Anterior knee pain and its intrinsic risk factors among runners in poor resourced peri-urban communities

Abstract

Anterior knee pain (AKP) is the most common overuse injury experienced by runners and is prevalent among females, adolescents and young adults. Several modifiable intrinsic risk factors have been suggested to contribute to AKP. The objective was to determine the prevalence and modifiable intrinsic risk factors for AKP among runners in poor resourced peri-urban communities in Ekurhuleni, South Africa. A cross-sectional study design was used. Population comprised of 347 runners from six developing running clubs. Convenient sampling method was used, and 183 participants were sampled using a Raosoft statistical tool. Participants were aged between 13- and 55-year-old with no history of degenerative and traumatic injuries. Standardized questionnaire was used to determine AKP prevalence and 12 physical tests were used to screen for modifiable intrinsic risk factors. Ethical clearance, permission from club managers and consent from participants were obtained. Data were collected over four months and SPSS was used to obtain descriptive (frequencies) and inferential (logistic regression) statistics. Anterior knee pain accounted for 40%. Males (57.9%) and youth (57.9%) with 3–5 years of running experience (31.1%) dominated. The AKP was significantly associated with age (c 2 = 6.484, P = 0.039) and running experience (c 2 = 8.389, P = 0.036). The following modifiable intrinsic risk factors were found to have contributed significantly to AKP: tight hamstrings ( P = 0.051, OR = 1.021); tight iliotibial band ( P = 0.046, OR = 1.122); weak quadriceps ( P = 0.040, OR = 0.154), weak hip control muscle ( P = 0.004, OR = 1.131) and patellar tilt abnormalities ( P = 0.015, OR = 1.332). Anterior knee pain is prevalent and modifiable intrinsic risk factors exist amongst runners. Routine approach to AKP should include consideration of modifiable risk factors. A transdisciplinary approach should be considered to compensate for the lack of resources in low socioeconomic communities.