Injuries In Novice Runners Research Articles

Can running-related injuries be prevented through an online behavioural intervention in adult novice runners? Results of a randomised controlled trial

ObjectiveTo evaluate the effectiveness of the Runfitcheck on time until the onset of a new running-related injury (RRI) among adult novice runners.MethodsA three-arm randomised controlled trial was conducted over 7...

Influence of music-based feedback training on peak tibial acceleration during running outside of the biomechanics laboratory

Gait retraining that stimulates impact reduction has resulted in fewer injuries in novice runners (Chan et al., 2018). However, feedback-driven retraining performed at a fixed running speed has bee...

Prognosis and prognostic factors of running-related injuries in novice runners: A prospective cohort study

ObjectivesTo investigate the prognosis and possible prognostic factors of running-related injuries (RRIs) in novice runners. DesignProspective cohort study. MethodsParticipants of Start to Run, a 6-weeks course for novice runners in The Netherlands, were asked to participate in this study. Before the start of the course a baseline questionnaire, on demographics, physical activity and perceived health, was sent to runners willing to participate. The 26- or 52-weeks follow-up questionnaires assessed information on RRIs and their duration. Only participants that sustained a RRI during follow-up were included in the analyses. An injury duration of 10weeks or shorter was regarded as a relatively good prognosis, while an injury duration of more than 10weeks was defined as a poor prognosis. To determine the associations between baseline characteristics and injury prognosis and between injury location and injury prognosis, multivariable logistic regression analyses were performed. Results347 participants (48.8%) sustained an RRI during follow-up. The RRIs had an overall median duration of eight weeks (range: 1–52weeks). Participants with a previous RRI were more likely to have a poor prognosis (OR 2.31; 95%CI 1.12–4.79), while a calf injury showed a trend towards an association with a relatively good prognosis (OR 0.49; 95%CI 0.22–1.11). ConclusionsThe duration of RRIs in novice runners is relatively long, with only calf injuries being associated with a good prognosis. This emphasizes the need of injury prevention measures in novice runners and adequate support during and after an RRI, especially in runners with a previous injury.

Lower Extremity Injuries in Novice Runners: Incidence, Types, Time Patterns, Sociodemographic and Motivational Risk Factors in a Prospective Cohort Study.

SUMMARY – The aim was to determine types and incidence of running-related lower extremity injuries and identify sociodemographic and motivational risk factors in novice runners attending an eight-month running school. Between January 2011 and October 2014, 349 novice runners were included. Sociodemographic, anthropometric, and data on running motivation and self-perceived health and fitness were collected. Subjects were screened for lower extremity injuries at regular three-month intervals. The cohort mean age was 35.46±7.31 years, and 271 (79.5%) were female. There were 173 (49.9%) injuries recorded, less frequently among women (42.9% vs. 62.7%, p=0.016; OR 0.878, 95% CI 0.788-0.977). The mean body mass index was 23.89±3.88 kg/m2 at baseline and 22.99±3.35 kg/m2 post-school (p<0.001). Median self-perceived fitness level on a ten-point visual analog scale was 4 (interquartile range (IQR) 3-5) at baseline and 8 (IQR 7-8) post-school (p<0.001). Median self-perceived overall health was 6 (IQR 5-8) at baseline and 8 (IQR 7-9) post-school (p<0.001). The knee had a significantly higher rate of injuries compared to other anatomic regions (p<0.001). Subjects listed improvement of fitness as the most common motivation for entering the school (n=159; 45.7%). In conclusion, novice runners should include strengthening exercises for knee injury prevention into their training routine.

A STUDY ON MEDICATION USE AND INJURIES IN OVER 1500 NOVICE RUNNERS

BackgroundIn sedentary subjects use of medication is expected to be high which may cause problems when taking up exercise as several types of medication have been linked to musculoskeletal disorders.ObjectiveTo...

THE IMPACT OF RUNNING INJURIES IN RELATION TO OTHER REASONS FOR DISCONTINUED RUNNING IN NOVICE RUNNERS

BackgroundThe risk of running injuries in novice runners is 17.8 (16.7–19.1) per 1000 h of running (Videbæk 2015). This might lead to the conclusion that running injuries are one of...

Running injuries in novice runners enrolled in different training interventions: a pilot randomized controlled trial.

NCT01900262. A total of 52 of the 129 (40%) novice runners experienced at least one running related injury: 21 in the functional strength training program, 16 in the resistance strength training program and 15 in the control stretching program. Injury rates did not differ between study groups [IR=32.9 (95% CI 20.8, 49.3) in the functional group, IR=31.6 (95% CI 18.4, 50.5) in the resistance group, and IR=26.7 (95% CI 15.2, 43.2)] in the control group. Although this was a pilot assessment, home-based strength training did not appear to alter injury rates compared to stretching. Future studies should consider methods to minimize participant drop out to allow for the assessment of injury risk. Injury risk in novice runners based on this pilot study will inform the development of future larger studies investigating the impact of injury prevention interventions.

The NLstart2run study: Economic burden of running-related injuries in novice runners participating in a novice running program.

To investigate the economic burden of running-related injuries (RRI) occurred during the 6-week 'Start-to-Run' program of the Dutch Athletics Federation in 2013. Prospective cohort study. This was a monetary cost analysis using the data prospectively gathered alongside the RRI registration in the NLstart2run study. RRI data were collected weekly. Cost diaries were applied two and six weeks after the RRI registration to collect data regarding healthcare utilisation (direct costs) and absenteeism from paid and unpaid work (indirect costs). RRI was defined as running-related pain that hampered running ability for three consecutive training sessions. From the 1696 participants included in the analysis, 185 reported a total of 272 RRIs. A total of 26.1% of the cost data (71 RRIs reported by 50 participants) were missing. Therefore, a multiple imputation procedure was performed. The economic burden (direct plus indirect costs) of RRIs was estimated at €83.22 (95% CI €50.42-€116.02) per RRI, and €13.35 (95% CI €7.07-€19.63) per participant. The direct cost per RRI was €56.93 (95% CI €42.05-€71.81) and the indirect cost per RRI was €26.29 (95% CI €0.00-€54.79). The indirect cost was higher for sudden onset RRIs than for gradual onset RRIs, with a mean difference of €33.92 (95% CI €17.96-€49.87). Direct costs of RRIs were 2-fold higher than the indirect costs, and sudden onset RRIs presented higher costs than gradual onset RRIs. The results of this study are important to provide information to public health agencies and policymakers about the economic burden of RRIs in novice runners.

The NLstart2run study: Training-related factors associated with running-related injuries in novice runners

The incidence of running-related injuries is high. Some risk factors for injury were identified in novice runners, however, not much is known about the effect of training factors on injury risk. Therefore, the purpose of this study was to examine the associations between training factors and running-related injuries in novice runners, taking the time varying nature of these training-related factors into account. Prospective cohort study. 1696 participants completed weekly diaries on running exposure and injuries during a 6-week running program for novice runners. Total running volume (min), frequency and mean intensity (Rate of Perceived Exertion) were calculated for the seven days prior to each training session. The association of these time-varying variables with injury was determined in an extended Cox regression analysis. The results of the multivariable analysis showed that running with a higher intensity in the previous week was associated with a higher injury risk. Running frequency was not significantly associated with injury, however a trend towards running three times per week being more hazardous than two times could be observed. Finally, lower running volume was associated with a higher risk of sustaining an injury. These results suggest that running more than 60min at a lower intensity is least injurious. This finding is contrary to our expectations and is presumably the result of other factors. Therefore, the findings should not be used plainly as a guideline for novices. More research is needed to establish the person-specific training patterns that are associated with injury.

Incidence of Running-Related Injuries Per 1000 h of running in Different Types of Runners: A Systematic Review and Meta-Analysis.

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.Electronic supplementary materialThe online version of this article (doi:10.1007/s40279-015-0333-8) contains supplementary material, which is available to authorized users.

The NLstart2run study: Incidence and risk factors of running-related injuries in novice runners.

Running is a popular form of physical activity, despite of the high incidence of running-related injuries (RRIs). Because of methodological issues, the etiology of RRIs remains unclear. Therefore, the purposes of the study were to assess the incidence of RRIs and to identify risk factors for RRIs in a large group of novice runners. In total, 1696 runners of a 6-week supervised "Start to Run" program were included in the NLstart2run study. All participants were aged between 18 and 65, completed a baseline questionnaire that covered potential risk factors, and completed at least one running diary. RRIs were registered during the program with a weekly running log. An RRI was defined as a musculo-skeletal complaint of the lower extremity or back attributed to running and hampering running ability for three consecutive training sessions. During the running program, 10.9% of the runners sustained an RRI. The multivariable Cox regression analysis showed that a higher age, higher BMI, previous musculo-skeletal complaints not attributed to sports and no previous running experience were related to RRI. These findings indicate that many novice runners participating in a short-term running program suffer from RRIs. Therefore, the identified risk factors should be considered for screening and prevention purposes.

Do novice runners have weak hips and bad running form?

First, we sought to better understand the predisposition of novice female runners to injury by identifying potential differences in running mechanics and strength between experienced female runners and active novice runners. Secondly, we aimed to assess the relationship between hip and trunk strength with non-sagittal hip kinematics during running. Two female populations were recruited: 19 healthy experienced runners and 19 healthy active novice runners. Strength measurements of the hip abductors and external rotators were measured using a hand held dynamometer while trunk endurance was assessed via a side-plank. Next, an instrumented gait analysis was performed while each participant ran at 3.3m/s. Group comparisons were made using an independent t-test to identify differences in the impact peak, loading rate, peak non-sagittal hip joint angles, trunk endurance, and hip strength. Pearson's correlation coefficients were calculated between hip kinematics and strength measurements. There were no statistically significant differences in impact peak, loading rate, peak non-sagittal hip kinematics, or strength. However, the novice runners did show a clinically meaningful trend toward increased peak hip internal rotation by 3.8° (effect size 0.520). A decrease in trunk side-plank endurance was associated with an increased peak hip internal rotation angle (r=−0.357, p=0.03), whereas isometric strength was not related to kinematics. Programs aiming to prevent injuries in novice runners should target trunk performance and possibly hip neuromuscular control, rather than hip strength.

The effectiveness of a preconditioning programme on preventing running-related injuries in novice runners: a randomised controlled trial

ObjectivesThere is no consensus on the aetiology and prevention of running-related injuries in runners. Preconditioning studies among different athlete populations show positive effects on the incidence of sports injuries.HypothesisA 4-week...

Interventions for preventing lower limb soft-tissue running injuries

Overuse soft-tissue injuries occur frequently in runners. Stretching exercises, modification of training schedules, and the use of protective devices such as braces and insoles are often advocated for prevention. This is an update of a review first published in 2001. To assess the effects of interventions for preventing lower limb soft-tissue running injuries. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (March 2011); The Cochrane Library 2010, Issue 4; MEDLINE (1966 to January 2011); EMBASE (1980 to January 2011); and international trial registries (17 January 2011). Randomised or quasi-randomised trials evaluating interventions to prevent lower limb soft-tissue running injuries. Two authors independently assessed risk of bias (relating to sequence generation, allocation concealment, blinding, incomplete outcome data) and extracted data. Data were adjusted for clustering if necessary and pooled using the fixed-effect model when appropriate. We included 25 trials (30,252 participants). Participants were military recruits (19 trials), runners from the general population (three trials), soccer referees (one trial), and prisoners (two trials). The interventions tested in the included trials fell into four main preventive strategies: exercises, modification of training schedules, use of orthoses, and footwear and socks. All 25 included trials were judged as 'unclear' or 'high' risk of bias for at least one of the four domains listed above.We found no evidence that stretching reduces lower limb soft-tissue injuries (6 trials; 5130 participants; risk ratio [RR] 0.85, 95% confidence interval [95% CI] 0.65 to 1.12). As with all non-significant results, this is compatible with either a reduction or an increase in soft-tissue injuries. We found no evidence to support a training regimen of conditioning exercises to improve strength, flexibility and coordination (one trial; 1020 participants; RR 1.20, 95% CI 0.77 to 1.87).We found no evidence that a longer, more gradual increase in training reduces injuries in novice runners (one trial; 486 participants; RR 1.02, 95% CI 0.72 to 1.45). There was some evidence from a poor quality trial that additional training resulted in a significant increase in the number of naval recruits with shin splints (one trial; 1670 participants; RR 2.02, 95% CI 1.11 to 3.70). There was limited evidence that injuries were less frequent in prisoners when running duration (one trial; 69 participants; RR 0.41, 95% CI 0.21 to 0.79) or frequency (one trial; 58 participants; RR 0.19, 95% CI 0.06 to 0.66) were reduced.Patellofemoral braces appear to be effective for preventing anterior knee pain (two trials; 227 participants; RR 0.41, 95% CI 0.24 to 0.67).Custom-made biomechanical insoles may be more effective than no insoles for reducing shin splints (medial tibial stress syndrome) in military recruits (one trial; 146 participants; RR 0.24, 95% CI 0.08 to 0.69).We found no evidence in military recruits that wearing running shoes based on foot shape, rather than standard running shoes, significantly reduced rate of running injuries (2 trials; 5795 participants; Rate Ratio 1.03, 95% CI 0.93 to 1.14). Overall, the evidence base for the effectiveness of interventions to reduce soft-tissue injury after intensive running is very weak, with few trials at low risk of bias. More well-designed and reported RCTs are needed that test interventions in recreational and competitive runners.

The GRONORUN 2 study: effectiveness of a preconditioning program on preventing running related injuries in novice runners. The design of a randomized controlled trial

BackgroundDistance running is a popular recreational exercise. It is a beneficial activity for health and well being. However, running may also cause injuries, especially of the lower extremities. In literature there is no agreement what intrinsic and extrinsic factors cause running related injuries (RRIs). In theory, most RRIs are elicited by training errors, this too much, too soon. In a preconditioning program runners can adapt more gradually to the high mechanical loads of running and will be less susceptible to RRIs. In this study the effectiveness of a 4-week preconditioning program on the incidence of RRIs in novice runners prior to a training program will be studied.Methods/DesignThe GRONORUN 2 (Groningen Novice Running) study is a two arm randomized controlled trial studying the effect of a 4-week preconditioning (PRECON) program in a group of novice runners. All participants wanted to train for the recreational Groningen 4-Mile running event. The PRECON group started a 4-week preconditioning program with walking and hopping exercises 4 weeks before the start of the training program. The control (CON) and PRECON group started a frequently used 9-week training program in preparation for the Groningen 4-Mile running event.During the follow up period participants registered their running exposure, other sporting activities and running related injuries in an Internet based running log. The primary outcome measure was the number of RRIs. RRI was defined as a musculoskeletal ailment or complaint of the lower extremities or back causing a restriction on running for at least three training sessions.DiscussionThe GRONORUN 2 study will add important information to the existing running science. The concept of preconditioning is easy to implement in existing training programs and will hopefully prevent RRIs especially in novice runners.Trial registrationThe Netherlands National Trial Register NTR1906. The NTR is part of the WHO Primary Registries.

Predictors of Running-Related Injuries in Novice Runners Enrolled in a Systematic Training Program

Background The popularity of running is still growing. As participation increases, running-related injuries also increase. Until now, little is known about the predictors for injuries in novice runners. Hypothesis Predictors for running-related injuries (RRIs) will differ between male and female novice runners. Study Design Cohort study; Level of evidence, 2. Methods Participants were 532 novice runners (226 men, 306 women) preparing for a recreational 4-mile (6.7-km) running event. After completing a baseline questionnaire and undergoing an orthopaedic examination, they were followed during the training period of 13 weeks. An RRI was defined as any self-reported running-related musculoskeletal pain of the lower extremity or back causing a restriction of running for at least 1 week. Results Twenty-one percent of the novice runners had at least one RRI during follow-up. The multivariate adjusted Cox regression model for male participants showed that body mass index (BMI) (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.05-1.26), previous injury in the past year (HR, 2.7; 95% CI, 1.36-5.55), and previous participation in sports without axial load (HR, 2.05; 95% CI, 1.03-4.11) were associated with RRI. In female participants, only navicular drop (HR, 0.85; 95% CI, 0.75-0.97) remained a significant predictor for RRI in the multivariate Cox regression modeling. Type A behavior and range of motion (ROM) of the hip and ankle did not affect risk. Conclusion Male and female novice runners have different risk profiles. Higher BMI, previous injury, and previous sports participation without axial loading are important predictors for RRI in male participants. Further research is needed to detect more predictors for female novice runners.

No Effect of a Graded Training Program on the Number of Running-Related Injuries in Novice Runners

Background Although running has positive effects on health and fitness, the incidence of a running-related injury (RRI) is high. Research on prevention of RRI is scarce; to date, no studies have involved novice runners. Hypothesis A graded training program for novice runners will lead to a decrease in the absolute number of RRIs compared with a standard training program. Study Design Randomized controlled trial; Level of evidence, 1. Methods GRONORUN (Groningen Novice Running) is a 2-armed randomized controlled trial comparing a standard 8-week training program (control group) and an adapted, graded, 13-week training program (intervention group), on the risk of sustaining an RRI. Participants were novice runners (N = 532) preparing for a recreational 4-mile (6.7-km) running event. The graded 13-week training program was based on the 10% training rule. Both groups registered information on running characteristics and RRI using an Internet-based running log. The primary outcome measure was RRIs per 100 participants. An RRI was defined as any musculoskeletal complaint of the lower extremity or back causing a restriction of running for at least 1 week. Results The graded training program was not preventive for sustaining an RRI (χ 2 = 0.016, df = 1, P = .90). The incidence of RRI was 20.8% in the graded training program group and 20.3% in the standard training program group. Conclusions This randomized controlled trial showed no effect of a graded training program (13 weeks) in novice runners, applying the 10% rule, on the incidence of RRI compared with a standard 8-week training program.