Abstract
BackgroundLong-distance runners’ understandings of overuse injuries are not well known which decreases the possibilities for prevention. The common sense model (CSM) outlines that runners’ perceptions of a health problem can be described using the categories identity, consequence, timeline, personal control, and cause. The aim of this study was to use the CSM to investigate perceptions of overuse injury among long-distance runners with different exercise loads.MethodsThe study used a cross-sectional design. An adapted version of the illness perception questionnaire revised (IPQ-R) derived from the CSM was used to investigate Swedish ultramarathon and marathon runners’ perceptions of overuse injuries. Cluster analysis was employed for categorizing runners into high and low exercise load categories. A Principal Component Analysis was thereafter used to group variables describing injury causes. Multiple logistic regression methods were finally applied using high exercise load as endpoint variable and CSM items representing perceptions of injury identity, consequence, timeline, personal control, and causes as explanatory variables.ResultsComplete data sets were collected from 165/443 (37.2%) runners. The symptoms most commonly associated with overuse injury were pain (80.1% of the runners), stiff muscles (54.1%), and stiff joints (42.0%). Overuse injury was perceived to be characterized by the possibility of personal control (stated by 78.7% of the runners), treatability (70.4%), and that the injury context was comprehensible (69.3%). The main injury causes highlighted were runner biomechanics (stated by 78.3%), the runner’s personality (72.4%), and running surface biomechanics (70.0%). Among men, a belief in that personality contributes to overuse injury increased the likelihood of belonging to the high exercise load category [Odds ratio (OR) 2.10 (95% Confidence interval (95% CI) 1.38–3.19); P = 0.001], while beliefs in that running biomechanics [OR 0.56 (95% CI 0.37–0.85); P = 0.006) and mileage (OR 0.72 (95% CI 0.54–0.96); P = 0.026] causes injury decreased the likelihood. In women, a strong perception that overuse injuries can be controlled by medical interventions decreased the likelihood of high exercise load [OR 0.68 (95% CI 0.52–0.89); P = 0.005].ConclusionThis study indicates that recognition among long-distance runners of the association between own decisions in overuse injury causation is accentuated by increased exercise loads.
Highlights
Marathon and ultramarathon running are popular forms of exercise among women and men, and participation in running competitions covering distances longer than 100 km and with 24 h duration continues to increase (Knechtle and Nikolaidis, 2018; Esteve-Lanao et al, 2019; Waldvogel et al, 2019) It is today recognized that overuse injuries constitute a common problem in runners, and that psychological factors play a role in the injury causation (van der Worp et al, 2015; Kerr et al, 2016; Hulme et al, 2017)
A belief in that personality contributes to overuse injury increased the likelihood of belonging to the high exercise load category [Odds ratio (OR) 2.10 (95% Confidence interval 1.38–3.19); P = 0.001], while beliefs in that running biomechanics [OR 0.56
A strong perception that overuse injuries can be controlled by medical interventions decreased the likelihood of high exercise load [OR 0.68; P = 0.005]
Summary
Marathon and ultramarathon running are popular forms of exercise among women and men, and participation in running competitions covering distances longer than 100 km and with 24 h duration continues to increase (Knechtle and Nikolaidis, 2018; Esteve-Lanao et al, 2019; Waldvogel et al, 2019) It is today recognized that overuse injuries constitute a common problem in runners, and that psychological factors play a role in the injury causation (van der Worp et al, 2015; Kerr et al, 2016; Hulme et al, 2017). Regarding the psychological effects of long-distance running, already early quantitative research reported an increase in mental fatigue and a decrease in psychological tension, and anxiety (Hassmén and Blomstrand, 1991) These effects were longer lasting than the more short-term mood changes that follow briefer sessions of aerobic exercise (van Wilgen and Verhagen, 2012). The results point toward that sportspersons with experiences from this injury type are prone to describe a holistic view on the causal mechanisms, where biological, psychological, and social factors are seen to contribute Strengthening this multi-factorial view on causation, ultramarathon runners were in a recent experimental study found to have higher cold pain tolerance and lower levels of pain-related anxiety than non-running controls (Roebuck et al, 2018b). The aim of this study was to use the CSM to investigate perceptions of overuse injury among long-distance runners with different exercise loads
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