Running Injuries Research Articles

EFICÁCIA DA INTERVENÇÃO FISIOTERAPÊUTICA EM CORREDORES NO ESPORTE: UM ESTUDO DE REVISÃO

INTRODUCTION: The incidence of sports injuries varies by type of sport, duration of practice, and competitiveness. In 2018-19, Australia spent approximately 1.2 billion AUD on treating sports injuries, highlighting the financial impact. The prevalence of lower limb injuries among runners ranges from 19.4% to 79.3%, emphasizing the need for effective prevention. Intensive training can lead to injuries; prevention is crucial to maintain long-term performance. METHODOLOGY: The review, conducted between October and December 2024, involved research in scientific databases such as PubMed, Scopus, Cochrane Library, and LILACS. Studies between 2019 and 2024 using the following descriptors: Physical Therapy Services AND Running AND Treatment, in Portuguese, English, and Spanish. RESULTS: A total of 1,143 articles were found in the search. After excluding duplicate studies and those involving animals, 230 met the criteria. Of these, 9 articles were read in full, and only 5 articles met the inclusion criteria for the review. DISCUSSION: Physiotherapeutic interventions are essential in the prevention and treatment of injuries in runners, with techniques such as cryotherapy and massage proving effective. Personalized training programs, including nutritional assessments, improve athletes’ healing and performance. CONCLUSION: New studies are needed to expand knowledge and validate existing strategies.

The Running Readiness Scale and Injury in Collegiate Track & Field and Cross Country Athletes.

Track & field and cross country athletes experience high rates of lower extremity injuries. The Running Readiness Scale (RRS) may help determine which athletes have a higher likelihood of lower extremity injury. To determine if RRS performance at the start of the season was related to likelihood of experiencing a lower extremity injury during the subsequent track & field or cross country season. Prospective cohort study. University. 113 NCAA Division III track & field athletes in running, jumping and vaulting events and cross country runners (50 female, 63 male, mean±SD age 19.9±1.3 years). Athletes were assessed on RRS tasks: double-leg hops, plank, step ups, single-leg squats, and wall sit at the start of their season and then were observed by team athletic trainers during the season for occurrence of lower extremity injuries that resulted in missing one or more practices or meets. Adjusted Odds Ratios (AOR) and 95% confidence intervals (CIs) were used to assess the likelihood of lower extremity injury. Thirty-seven athletes (32.7%) experienced a lower extremity injury. Athletes scoring ≤3 on the RRS were almost five times more likely to experience lower extremity injury (AOR=4.8; 95%CI: 2.1-11.3) than athletes scoring ≥ 4. Athletes failing double-leg hops or wall sit tasks were more likely to experience lower extremity injury (p<0.05). Track & field and cross country athletes with RRS scores of ≤3 had a higher likelihood of lower extremity injury than those with scores of ≥4.

Predictors of pelvic acceleration during treadmill running across various stride frequency conditions

ABSTRACT Pelvic running injuries often require extensive rehabilitation and pelvic girdle pain is a barrier to running engagement in population sub-groups, such as perinatal women. However, exploration into how external pelvic loading may be altered during running is limited. This study assessed which biomechanical variables influence changes in external peak pelvic acceleration during treadmill running, across various stride frequency conditions. Twelve participants (7 female, 5 male) ran (9 km∙h−1) at their preferred stride frequency, and at ± 5% and ± 10% of their preferred stride frequency. Coordinate and acceleration data were collected using a motion capture system and inertial measurement units. Linear mixed models assessed peak tibial acceleration, displacement from hip to knee and ankle, contact time, and stride frequency as predictors of peak pelvic acceleration. Stride frequency and contact time interacted to predict peak vertical (p = .006) and resultant (p = .009) pelvic acceleration. When modelled, short contact times and low stride frequencies produced higher peak vertical (p = .007) and resultant (p = .016) pelvic accelerations than short contact times and average, or high stride frequencies. Increasing contact time, or increasing stride frequency at shorter contact times, may therefore be useful in reducing pelvic acceleration during treadmill running.

Using Self-Reported Training Characteristics to Better Understand Who Is More Likely to Sustain Running-Related Injuries Than Others: The Garmin-RUNSAFE Running Health Study.

Running is a popular form of physical activity, yet it comes with risks, including running-related injuries (RRIs). This cohort study aimed to use self-reported baseline data on running experience, weekly running frequency, greatest running distance in 1 week, and running program to investigate if certain adult runners were more likely to sustain RRI than others. Runners, aged ≥ 18 years, familiar with the English language and using a Garmin watch to track their running were included. Running data and injury status were collected prospectively through the Garmin Connect application and weekly questionnaires over 18 months. Exposure variables were self-reported running experience (years), weekly running frequency and distance, and use of structured running program (last 3 months before inclusion). The outcome was RRI. Time to event statistics was used to calculate cumulative risk differences (cRD) within groups of each exposure. Data were analyzed at 1000 km (km). A total of 7391 runners were included. The cumulative injury proportion was 57.8% [95% CI: 56.4%; 59.2%] after 1000 km. Those running > 105 km (cRD = -31.6, 95% CI -23.1; -40.1), 7 times per week (cRD = -47.1, 95% CI -35.9; -58.3) and followed a structured running program (cRD = 4.4; 95% CI 0.9; 7.8) had the fewest new RRIs. For running experience, those with few (< 1 years) or many years (> 40 years) of experience had the most RRIs. Runners were more prone to sustain an RRI if they had few (< 1) or many (> 40) years of running experience, lower total weekly running frequency (< 2 times/week), shorter weekly running distance (< 25 km), or did not use a structured running program.

Accuracy of self-reported foot strike pattern detection among endurance runners.

Foot strike pattern is often associated with running related injury and the focus of training and rehabilitation for athletes. The ability to modify foot strike pattern depends on awareness of foot strike pattern before being able to attempt change the pattern. Accurate foot strike pattern detection may help prevent running related injury (RRI) and facilitate gait modifications and shoe transitions. The purposes of this study were to determine the accuracy of self-reported foot strike pattern among endurance runners, to identify what factors were predictive of accurate foot strike detection and recent RRI. This was a retrospective, cross-sectional study which included endurance runners (N = 710; 51.5% female; 35.4 ± 15.5 years; 51.6% were training competitively at the time of testing) with different running injury histories. Runners self-reported foot strike pattern [rearfoot, non-rearfoot (mid or forefoot), or "don't know"] and information about shoewear specifics. All runners performed a single session of running at self-selected speed on an instrumented treadmill with 3D motion capture and high-speed filming that verified actual foot strike. Logistic regression was used to predict accuracy of foot strike detection and RRI. Overall accuracy of foot strike detection was low (42.7%; p < 0.01). Self-reported foot strike was 28.3% for rearfoot, 47.0% for nonrearfoot forefoot strike and 24.6% did not know. Biomechanical analyses actually showed that 34% of rearfoot strikers accurately detected rearfoot strike, while 69.5% of non-rearfoot strikers self-reported accurate non-rearfoot strike (p < 0.05). Runners who "did not know" their strike had the highest prevalence of RRI compared to runners who self-reported nonrearfoot or rearfoot strike (73% vs. 56% and 58%; p < .001). After accounting for several variables, shoe heel-to-toe drop was a consistent predictor of accurate strike detection [OR = 0.93 (0.88-0.99); p = 0.026] and RRI in last six months [OR = 1. 1 (1.01-1.17); p = 0.018]. RRI were also predicted by recent shoe change [OR = 2.8 (1.7-4.6); p < 0.001]. Accurate detection of actual foot strike by endurance runners varies by the actual foot strike type determined during testing and is associated shoe characteristics. These findings demonstrate the importance of accurately identifying foot strike pattern and recommending footwear as a factor if planning to use retraining to alter foot strike pattern.

Sex Differences and Extracorporeal Shockwave Therapy Outcomes in Runners with Achilles or Hamstring Tendinopathy.

Background/Objectives: Achilles and hamstring tendinopathies are common injuries in runners, and extracorporeal shockwave therapy (ESWT) may be an effective treatment. Runners are at risk for lower extremity tendinopathies and the Male and Female Athlete Triad (Triad). The purpose of this study is to evaluate the association of sex, exposure to hormonal contraceptives, menopause, and Triad-related risk factors with ESWT outcomes in the treatment of Achilles and hamstring tendinopathy. Methods: This is a retrospective cohort study of runners with either Achilles or hamstring tendinopathy who received radial or combined radial and focused ESWT. Tendon function was measured using Victorian Institute of Sport Assessment (VISA) questionnaires completed before and following treatment. Treatment success was defined by a change in VISA score that met the minimal clinically important difference (MCID). Results: There were 88 runners (54.5% female, 45.5% male) with Achilles (52.3%) or hamstring (47.7%) tendinopathy. No measurable difference was found in the proportion of females and males overall that achieved the MCID (57.1% and 72.5%, p = 0.17). Similar rates of females and males met MCID for Achilles (77.8% and 75.0%, p = 0.83) and hamstring tendinopathy (46.7% and 66.7%, p = 0.24). However, females with Achilles or hamstring tendinopathy who used oral contraceptive pills (OCPs) were less likely to meet the MCID compared to females not on OCPs (p = 0.031); this finding was present in a subgroup analysis of runners with only Achilles tendinopathy (p = 0.025). No associations were found between achieving the MCID and Triad risk factors, including body mass index, energy availability, weight-related behaviors, bone health, or menstrual function (all p > 0.05). Conclusions: Female and male runners reported similar success rates for ESWT, and Triad risk factors were not found to impact outcomes. However, females who used oral contraceptive pills were less likely to achieve the MCID from ESWT.

Using complex systems to understand running-related injuries

ABSTRACT This study aims to investigate anthropometric and training characteristics associated with injuries in runners using a complex approach. We conducted a cross-sectional study with 97 Brazilian runners of both sexes (age: 39.1 ± 11.5 years; body mass index: 24.2 ± 4.2 kg/m2). A web survey was used for data collection, including age, sex, body weight, body height, training volume/frequency, session duration, running pace and injury information (yes or no; the number of injuries). The partial correlation parameter was used for network estimation, considering both sexes. For women, injury occurrence was positively and strongly associated with training frequency (r = 0.57) and the number of competitions (r = 0.64), while for men, a negative and strong association was found with age (r=-0.69), and positive associations were observed with BMI (r = 0.89) and training volume (r = 0.82). Network centrality showed that training session duration and the number of competitions/year presented a higher expected influence value for women (−1.47) and men (−1.31). Using a non-linear approach with Brazilian non-professional runners, training characteristics had a stronger influence on running-related injuries.

Incidence, severity, and risk factors for injuries in female trail runners – A retrospective cross-sectional study

ObjectivesTo determine the incidence, severity, and nature of injuries sustained by female trail runners and investigate selected training variables as risk factors for injuries. DesignCross-sectional, retrospective cohort study. SettingOnline questionnaire (Jisc Online Surveys). ParticipantsFemale trail runners (n = 62) aged 39.1 ± 12.4 years. Main outcome measuresTraining metrics (average weekly number of running sessions, mileage (km), session duration (mins), pace (min/km), ascent (m) and descent (m), number of running doubles per week, number of cross training doubles per week, type of cross training), incidence, severity and nature of trail running injuries sustained in the previous 12 months. ResultsThe injury incidence was 14.3 injuries per 1000 h and mean severity score (OSTRC- H) was 80.95 ± 21.74. The main anatomical region affected was the lower limb (63.4%), primarily the ankle (13.9%), knee (13.0%) and lower leg (12.2%). The most common injury was tendinopathy (25.2%). A higher number of injuries sustained in the previous 12 months was weakly associated with a higher average duration of other (not trail) weekly running sessions (p = 0.017). ConclusionsFindings from this study could inform future injury prevention and treatment strategies. Prospective, longitudinal data on injuries in female trail runners is needed.

The effect of PNF combination exercise therapy on shin splint injuries in marathon runners

Training at high intensity without proper warm-up and cool-down can cause shin splint injuries in runners. This may lead to a decline in the athlete’s performance during training and competition. This study aims to determine the effect of PNF training therapy on shin splint injuries in marathon runners. This research employs a quasi-experimental approach with a One Group Pretest-Posttest Design. Data collection methods include tests and measurements using a goniometer to assess joint range of motion (ROM) and the Visual Analogue Scale (VAS) to measure pain levels. The population in this study consisted of running athletes from the Yogyakarta running community, with a sample of 16 individuals selected based on specific criteria. The study results showed a significant average reduction in knee pain of 1.00 and ankle pain of 0.94. Additionally, an increase in knee ROM was observed: flexion increased by 7.81; extension by 7.82; adduction by 4.25; and abduction by 3.75. Ankle ROM also increased: dorsiflexion by 5.94, plantarflexion by 3.62, inversion by 3.57, and eversion by 2.68.

Translation, cross-cultural adaptation, validation, and reliability of the University of Wisconsin running injury and recovery index to Brazilian Portuguese (UWRI-BR)

ObjectiveTo translate and cross-culturally adapt the University of Wisconsin Running Injury and Recovery (UWRI) to Brazilian Portuguese (UWRI-BR) and assess its psychometric properties. MethodsThe Brazilian version of the UWRI questionnaire was based on the guideline proposed by Guillemin. The UWRI was translated, back-translated, and culturally adapted. Fifty runners responded to the pre-final version to validate the final version. Ninety-seven runners participated in the content validity of the UWRI-BR, and 58 runners in the assessment of reliability baseline 48–72 h after the first response. The Lower Extremity Functional Scale (LEFS) and 12-item Short Form Health Survey (SF-12) version 2 (SF-12_2) were applied to construct validity. ResultsThe final version of UWRI-BR showed a positive moderate correlation with LEFS (r = 0.65, p < 0.01) and weak with SF-12_2 (r = 0.31, p < 0.01). UWRI-BR showed excellent internal consistency (α = 0.92) and test-retest Reliability (ICC = 0.83; 95% CI (0,72–0,90). ConclusionThe Brazilian version of the UWRI was a valid and reliable tool for evaluating and monitoring the progression of runners with running-related injuries.

Research on Optimal Control of Treadmill Shock Absorption Based on Ground Reaction Force Constraint

Research shows that treadmill shock-absorbing devices can reduce the impact of ground reaction forces on the knee and ankle joints during running. Most existing treadmills use fixed or passive shock absorption, meaning their shock-absorbing systems do not actively adjust to changes in ground reaction forces (GRFs). Methods: This study establishes a mathematical model integrating human motion biomechanics and treadmill running surfaces, analyzing the relationships between various parameters affecting the system. Ultimately, an optimal shock-absorbing treadmill control system is designed, utilizing a microcontroller as the main control unit, airbags for shock absorption, and a widely used foot pressure testing system. Objective: The goal is to more effectively prevent running injuries caused by excessive foot pressure. Compared to conventional shock absorption systems, this design features an active multilevel adjustment function with higher precision in regulation. Results: The experimental results demonstrate that the ground reaction force (GRF) generated by the optimal shock-absorbing treadmill control system is reduced by up to 10% compared to that of a conventional shock-absorbing treadmill. Conclusions: This leads to a smaller impact force on the knees due to foot pressure, resulting in better injury prevention outcomes.

Runners injuries - main types of injuries of the musculoskeletal system of the lower limb and their treatment and prevention

Introduction and purposeRunning is currently one of the most popular physical activities practiced by people around the world, and the number of runners has been growing significantly for many years. The incidence of running-related lower limb injuries in runners ranges between 19.4% and 79.3% [1].The paper presents research results on the main types of injuries of the musculoskeletal system of the lower limb in runners, their risk factors, methods of treatment and prevention. The results indicate a significant relationship between regular training and the occurrence of injuries, and also emphasize the importance of prevention through rest, appropriate running technique and the selection of footwear. The work provides practical tips for runners and coaches that can help reduce the risk of injuries and improve the quality of training. Materials and methods The review was conducted by searching PubMed and other scientific databases focusing on currently available publications. The literature available in the PubMed database was reviewed using the following keywords: “running”, “running injuries”, “tendinopathy”, "running related injuries”, “running biomechanics”, “musculoskeletal injuries”. The analysis of 38 articles published between 2014-2024 was used to write the paper. Conclusions Running has many health benefits, but unfortunately it can also have a negative effect. The development of medical literature regarding appropriate prevention, knowledge of risk factors and treatment methods improves the prognosis of injuries in runners. Evolving diagnostic imaging, body monitoring, prevention, and adequate rest between activities are essential to long-term success in preventing running-related injuries.

A Robotic Clamped-Kinematic System to Study Knee Ligament Injury.

Knee ligament injury is among the most common sports injuries and is associated with long recovery periods and low return-to-sport rates. Unfortunately, the mechanics of ligament injury are difficult to study in vivo, and computational studies provide limited insight. The objective of this study was to implement and validate a robotic system capable of reproducing natural six degree-of-freedom clamped-kinematic trajectories on human cadaver knees (meaning that positions and orientations are rigidly controlled and resultant loads are measured). To accomplish this, we leveraged the field's recent access to high-fidelity bone kinematics from dynamic biplanar radiography (DBR), and implemented these kinematics in a coordinate frame built around the knee's natural flexion-extension axis. We assessed our system's capabilities in the context of ACL injury, by moving seven cadaveric knee specimens through kinematics derived from walking, running, drop jump, and ACL injury. We then used robotically simulated clinical stability tests to evaluate the hypothesis that knee stability would be only reduced by the motions intended to injure the knee. Our results show that the structural integrity of the knee was not compromised by non-injurious motions, while the injury motion produced a clinically relevant ACL injury with characteristic anterior and valgus instability. We also demonstrated that our robotic system can provide direct measurements of reaction loads during a variety of motions, and facilitate gross evaluation of ligament failure mechanisms. Clamped-kinematic robotic evaluation of cadaver knees has the potential to deepen understanding of the mechanics of knee ligament injury.

Comparison of Weekly Training Load and Acute: Chronic Workload Ratio Methods to Estimate Change in Training Load in Running.

Before examining the impact of training load on injury risk in runners, it is important to gain insight into the differences between methods that are used to measure change in training load. To investigate differences between 4 methods when calculating change in training load: (1) weekly training load; (2) acute : chronic workload ratio (ACWR), coupled rolling average (RA); (3) ACWR, uncoupled RA; (4) ACWR, exponentially weighted moving average (EWMA). Descriptive epidemiology study. This study is part of a randomized controlled trial on running injury prevention among recreational runners. Runners received a baseline questionnaire and a request to share global positioning system training data. Runners who registered for running events (distances 10-42.195 km) in the Netherlands. The primary outcome measure was the predefined significant increase in training load (weekly training loads ≥ 30% progression and ACWRs ≥ 1.5), based on training distance. Proportional Venn diagrams visualized the differences between the methods. A total of 430 participants (73.3% men; mean age = 44.3 ± 12.2 years) shared their global positioning system training data for a total of 22 839 training sessions. For the weekly training load, coupled RA, uncoupled RA, and EWMA method, respectively, 33.4% (95% CI = 32.8, 34.0), 16.2% (95% CI = 15.7, 16.6), 25.8% (95% CI = 25.3, 26.4), and 18.9% (95% CI = 18.4, 19.4) of the training sessions were classified as significant increases in training load. Of the training sessions with significant increases in training load, 43.0% from the weekly training load method were different than the coupled RA and EWMA methods. Training sessions with significant increases in training load based on the coupled RA method showed 100% overlap with the uncoupled RA and EWMA methods. The difference in the change in training load measured by weekly training load and ACWR methods was high. To validate an appropriate measure of change in training load in runners, future research on the association between training loads and running-related injury risk is needed.

Interlaboratory Study Toward Combining Gait Kinematics Data Sets of Long-Distance Runners.

The limited sample size in gait studies has hampered progress in the field. This challenge could be addressed through multicenter studies, thereby leveraging data sets from different laboratories. This study compared 3-dimensional lower-extremity running kinematics between the Biomechanics and Motor Control Laboratory, Federal University of ABC (Brazil), and the Running Injury Clinic, University of Calgary (Canada). Three-dimensional lower-extremity kinematics from 23 male runners were collected from each laboratory using comparable instrumentation and experimental procedures. The 3-dimensional hip, knee, and ankle angles were compared within and between centers using root-mean-square deviation. Two-sample t tests Statistical Parametric Mapping tested the hypothesis that the data from both laboratories were not different. The sagittal plane hip, knee, and ankle angles were similar between laboratories, while notable differences were observed for frontal (hip and ankle) and transverse (hip and knee) plane angles. The average interlaboratory root-mean-square deviation (2.6°) was lower than the intralaboratory root-mean-square deviation (Biomechanics and Motor Control = 4.8°, Running Injury Clinic = 5.6°), with the ankle transverse angle displaying the smallest, and the knee transverse angle displaying the largest variability. This study demonstrates the potential of combining gait kinematics data from different laboratories to increase sample size, but frontal and transverse plane data should be considered with caution.

TCM diagnostics for injury prevention in Mid/Long-Distance runs

The middle and long-distance running event in the "College Students' Physical Health Standards" test has the effect of enhancing students' willpower, expressiveness, and social adaptability. However, injuries are highly likely to occur during the middle and long-distance running, which can cause physical harm and mental pressure to schools, teachers, parents, and students, and affect the authenticity of the test results. The "Four Diagnostic Methods" of Traditional Chinese Medicine (TCM) are treasures of our country's traditional medical culture. By utilizing the rich theories and experiences of TCM' s "Four Diagnostic Methods" to explore the hidden dangers that lead to sports injuries, it is possible to prevent injuries in middle and long-distance running at an early stage and reduce the occurrence of sports injuries.

The Dogma of Running Injuries: Perceptions of Adolescent and Adult Runners.

Adults perceive certain factors to increase or decrease the risk of sustaining running-related injuries, but many of their perceptions are not supported by research. Little is known about the perceptions that adolescent runners hold. Investigating perceptions for adolescent runners is needed to assist in the development of future injury educational materials, as these resources may need to be tailored differently for adolescents and adults. To identify factors that adolescent runners perceive as risk or protective factors for running-related injuries and to compare these perceptions with those of adult runners. Cross-sectional study. Online survey. We surveyed 302 adolescent (164 females, 138 males; age = 16.0 ± 1.4 years [range, 12-19 years]) and 357 adult runners (197 women, 160 men; age = 40.7 ± 11.8 years [range, 20-77 years]). Participants completed a survey with questions about whether factors related to training habits, footwear, biomechanics, strength, stretching, or nutrition influence the risk of sustaining a running-related injury. If ≥75% of adolescents indicated that a factor increases or decreases the risk of sustaining an injury, we considered that factor to be a perceived risk or protective factor, respectively. We also performed Fisher's exact test to compare the proportion of adolescent and adult runners who responded with "increase," "decrease," "neither increase or decrease," or "I don't know" to each question. Adolescent runners perceived training habits, footwear, biomechanics, strength, stretching, and nutrition to increase or decrease the risk of sustaining a running-related injury. A larger proportion of adolescents than adults perceived that more footwear cushioning and stretching decrease injury risk, but a smaller proportion perceived that overtraining increases injury risk and strength decreases injury risk. Differences in perceptions exist between adolescent and adult runners, and future educational materials and research questions may need to be tailored for different running populations.

The art of choosing the right running shoe review article

This review aims to synthesize current knowledge on running biomechanics, structure and materials of running shoes, and critical factors to consider when choosing the right running shoe to enhance performance and reduce injury risk. A search was performed across major electronic databases, including PubMed, EMBASE, Web of Science, and Google Scholar. Selected studies were then analyzed and synthesized to pinpoint the key factors in choosing the right running shoe, including biomechanics, shoe structure, injury prevention, and the benefits and limitations of different running shoe options. The running shoe choice significantly affects the running performance and injury risk. Key features, such as shoe drop, cushioning, stiffness, and weight must be considered based on the runner’s anatomy, gait, and training regimen. Personalized recommendations, informed by a thorough understanding of shoe biomechanics and individual runner needs, are crucial for optimizing the running efficiency and minimizing injuries.

Predictive Value of the KOJI AWARENESS Self-Evaluation System for Running Injuries in Elite Male Long-Distance Runners: A Prospective Cohort Study.

The KOJI AWARENESS (KA) test is a practical self-evaluation tool that assesses body movements and may help develop individual conditioning plans to improve movement function. However, the association between preseason KA scores and in-season injury occurrence remains unexplored. To investigate whether the KA self-screening test score can predict running-related injuries in elite long-distance runners. Cohort study; Level of evidence, 2. A total of 47 elite college male long-distance runners (age, 18-22 years) were enrolled in this study in June 2022. The participants underwent the KA self-screening test to assess preseason upper limb, core, and lower limb function. Running-related injuries with a training time loss of >3 weeks were tracked for 6 months during the season. The participants were divided into injury and noninjury groups, and between-group comparisons and receiver operating characteristic (ROC) curve analysis were used to determine the association between the KA scores and the injury incidence. Chi-square tests and risk ratios were calculated based on the cutoff value- and injury-based grouping. Among the runners, 10 (21.3%) sustained an injury. There were no significant differences in the demographic characteristics between the injury and noninjury groups. The injury group had significantly lower KA scores than the noninjury group (median, 44.5 [interquartile range, 43-46.8] vs median, 48 [interquartile range, 46-50], respectively; P = .009). The ROC curve analysis determined a cutoff value of 46.5 points (sensitivity, 73%; specificity, 63.6%), indicating that the KA scores exhibited a relatively high predictive value for running-related injuries (area under the ROC curve, 0.764 [95% CI, 0.600-0.930]). The risk ratio for group division based on the cutoff value was 2.590 (95% CI, 1.329-5.047). These findings demonstrated that the KA test is an effective self-screening tool for predicting the risk of running-related injuries in elite male long-distance runners.

Unveiling the influence of hip isokinetic strength on lower extremity running kinematics in male national middle-distance runners: a correlational analysis

BackgroundThe relationship between hip strength deficiency in various planes and musculoskeletal injuries within the movement system has been well-established in numerous studies. The present study sought to explore the relationships between hip strength and specific aspects of lower extremity running kinematics.MethodologyTo achieve this objective, the three-dimensional running kinematics of 21 male elite middle-distance runners (mean age: 19.7 ± 1.2 years; mean experience 6.5 ± 1.0 years) were assessed using nine high-speed cameras on a treadmill at a speed of 16 km·h⁻¹. Concurrently, isokinetic hip strength was measured at a speed of 60 deg·s⁻¹ in both the dominant and non-dominant legs. The Pearson correlation coefficient and Paired Samples t-test were utilized.ResultsWhile no significant differences were found in several isokinetic strength measurements, notable differences in running kinematics were observed. Specifically, pelvic drop at midstance (MS) was significantly lower in the DL (5.79 ± 3.00°) compared to the NDL (8.71 ± 1.39°) with a large effect size (t=-4.04, p < 0.001, Cohen’s d = 1.25). Additionally, knee adduction at maximum showed a moderate effect size difference, with the DL at 2.99 ± 1.13° and the NDL at 3.81 ± 1.76° (t=-2.74, p = 0.03, Cohen’s d = 0.55). Results indicated a moderate to highly positive association between running knee adduction in the dominant leg and hip external rotation (r = 0.67, p < 0.05), concentric extension (r = 0.77, p < 0.05), and concentric abduction (r = 0.78, p < 0.05). Additionally, the running tibial external rotation angle in the dominant leg exhibited an inverse relationship with all strength measurements, with statistical significance observed only for concentric extension force (r=-0.68, p < 0.05). Furthermore, hip internal rotation force demonstrated a highly inverse correlation with foot pronation in the dominant leg (r=-0.70, p < 0.05) and anterior pelvic tilt in the non-dominant leg (r=-0.76, p < 0.05).ConclusionsThese findings underscore the interrelation between hip strength and running kinematics, particularly on the dominant side. In light of these observations, it is imperative to consider hip strength exercises as integral components for correcting running kinematics. Coaches should also be mindful that kinematic deviations contributing to running injuries may manifest unilaterally or specifically in the dominant leg.