Running Injuries Research Articles

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.

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.

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.

Effects of a 10-week footstrike transition programme on tibial stress fracture probability; a randomized controlled intervention using finite element and probabilistic modelling

Introduction: The aim of this study was to undertake a randomized control trial examining the effects of a 10-week footstrike transition program on tibial stress fracture risk compared to control. Material and methods: Twenty habitual rearfoot strike runners were randomly assigned to either footstrike or control groups. The footstrike group undertook a graduated 10-week program which allowed them to convert their habitual rearfoot strike pattern, whereas the control group maintained their normal training regime without any alterations to their strike pattern. Running biomechanics were collected using an eight-camera motion capture system, and ground reaction forces using a force plate. Tibial strains were quantified using finite element modelling and stress fracture probability calculated via probabilistic modelling over 100 days of running. The primary outcome: tibial stress fracture probability, and secondary outcomes: running biomechanics, muscle forces, joint contact forces, and tibial strain indices were measured at baseline and after 10 weeks. Results: Intention-to-treat analyses revealed no significant alterations in the primary outcome (Footstrike: baseline = 12.82% &amp; 10-weeks = 10.82%, Control: baseline = 15.43% &amp; 10-weeks = 13.39%) between arms. However, alterations in the strike index (Footstrike: baseline = 21.79% &amp; 10-weeks = 65.74%, Control: baseline = 13.61% &amp; 10-weeks = 12.41%) and the loading rate (Footstrike: baseline = 165.85BW/s &amp; 10-weeks = 100.01 BW/s, Control: baseline = 170.13 BW/s &amp; 10-weeks = 197.87 BW/s) were significantly greater in the footstrike group compared to the control one. Conclusion: This trial concludes that the footstrike intervention adopted in this study was not effective in mediating improvements in tibial stress fracture risk, although future intervention trials could examine the efficacy of footstrike modification on other musculoskeletal injuries in runners.

The impact of combined therapy on healing of foot injuries in runners

Purpose. The structure of the lower body has a very important role as support for the body and is often injured in runners. The aim of this study was to determine whether there is an impact of providing combined therapy on the healing of foot injuries. Material and methods. The type of research used was experimental, with a randomized pretest and posttest group design. The total research sample was 56 runners who were divided into four therapy groups, namely the sports massage, trigger point, chiropractic, and 1 control group. Measurement of the degree of strain uses visual analogue scale (VAS) criteria. Results. From the research results, it is known that providing therapy to the sports massage, trigger point, chiropractic group and 1 control group can reduce the intensity of strain pain (2.35 ± 0.756; 1.63 ± 0.840; 2.24 ± 0.840; 3.71 ± 0.756) with p-value = 0.001. Conclusions. Based on the stages of the research results, it can be concluded: 1) There was a significant impact after being given sports massage, trigger point and chiropractic therapy on reducing pain intensity 15 minutes after treatment; 2) There was no significant difference between the sports massage, trigger point and chiropractic treatment groups on pain intensity 15 minutes after treatment.

Predicting Musculoskeletal Loading at Common Running Injury Locations Using Machine Learning and Instrumented Insoles.

Wearables have the potential to provide accurate estimates of tissue loads at common running injury locations. Here we investigate the accuracy by which commercially available instrumented insoles (ARION; ATO-GEAR, Eindhoven, The Netherlands) can predict musculoskeletal loading at common running injury locations. Nineteen runners (10 males) ran at five different speeds, four slopes, with different step frequencies, and forward trunk lean on an instrumented treadmill while wearing instrumented insoles. The insole data were used as input to an artificial neural network that was trained to predict the Achilles tendon strain, and tibia and patellofemoral stress impulses and weighted impulses (damage proxy) as determined with musculoskeletal modeling. Accuracy was investigated using leave-one-out cross-validation and correlations. The effect of different input metrics was also assessed. The neural network predicted tissue loading with overall relative percentage errors of 1.95 ± 8.40%, -7.37 ± 6.41%, and -12.8 ± 9.44% for the patellofemoral joint, tibia, and Achilles tendon impulse, respectively. The accuracy significantly changed with altered running speed, slope, or step frequency. Mean (95% confidence interval) within-individual correlations between modeled and predicted impulses across conditions were generally nearly perfect, being 0.92 (0.89 to 0.94), 0.95 (0.93 to 0.96), and 0.95 (0.94 to 0.96) for the patellofemoral, tibial, and Achilles tendon stress/strain impulses, respectively. This study shows that commercially available instrumented insoles can predict loading at common running injury locations with variable absolute but (very) high relative accuracy. The absolute error was lower than the methods that measure only the step count or assume a constant load per speed or slope. This developed model may allow for quantification of in-field tissue loading and real-time tissue loading-based feedback to reduce injury risk.

Viability of Structured Gait Retraining for Improving Clinical Outcomes Following Running-related Injury in Active Duty Service Members.

All branches of the U.S. Military have a running component of their physical readiness testing battery. Running-related musculoskeletal injuries affect 20 to 40% of DoD Service Members each year. Running form has not historically been addressed with military running-related injuries. To assess the utility of a structured gait retaining protocol designed to treat the onset of running-related pain and/or injury by correcting identified biomechanical risk factors for injury and improve clinical outcomes. Case series. A total of 160 Active Duty Service Members (ADSMs) with running-related lower-body musculoskeletal injuries were referred by a physical therapist for a multisession gait retraining program termed "Run with CLASS" (Cadence, Lean, Alignment, Soft-landing, Strike). Run with CLASS utilized various drills to emphasize impact progression, proximal strengthening, and proprioception and spatial awareness. Results revealed that the implemented gait retraining protocol significantly improved running parameters following lower-body injury as evidenced by increased cadence, improved functional assessment scores, and a marked transition from predominantly heel strike to forefoot strike patterns during running. A 3-week supervised gait retraining program focused on the gait retraining program termed "Run with CLASS" (Cadence, Lean, Alignment, Soft-landing, Strike) was successful in altering biomechanics of self-selected running gait by increasing cadence and transitioning ADSMs to a forefoot foot strike. Additionally, ADSMs reported significant improvements on the self-reported functional scores on the University of Wisconsin Running Injury and Recovery Index and Single Assessment Numerical Evaluation. 4.

THE STUDY OF PREVALENCE, MANAGEMENT AND OUTCOME OF MUSCULOSKELETAL INJURIES IN RUNNERS: A COMPREHENSIVE SYSTEMATIC REVIEW

Background: Running's popularity has surged globally, doubling in the last decade, due to its accessibility and health benefits. However, it carries a high injury risk, especially in lower extremities, with rates varying by distance. Understanding injury prevalence and risk factors is essential. This study aims to serve a comprehensive systematic review to analyze the prevalence, management and outcome of musculoskeletal injuries in runners based on literatures of the last 10 years. Methods: The review adhered to PRISMA 2020 standards and analyzed full-text English literature from 2014 to 2024. It excluded editorials, review papers from the same journal, and submissions lacking a DOI. Literature sources included PubMed, SagePub, SpringerLink, and Google Scholar. Result: A total of 655 articles were retrieved from online databases (PubMed, SagePub, SpringerLink and Google Scholar). After three rounds of screening, ten articles directly relevant to the systematic review were selected for full-text reading and analysis. Conclusion: Musculoskeletal injuries in runners are common. Tailored interventions like gait retraining and targeted exercises can reduce their incidence and severity. Further research is needed to assess long-term effects and develop standardized prevention and management protocols for diverse running populations.

Outcomes of Surgical Management of Turf Toe: 12-Year Results.

Background "Turf toe" is a classical capsuloligamentous injury to the plantar surface of the metatarsophalangeal (MTP) joint of the great toe. The name is synonymous with injuries sustained on artificial turf or hard grounds. The classical injury pattern is a hyperdorsiflexion injury with an axial load. The outcomes of these injuries are unpredictable and there are no clear guidelines for the management of these injuries. These injuries are debilitating and can lead to long-term problems and inability to return to pre-injury activity level if missed. We present a long-term surgical follow-up of severe grade 3 turf toe injuries. Methods In the period from 2011 to 2022, we treated 20 patients with turf toe/MTP joint instability. There were 10 football injuries (50%), six running injuries (30%), two gymnastic injuries (10%), one motorcycle injury (0.5%), and one was a ballet dancer (0.5%). All the grade 1 and 2 injuries were treated conservatively with rest, ice application, and splinting of the toe. Grade 3 injuries were treated surgically and strict rehabilitation protocol was followed. Results The mean age at surgery was 32.7 years and the average patient follow-up was 7.5 months after surgery. The Manchester-Oxford Foot Questionnaire (MOXFQ) score showed a statistically significant improvement from a mean of 73.0 (median = 75) preoperatively to 28.1 (median = 28.6) postoperatively (median improvement = 46.4, P = 0.022). Similarly, there was a significant improvement in pain score, which showed an improvement from a mean of 72.9 (median = 70.0) preoperatively to a mean of 22.9 (median = 25.0) postoperatively (median improvement = 51.3, P = 0.022). Conclusion Turf toe is a serious injury that may prevent a high percentage of patients from resuming their previous physical activities. The correct identification, classification, and grading of the first MTP joint instability helps in decision-making and achieving good surgical outcomes.

LITERATUR REVIEW: PENCEGAHAN CEDERA DAN REHABILITASI PADA PELARI TRAIL

Trail running is sports activity that combines two activities, namely mountain climbing and running. Trail running activities are carried out on mountains that have tracks in the form of paths, in the form of ground stones, or a mixture of sand and small rocks. Trail running was first carried out in the United States of America and continues to develop in Indonesia for example Bandung, Probolinggo, Lombok dan Banyuwangi, Which have been associated in the form of ITRA (International Trail Running Association). The majority of trail running injuries occur in the lower legs, especially the knees and ankles. The main mechanisms underlying injury and injury development include inadequate neuromotor control-balance-coordination ,running through fatigue and abnormal kinematics on a variety of terrain. Pre-Rehabilitation programs such as strengthening the kinetic chain consisting of dynamic flexibility, neuromotor strength and balance, plyometrics exercises can encourage stable and also controlled movement on trails. Educating patients about symptoms of early musculoskeletal soreness and training adjustments also proved to help prevent injuries from developing into serious overuse injuries. Regarding to the increasing number of the injury in trail runners, this article was wrote to describe the role of injury prevention and safe training to reduce the risk of injury and also early rehabilitation program for the injured runners. Study by Vincent et all that review the injury prevention, safe training and rehabilitation to return to sport was the main source in the discussion. The review result showed that educating the runners to prevent injury and how to do the safe running shown a positive impact to reduce the numbers of injury. Early rehabilitation program also shown a good impact in promoting healing in injured runners.

ACTN3 XX Genotype Negatively Affects Running Performance and Increases Muscle Injury Incidence in LaLiga Football Players.

The aim of this study was to investigate the association of the ACTN3 rs1815739 polymorphism with match running performance and injury incidence in top-level professional football players. A total of 315 top-level professional football players from the first division of Spanish football (i.e., LaLiga) participated in this prospective and descriptive study. The ACTN3 rs1815739 genotype was identified for each player using genomic DNA samples. During LaLiga 2021-2022, players' performance was obtained through a validated camera system in all official matches. Additionally, the incidence of non-contact injuries was obtained by each team's medical staff according to the International Olympic Committee (IOC) statement. From the study sample, 116 (36.8%) players had the RR genotype, 156 (49.5%) had the RX genotype, and 43 (13.7%) had the XX genotype. The anthropometric characteristics of the players were similar across genotypes. However, the total running distance (p = 0.046), the distance at 21.0-23.9 km/h (p = 0.042), and the number of sprints (p = 0.042) were associated with the ACTN3 genotype. In all these variables, XX players had lower match performance values than RR players. Additionally, total and match injury incidences were higher in XX players than in RR players (p = 0.026 and 0.009, respectively). The rate of muscle injuries was also higher in XX players (p = 0.016). LaLiga football players with the ACTN3 XX genotype had lower match running performance and a higher incidence of non-contact injuries over the season.