Dataset Information

Running-Related Biomechanical Risk Factors for Overuse Injuries in Distance Runners: A Systematic Review Considering Injury Specificity and the Potentials for Future Research.

ABSTRACT:

Background

Running 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.

Objective

To identify and evaluate the evidence for the most relevant BRFs for ROIs determined during running and to suggest future research directions.

Design

Systematic review considering prospective and retrospective studies. (PROSPERO_ID: 236,832).

Data sources

PubMed. Connected Papers. The search was performed in February 2021.

Eligibility criteria

English 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.

Results

Sixty-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.

Conclusion

This 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.

SUBMITTER: Willwacher S

PROVIDER: S-EPMC9325808 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

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.

Project description:BackgroundBecause of the complex and multifaceted nature of running injuries, a multifactorial approach when investigating running injuries is required.HypothesisCompared with uninjured runners, injured runners would exhibit different running biomechanics, display more fatigue changes, and would run a greater weekly running volume; more injured runners would also report having a previous injury.Study designProspective cohort study.Level of evidenceLevel 4.MethodsAt commencement of the study, data were collected on demographics, anthropometrics, training history, previous injury history, and center-of-mass accelerations during a long-distance overground run. Participants completed weekly training diaries and were monitored for 1 year for an injury.ResultsA total of 76 runners completed the study, with 39 (22 male; 17 female) reporting an injury. Compared with male uninjured runners, male injured runners were heavier and ran a greater weekly distance. Male runners (injured and uninjured) exhibited increases in mediolateral center-of-mass accelerations during the run. Compared with female uninjured runners, female injured runners were heavier, ran with longer flight times and lower step frequencies, and more of them had reported an injury in the previous year and had increased speed training in the weeks prior to injury. Over 60% of male injured runners and over 50% of female injured runners had increased their weekly running distance by >30% between consecutive weeks at least once in the 4 weeks prior to injury.ConclusionFactors that may be related to injury for male runners include being heavier, running a greater weekly distance, and exhibiting fatigue changes in mediolateral center-of-mass accelerations. Factors that may be related to injury for female runners include being heavier, having an injury in the previous year, running with longer flight times and lower step frequencies, and increasing speed training prior to injury. Increases in weekly running distance in 1 consecutive week (particularly >30%) needs to be monitored in training, and this along with the other factors found may have contributed to injury development.Clinical relevanceThis study found that multiple factors are related to running injuries and that some factors are sex specific. The findings can aid in injury prevention and management.

Project description:ContextRunning-related injuries are common in distance runners. Strength training is used for performance enhancement and injury prevention. However, the association between maximal strength and distance-running biomechanics is unclear.ObjectiveTo determine the relationship between maximal knee- and hip-extensor strength and running biomechanics previously associated with injury risk.DesignCross-sectional study.SettingResearch laboratory.Patients or other participantsA total of 36 collegiate distance runners (26 men, 10 women; age = 20.0 ± 1.5 years, height = 1.74 ± 0.09 m, mass = 61.97 ± 8.26 kg).Main outcome measure(s)Strength was assessed using the 1-repetition maximum (1RM) back squat and maximal voluntary isometric contractions of the knee extensors and hip extensors. Three-dimensional running biomechanics were assessed overground at a self-selected speed. Running variables were the peak instantaneous vertical loading rate; peak forward trunk-lean angle; knee-flexion, internal-rotation, and -abduction angles and internal moments; and hip-extension, internal-rotation, and -adduction angles and internal moments. Separate stepwise linear regression models were used to examine the associations between strength and biomechanical outcomes (ΔR2) after accounting for sex, running speed, and foot-strike index.ResultsGreater 1RM back-squat strength was associated with a larger peak knee-flexion angle (ΔR2 = 0.110, ΔP = .045) and smaller peak knee internal-rotation angle (ΔR2 = 0.127, ΔP = .03) and internal-rotation moment (ΔR2 = 0.129, ΔP = .03) after accounting for sex, speed, and foot-strike index. No associations were found between 1RM back-squat strength and vertical loading rate, trunk lean, or hip kinematics and kinetics. Hip- and knee-extensor maximal voluntary isometric contractions were also not associated with any biomechanical variables.ConclusionsGreater 1RM back-squat strength was weakly associated with a larger peak knee-flexion angle and smaller knee internal-rotation angle and moment in collegiate distance runners. Runners who are weaker in the back-squat exercise may exhibit running biomechanics associated with the development of knee-related injuries.

Project description:BackgroundMaximal aerobic speed (MAS) is a useful parameter to assess aerobic capacity and estimate training intensity in middle- and long-distance runners. However, whether middle- and long-distance runners reach different levels of MAS compared to other endurance athletes with similar V̇O2max has not been previously studied. Therefore, we aimed to compare V̇O2max, MAS and spatiotemporal parameters between sub-elite middle- and long-distance runners (n = 6) and endurance non-runners (n = 6). In addition, we aimed to compare the maximal blood lactate concentration [BLa] experienced by participants after conducting these tests.MethodsTelemetric portable respiratory gas analysis, contact and flight time, and stride length and rate were measured using a 5-m contact platform during an incremental test at a synthetic athletics track. V̇O2, heart rate, respiratory quotient values in any 15 s average period during the test were measured. [BLa] was analyzed after the test . Running spatiotemporal parameters were recorded at the last two steps of each 400 m lap. A coefficient of variation (%CV) was calculated for each spatiotemporal variable in each participant from 8 km h-1 onwards.ResultsWhereas runners reported faster MAS (21.0 vs. 18.2 km h-1) than non-runners (p = 0.0001, ES = 3.0), no differences were found for V̇O2max and maximum blood lactate concentration during the running tests (p > 0.05). While significant increases in flight time and stride length and frequency (p < 0.001, 0.52 ≤ ηp2 ≤ 0.8) were observed throughout the tests, decreases in contact time (p < 0.001, ηp2=0.9 ) were reported. Runners displayed a greater %CV (p = 0.015) in stride length than non-runners. We conclude that middle- and long-distance runners can achieve a faster MAS compared to non-running endurance athletes despite exhibiting a similar V̇O2max. This superior performance may be associated to a greater mechanical efficiency. Overall, runners displayed a greater ability to modify stride length to achieve fast speeds, which may be related to a more mechanically efficient pattern of spatiotemporal parameters than non-runners.