' experience. In doing so, we may expect that runners can connect these typical gestalts to their own personal experiences and stories as trail runners in order to sustain a viable approach to their sport.
| S-EPMC6213919 | biostudies-literature
Project description:PurposeThis umbrella systematic review (SR) of SRs and meta-analysis seeks to comprehensively synthesize existing literature to identify and consolidate the diverse range of risk factors contributing to running-related injuries (RRIs).MethodsSystematic searches were conducted on June 28, 2023, across Web of Science, SPORTDiscus, Scopus, PubMed, and Cochrane Library. We included SRs, whether accompanied by meta-analyses or not, that focused on investigating risk factors for RRIs within observational studies. The methodological quality of the SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews II. To assess the extent of overlap across reviews, the corrected covered area metric was calculated.ResultsFrom 1509 records retrieved, 13 SRs were included. The degree of overlap between SRs was low (4%), and quality varied from critically low (n = 8) to low (n = 5). Two hundred seven outcomes assessed in 148 primary studies were identified as being associated with the occurrence of RRIs. The effect sizes of the associations for which risk measures were reported (n = 131) were classified as large (n = 30, 23%), medium (n = 38, 29%), small (n = 48, 37%) or no effect (n = 15, 11%). Running/training characteristics, health and lifestyle factors, along with morphological and biomechanical aspects, exhibit large effect sizes in increasing the risk for RRIs.ConclusionDrawing from the outcomes of the low-quality SRs and associations with large effect sizes, our findings indicate that running/training characteristics and health and lifestyle factors, as well as morphological and biomechanical aspects, are all implicated in elevating the risk of RRIs, emphasizing the multifactorial basis of injury incidence in running. Given the low quality and heterogeneity of SR, individual findings warrant cautious interpretation.
| S-EPMC11336318 | biostudies-literature
Project description:BackgroundRunning overuse injuries (ROIs) occur within a complex, partly injury-specific interplay between training loads and extrinsic and intrinsic risk factors. Biomechanical risk factors (BRFs) are related to the individual running style. While BRFs have been reviewed regarding general ROI risk, no systematic review has addressed BRFs for specific ROIs using a standardized methodology.ObjectiveTo identify and evaluate the evidence for the most relevant BRFs for ROIs determined during running and to suggest future research directions.DesignSystematic review considering prospective and retrospective studies. (PROSPERO_ID: 236,832).Data sourcesPubMed. Connected Papers. The search was performed in February 2021.Eligibility criteriaEnglish language. Studies on participants whose primary sport is running addressing the risk for the seven most common ROIs and at least one kinematic, kinetic (including pressure measurements), or electromyographic BRF. A BRF needed to be identified in at least one prospective or two independent retrospective studies. BRFs needed to be determined during running.ResultsSixty-six articles fulfilled our eligibility criteria. Levels of evidence for specific ROIs ranged from conflicting to moderate evidence. Running populations and methods applied varied considerably between studies. While some BRFs appeared for several ROIs, most BRFs were specific for a particular ROI. Most BRFs derived from lower-extremity joint kinematics and kinetics were located in the frontal and transverse planes of motion. Further, plantar pressure, vertical ground reaction force loading rate and free moment-related parameters were identified as kinetic BRFs.ConclusionThis study offers a comprehensive overview of BRFs for the most common ROIs, which might serve as a starting point to develop ROI-specific risk profiles of individual runners. We identified limited evidence for most ROI-specific risk factors, highlighting the need for performing further high-quality studies in the future. However, consensus on data collection standards (including the quantification of workload and stress tolerance variables and the reporting of injuries) is warranted.
| S-EPMC9325808 | biostudies-literature
Project description:The purpose of this study was to compare the variations of weekly workload indices of internal and external load measures across the three weeks prior to injury occurrences in trail runners. Twenty-five trail runners (age: 36.23 ± 8.30 years old; body mass: 67.24 ± 5.97 kg; height: 172.12 ± 5.12 cm) were monitored daily for 52 weeks using global positioning systems (GPSs) to determine the total distance covered. Additionally, a rate of perceived exertion (RPE) scale was applied to determine session-RPE (sRPE: RPE multiplied by training time). The accumulated load (AL), acute: chronic workload ratio (ACWR), training monotony (TM), and training strain (TS) indices were calculated weekly for each runner. During the period of analysis, the injury occurrences were recorded. The differences were observed in AL and ACWR for sRPE and training time were significantly greater during the injury week when compared to the previous weeks. Similar evidence was found in TM and TS indices for sRPE, training time, and total distance. Furthermore, no meaningful differences were observed in AL and ACWR for total distance in the weeks prior to injury occurrence. Nevertheless, significant between-subjects variability was found, and this should be carefully considered. For that reason, an individualized analysis of the workload dynamics is recommended, avoiding greater spikes in load by aiming to keep a progressive increment of load without consequences for injury risk.
| S-EPMC7312824 | biostudies-literature
Project description:BackgroundMarathons are the most challenging form of running, and amateur athletes may be more prone to injury due to a lack of professional knowledge and instruction in running.PurposeTo analyze the MRI manifestations of and factors related to knee injuries in amateur marathon runners.SubjectsData were collected from a hospital database of 105 qualified amateur marathon athletes (65 males,40 females), between May 2018 and December 2021.Field strength/sequence1.5T MR: sagittal fs-PDWI, sagittal T1WI and sagittal 3D-DESS sequence.AssessmentThe MRI manifestations of knee joint injury were analyzed and evaluated by two radiologists.Statistical testsThe inter-observer agreement on MRI readings was analyzed using the kappa coefficient, and binary logistic regression analysis was employed to identify factors associated with knee injuries.ResultsThe overall prevalence of knee cartilage lesions, meniscus lesions and bone marrow edema among amateur marathon runners was 45.7%, 72.4%, and 49.5% respectively. Our analysis revealed that older age (OR = 1.135, P<0.001), higher BMI (OR = 1.236, P = 0.044), and slower pace (OR = 2.305, P = 0.017) were associated with increased risk of articular cartilage disease. Furthermore, older age (OR = 1.425, P<0.001) was identified as a risk factor for meniscal lesions, while older age (OR = 1.088, P = 0.002) was bone marrow edema. Notably, no significant correlation was observed between knee joint injuries of amateur marathon athletes and gender or the monthly running distance (P>0.05).ConclusionsThe occurrence of knee injuries among amateur marathon athletes was highly prevalent, with the patellofemoral joint cartilage and posterior horn of medial meniscus being frequently affected areas. Moreover, age, BMI, running years and pace were significant risk factors of knee joint injury.
| S-EPMC11232983 | biostudies-literature
Project description:BackgroundThe purpose of the present study was to explore the feasibility of collecting GPS data and the usability of GPS data to evaluate associations between the training load and onset of running-related knee injuries (RRKIs).MethodsParticipants of the INSPIRE-trial, a randomized-controlled trial on running injury prevention, were asked to participate in this study. At baseline, demographic variables were collected. Follow-up questionnaires assessed information on RRKIs. Participants with a new reported RRKI and uninjured participants were sent a GPS export request. Weekly GPS-based training distances were used to calculate Acute:Chronic Workload Ratios (ACWRs).ResultsA total of 240 participants (62.7%) tracked their running training sessions with the use of a GPS-enabled device or platform and were willing to share their GPS data. From the participants (N = 144) who received a GPS export request, 50.0% successfully shared their data. The majority (69.4%) of the shared GPS data were usable for analyses (N = 50). GPS data were used to present weekly ACWRs of participants with and without an RRKI eight weeks prior to RRKI onset or running event.ConclusionsIt seems feasible to collect GPS data from GPS-enabled devices and platforms used by recreational runners. The results indicate that GPS data is usable to calculate weekly ACWRs to evaluate associations between training load and onset of RRKIs in recreational runners. Therefore, GPS-based ACWR measures can be used for future studies to evaluate associations between training load and onset of RRIs.
| S-EPMC9052652 | biostudies-literature