Running Injuries Research Articles

Running Habits and Injury Frequency Following COVID-19 Restrictions in Adolescent Long-Distance Runners.

A decline in youth running was observed at the start of the COVID-19 pandemic. We investigated whether the resumption of organized running after social distancing restrictions changed running habits or injury frequency in adolescent runners. Adolescents (age = 16.1 [2.1]y) who participated in long-distance running activities completed an online survey in the Spring and Fall of 2020. Participants self-reported average weekly running habits and whether they sustained an injury during the Fall 2020 season. Poisson regression models and 1-way analysis of variance compared running habits while Fisher exact test compared differences in frequencies of injuries during Fall 2020 among season statuses (full, delayed, and canceled). All runners, regardless of season status, increased weekly distance during Fall 2020. Only runners with a full Fall 2020 season ran more times per week and more high-intensity runs per week compared with their Spring 2020 running habits. There were no differences in running volume or running-related injury frequency among Fall 2020 season statuses. There were no significant differences in running-related injury (RRI) frequency among runners, regardless of season status, following the resumption of cross-country. Health care providers may need to prepare for runners to increase running volume and intensity following the resumption of organized team activities.

Impact Assessment of Weather Conditions on Running Performance and Injury Probability: An Integrated Analysis

Impact Assessment of Weather Conditions on Running Performance and Injury Probability: An Integrated Analysis

CAUSAS E PREVENÇÃO DE LESÕES ESPORTIVAS NO BASQUETEBOL JUVENIL

ABSTRACT Introduction: Basketball is a fast, intense sport requiring much reasoning and dexterity. It comprises running, jumping, throwing, and other injuries. Students and sports fans deeply love this sport. However, due to the characteristics of basketball, there are many risks of sports injuries in basketball. Objective: Investigate the causes of sports injuries in youth basketball training and evaluate preventive countermeasures. Methods: This paper analyzes basketball's injury mechanism, causes, and occurrence rules through survey questionnaires. Statistical analysis and recent literature research are performed to support a preventive protocol. Results: A protocol for injury prevention and mitigation in basketball was presented. Conclusion: To ensure normal training and competition in basketball, one must pay attention to the intrinsic characteristics of injuries in its players, considering the multiple variables that integrate the risks to the athletes' health. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

A Pilot Study of Plantar Mechanics Distributions and Fatigue Profiles after Running on a Treadmill: Using a Support Vector Machine Algorithm.

The treadmill is widely used in running fatigue experiments, and the variation of plantar mechanical parameters caused by fatigue and gender, as well as the prediction of fatigue curves by a machine learning algorithm, play an important role in providing different training programs. This experiment aimed to compare changes in peak pressure (PP), peak force (PF), plantar impulse (PI), and gender differences of novice runners after they were fatigued by running. A support vector machine (SVM) was used to predict the fatigue curve according to the changes in PP, PF, and PI before and after fatigue. 15 healthy males and 15 healthy females completed two runs at a speed of 3.3 m/s ± 5% on a footscan pressure plate before and after fatigue. After fatigue, PP, PF, and PI decreased at hallux (T1) and second-fifth toes (T2-5), while heel medial (HM) and heel lateral (HL) increased. In addition, PP and PI also increased at the first metatarsal (M1). PP, PF, and PI at T1 and T2-5 were significantly higher in females than in males, and metatarsal 3-5 (M3-5) were significantly lower in females than in males. The SVM classification algorithm results showed the accuracy was above average level using the T1 PP/HL PF (train accuracy: 65%; test accuracy: 75%), T1 PF/HL PF (train accuracy: 67.5%; test accuracy: 65%), and HL PF/T1 PI (train accuracy: 67.5%; test accuracy: 70%). These values could provide information about running and gender-related injuries, such as metatarsal stress fractures and hallux valgus. Application of the SVM to the identification of plantar mechanical features before and after fatigue. The features of the plantar zones after fatigue can be identified and the learned algorithm of plantar zone combinations with above-average accuracy (T1 PP/HL PF, T1 PF/HL PF, and HL PF/T1 PI) can be used to predict running fatigue and supervise training. It provided an important idea for the detection of fatigue after running.

Anxiety state impact on recovery of runners with lower extremity injuries.

This prospective cohort study examined the impact of high anxiety levels on psychological state and gait performance during recovery in runners with lower body injuries. Recreational runners diagnosed with lower body injuries who had reduced running volume (N = 41) were stratified into groups using State Trait Anxiety Inventory (STAI) scores: high anxiety (H-Anx; STAI ≥40 points) and low anxiety (L-Anx; STAI <40 points). Runners were followed through rehabilitation to return-to-run using monthly surveys. Main outcome measures included kinesiophobia (Tampa Scale of Kinesiophobia, TSK-11), Positive and Negative Affect Schedule (PANAS; Positive and negative scores), Lower Extremity Function Scale (LEFS), running recovery (University of Wisconsin Running Injury and Recovery Index [UWRI]) and CDC Healthy Days modules for general health, days of anxiety/tension, disrupted sleep and work/usual activities. Running biomechanics were assessed at baseline and the final visit using 3D motion capture and a force-plated treadmill. The time to return-to-running for was 5.0±3.1 and 7.9±4.1 months for L-Anx and H-Anx, respectively and participants who withdrew (n = 15) did so at 7.7±6.2 months. L-Anx maintained low anxiety and H-Anx reduced anxiety from baseline to final visit (STAI = 31.5 to 28.4 points, 50.4 to 37.8 points, respectively), whereas the withdrawn runners remained clinically anxious at their final survey (41.5 to 40.3 points; p < .05). Group by time interactions were found for PANAS positive, LEFS UWRI, general health scores, and days feeling worry, tension and anxiety (all p < .05). Final running performance in L-Anx compared to H-Anx was most improved with cadence (8.6% vs 3.5%; p = .044), impact loading rate [-1.9% vs +8.9%] and lower body stiffness [+14.1% vs +3.2%; all p < .05). High anxiety may identify runners who will experience a longer recovery process, health-related functional disruptions, and less optimization of gait biomechanics during rehabilitation after a lower extremity injury.

Differences in the coordination and its variability among foot joints during running in neutral foot and flatfoot.

Flatfoot is a well-known foot deformity, with a prevalence of 11.2%-29.0% among adults. Running injuries can occur in individuals with flatfoot; however, the underlying mechanism remains unknown. We investigated the coordination pattern and variability among foot joints while running by comparing participants with neutral foot and with flatfoot. Participants with neutral foot (n=15) and flatfoot (n=15) were asked to run at their preferred speed. Using the modified vector coding technique, the coupling angle between the foot joints, representing interjoint coordination, was calculated and categorized into four coordination patterns. The standard deviation of the coupling angle was computed to measure the coordination variability during the stance phase. There were no differences in the spatiotemporal parameters (speed, step length, and cadence) between the groups. In the sagittal rearfoot and sagittal midfoot coordination patterns, the flatfoot group showed a significantly greater proportion of anti-phase with proximal dominancy and a lower proportion of in-phase with proximal dominancy than the neutral foot group during early stance. Coordination variabilities between the sagittal rearfoot and sagittal midfoot (midstance), between the sagittal midfoot and sagittal forefoot (early stance), and between the frontal rearfoot and sagittal midfoot (midstance) were greater in the flatfoot group than in the neutral foot group. This may explain why those with flatfoot are likely to experience running injuries.

Factors Associated With Running-Related Injuries in Recreational Runners With a History of Running Injuries.

To identify the incidence and characteristics associated with a higher injury risk in recreational runners who suffered a running-related injury (RRI) in the previous 12 months. Prospective cohort study among recreational runners who registered for a Dutch running event (5-42.2 km) and suffered an RRI in the 12 months before inclusion. Open population. Recreational runners with a previous reported injury. At baseline, information on demographics, training characteristics, health complaints, and RRI history was collected. With 3 follow-up questionnaires (2 weeks before, 1 day after, and 1 month after the running event), the occurrence of new RRIs was registered. In total, 548 participants (55.1%) sustained a new RRI during follow-up. In total, 20.5% of the new RRIs was located at the same anatomical location as the previous RRI. Runners who registered for a marathon had a higher chance to sustain a new RRI [odd ratio (OR) 1.72; 95% confidence intervals (CIs), 1.17-2.53]. Also previous RRIs in the upper leg (OR 1.59; 95% CI, 1.15-2.19) and lower leg (OR 1.61; 95% CI, 1.18-2.21) were associated with an increased injury risk. Especially being a marathon runner and the anatomical location of previous RRIs seem to be associated with the injury risk in recreational runners with a previous RRI.

Differences in kinetic variables between injured and uninjured rearfoot runners: A hierarchical cluster analysis.

Running is a popular form of physical activity with a high incidence of running-related injuries. However, the etiology of running-related injuries remains elusive, possibly due to the heterogeneity of movement patterns. The purpose of this study was to investigate whether different clusters existed within a large group of injured and uninjured runners based on their kinetic gait patterns. A sample of 134 injured and uninjured runners were acquired from an existing database and 12 discrete kinetic and spatiotemporal variables which are commonly associated with running injuries were extracted from the ground reaction force waveforms. A principal components analysis followed by an unsupervised hierarchical cluster analysis was performed. The results revealed two distinct clusters of runners which were not associated with injury status (OR=1.14 [0.57, 2.30], χ2 =0.143, p=0.706) or sex (OR=1.72 [0.85, 3.49], χ2 =2.3258, p=0.127). These results suggest that while there appeared to be evidence for two distinct clusters within a large sample of injured and uninjured runners, there is no association between the kinetic variables and running related injuries.

Incidence of Injuries in Street Runners and Associated Factors: A Systematic Review

The objective of the present study was to verify the incidence of injuries in street runners within a systematic review identifying the profile of the runners, the main injuries, the control of loads and other variables of the training, if there is professional monitoring, in the perspective of correlating the training characteristics with the incidence of injuries, which are no longer the associated factors. the results of the systematic search that identified a total of 107 articles in the electronic databases SciELO and LILACS and one more by manual search. After selection, the articles due to duplicity were removed, later the ineligible ones. Six studies were selected and included in the present systematic review. Totaling 998 individuals who participated in these 6 studies. The prevalence of injuries in runners found in the present study is worrisome, the main types being muscle strains and the main affected site reported is the knee. Both intrinsic and extrinsic factors were associated with injuries, such as: age, anthropometric characteristics, time of participation in races, characteristics of training and competition, clothing and performance of other activities concurrently with the race.

Clinical Application of Gait Retraining in the Injured Runner.

Despite its positive influence on physical and mental wellbeing, running is associated with a high incidence of musculoskeletal injury. Potential modifiable risk factors for running-related injury have been identified, including running biomechanics. Gait retraining is used to address these biomechanical risk factors in injured runners. While recent systematic reviews of biomechanical risk factors for running-related injury and gait retraining have been conducted, there is a lack of information surrounding the translation of gait retraining for injured runners into clinical settings. Gait retraining studies in patients with patellofemoral pain syndrome have shown a decrease in pain and increase in functionality through increasing cadence, decreasing hip adduction, transitioning to a non-rearfoot strike pattern, increasing forward trunk lean, or a combination of some of these techniques. This literature suggests that gait retraining could be applied to the treatment of other injuries in runners, although there is limited evidence to support this specific to other running-related injuries. Components of successful gait retraining to treat injured runners with running-related injuries are presented.

Comparing Functional Motor Control Exercises With Therapeutic Exercise in Wrestlers With Iliotibial Band Syndrome.

Iliotibial band syndrome (ITBS) is a common overuse injury in runners with parallels to our findings of overuse in Greco Roman wrestlers. Despite research indicating coordination and movement-based factors about the hip, no studies were found using functional motor control (FMC) in runners or wrestlers with ITBS. Thus, we compared FMC exercises and therapeutic exercises (TEs) on pain, function, muscle strength, and range of motion (ROM) in national-level Greco Roman wrestlers with ITBS. Controlled laboratory study. Sixty national-level Greco Roman wrestlers diagnosed with ITBS were randomly assigned to 8weeks of FMC exercises, TE, and a control group (20 individuals for each group). Pain (visual analog scale), function (triple hop test for distance, single-leg vertical jump test, and agility T test), muscle strength (handheld dynamometer), and ROM (goniometer) were measured at baseline and 8weeks after intervention as posttest. Although both interventions significantly reduced pain (P < .001, η2 = .87), improved function (triple hop test P = .004, η2 = .94; single-leg vertical jump P = .002, η2 = .93; and T test P < .001, η2 = .93) and strength (hip abduction (P < .001, η2 = .52), hip external rotation (P = .02, η2 = .95), knee flexion (P ≤ .001, η2 = .94), and knee extension (P < .001, η2 = .91) compared with the control group, FMC showed more significant improvements in comparison with TE. Significant differences (P = .001) were observed between FMC and TE compared with the control group in ROM outcome. However, TE was more effective than FMC in improving ROM hip abduction (P < .001, η2 = .93), hip adduction (P = .000, η2 = .92), hip internal rotation (P < .001, η2 = .92), and hip external rotation (P < .001, η2 = .93). FMC exercises were superior to TE in terms of pain, function, and muscle strength, whereas TE was more effective for improving ROM. FMC exercise is suggested as an effective intervention for improvement of the outcomes related to ITBS in national-level Greco Roman wrestlers.

The Effect of Maximalist Running Shoes on Impact Loading: A Critically Appraised Topic

Clinical Scenario: Running injuries are common in runners. The use of maximal cushioned shoes (MAX) has been suggested as a preventive measure for reducing impact loading and thus running-related injuries. Clinical Question: Do maximalist running shoes reduce impact loading compared to traditional shoes in runners? Summary of Key Findings: A search was performed for articles exploring MAX on impact loading in runners. Five articles were included in this critically appraised topic. All were case-controlled laboratory studies that compared the MAX to a traditional running shoe. None of the studies found a reduction in impact loading with use of the MAX. Clinical Bottom Line: Based on five case-controlled studies, a MAX does not reduce impact loading on level surfaces or downhill running. Based on mixed results, the MAX may increase impact forces during level and downhill running. Future research should include randomized controlled trials that assess impact forces after the runner has adapted to the MAX and after running ultradistances. Strength of Recommendation: In agreement with the Center of Evidence-Based Medicine, the consistent results from five Level III intervention studies designate that there is Level C evidence that MAX do not reduce impact loading during a single running trial.

Effect of Running-Induced Fatigue on Tibial Acceleration and the Role of Lower Limb Muscle Strength, Power, and Endurance.

High-impact loads have been linked with running injuries. Fatigue has been proposed to increase impact loads, but this relationship has not been rigorously examined, including the associated role of muscle strength, power, and endurance. This study aimed to investigate the effect of fatigue on impact loading in runners and the role of muscle function in mediating changes in impact loading with fatigue. Twenty-eight trained endurance runners performed a fixed-intensity time to exhaustion test at 85% of V̇O 2max . Tibial accelerations were measured using leg-mounted inertial measurement units and sampled every minute until volitional exhaustion. Tests of lower limb muscle strength, power, and endurance included maximal isometric strength (soleus, knee extensors, and knee flexors), single leg hop for distance, and the one leg rise test. Changes in peak tibial acceleration (PTA, g ) were compared between time points throughout the run (0%, 25%, 50%, 75%, and 100%). Associations between the change in PTA and lower limb muscle function tests were assessed (Spearman's rho [ rs ]). PTA increased over the duration of the fatiguing run. Compared with baseline (0%) (mean ± SD, 9.1 g ± 1.6 g ), there was a significant increase at 75% (9.9 g ± 1.7 g , P = 0.001) and 100% (10.1 g ± 1.8 g , P < 0.001), with no change at 25% (9.6 g ± 1.6 g , P = 0.142) or 50% (9.7 g ± 1.7 g , P = 0.053). Relationships between change in PTA and muscle function tests were weak and not statistically significant ( rs = -0.153 to 0.142, all P > 0.05). Peak axial tibial acceleration increased throughout a fixed-intensity run to exhaustion. The change in PTA was not related to performance in lower limb muscle function tests.

Design feature combinations effects of running shoe on plantar pressure during heel landing: A finite element analysis with Taguchi optimization approach.

Large and repeated impacts on the heel during running are among the primary reasons behind runners’ injuries. Reducing plantar pressure can be conducive to reducing running injury and improving running performance and is primarily achieved by modifying the design parameters of running shoes. This study examines the effect of design parameters of running shoes (i.e., heel-cup, insole material, midsole material, and insole thickness) on landing peak plantar pressure and determines the combination of different parameters that optimize cushion effects by employing the Taguchi method. We developed the foot–shoe finite element (FE) model through reverse engineering. Model assembly with different design parameters was generated in accordance with the Taguchi method orthogonal table. The effectiveness of the model was verified using the static standing model in Ansys. The significance and contribution of different design parameters, and the optimal design to reduce plantar pressure during landing, were determined using the Taguchi method. In the descending order of percentage contribution was a conforming heel-cup (53.18%), insole material (25.89%), midsole material (7.81%), and insole thickness (2.69%). The more conforming heel-cup (p < 0.001) and softer insole (p = 0.001) reduced the heel pressure during landing impact. The optimal design of running shoe in this study was achieved with a latex insole, a 6 mm insole thickness, an Asker C-45 hardness midsole, and a 100% conforming heel-cup. The conforming heel-cup and the insole material significantly affected the peak plantar pressure during heel landing. The implementation of a custom conforming heel-cup is imperative for relieving high plantar pressure for long-distance heel-strike runners.

The Missing Link in Running Injury Research: Nonrunning Physical Activity.

SYNOPSIS: Overuse injuries from running occur when the loading stimulus exceeds the tissue-specific loading capacity. Excessive running exposure (training errors) are important precursors to injury. Despite the intuitive relationship between loading, running volume, and injury, a definitive safe loading exposure that can reliably differentiate between injured and uninjured groups remains elusive. We propose that a singular focus on running-related factors such as gait, running surface change, sudden change in running volume, frequency of running, and acute-to-chronic workload make it difficult to identify reliable mechanisms of loadrelated running injury. Given that the accumulated loading from nonrunning exercise and physical activities of daily living can impose substantial and consequential load on the musculoskeletal system, we make the case for considering loading from all sources of physical activity as a contributor to running injury. J Orthop Sports Phys Ther 2022;52(11):705-708. Epub: 9 September 2022. doi:10.2519/jospt.2022.11288.

Comparison Of Injury For Non-contact Sports (track) Versus Contact Sports (rugby)

PURPOSE: Contact events are considered as the main factor leading to injury in Rugby Union, induced by a high injury incidence. Running is an important part both in rugby and track athletics, and the injury incidence rates for running is significantly lower than contact event injuries in rugby. Therefore, the aim of this study was to compare the injury characteristics of rugby and track running, intended to inform the athlete, coach and strength and conditioning expert who may be involved with both sports. METHODS: Rugby injury characteristics were described by retrospectively analysing three seasons of injury data from 1,400 players collected by Irish Rugby Injury Surveillance (IRIS) from male and female amateur rugby clubs (contact sport), and comparing those findings with the results of high-quality experimental literature about track running injuries (non-contact sport) with more than 4000 runners. RESULTS: Contact events are the main cause of injuries for rugby players, especially for forwards position players. Strain (28.6%), sprain (24.3%), haematoma/contusion (11.1%), and concussion (11.3%) were the most common injuries, which were mainly located in the head (16.7%), shoulder (13.4%), thigh (13.2%), knee (11.7%) and ankle/foot (13.8%), and mainly occurred during matches. The data collected from the running literature show the significant difference of injury characteristic between running and rugby. Overuse is the primary mechanism of running injuries. The majority of injuries were musculoskeletal injuries. Injuries in lower extremities account for a large proportion of all running injuries (64-87%), and the knee was the most commonly injured joint (28%), followed by foot/ankle (26%), lower leg (16%). Rugby injuries mostly occur in match plays (81%), running injuries occur in training (73%). CONCLUSIONS: Contact events contribute to a large proportion of rugby injuries, whilst most running injuries were musculoskeletal injuries caused by overuse. For running injuries, improving the standard injury definitions and adhering to an international injury epidemiology study consensus will be beneficial to increase the consistency and comparability of different studies and across sports. Supported by the Irish Rugby Football Union, Irish Research Council, and the Health Research Institute UL.

Changes Of Bone Metabolism Markers In Japanese Male Long Distance Runners During In-season

Stress fracture is one of the most common overuse injuries in runners and there are many risk factors that predispose to this injury. Previous studies have focused on bone metabolism and the correlation between stress fractures and bone metabolism has been reported. However, most studies are on female athletes, and little is known on male athletes. Moreover, long-term bone metabolic process in athletes is unknown. PURPOSE: To investigate changes bone metabolism markers in male long distance runners during in-season METHODS: Twenty-five male long distance runners participated in this study, and total of 11 athletes were qualified for analysis (24 ± 4.3 yrs, 170.4 ± 5.0 cm, 55.9 ± 3.7 kg) after excluding those who were injured and/or were not able to run more than 200 km per month. Blood samples were collected from 9 am to 11 am during pre-season (PRs), post-track season (PTs), and road-race season(RRs). Athletes were instructed to refrain from training prior to blood collection. To assess bone metabolism bone-specific alkaline phosphatase(BAP) and tartrate-resistant acid phosphatase-5b(TRACP-5b) were measured. In addition, athletes reported their monthly training volume of one month prior the first measurement. Changes of bone metabolic markers were assessed by one-way ANOVA with repeated measures and correlations between training volume and both markers were made using Spearman’s rank correlation coefficient. RESULTS: BAP in PTs (14.98 ± 3.11 vs. 16.62 ± 3.76 p = 0.004) and RRs (14.85 ± 3.68 vs. 16.62 ± 3.76 p = 0.004) were significantly lower than that of PRs. There were no statistically significant changes in TRACP-5b. Moreover, there were not any correlations between monthly training volume and both bone metabolism markers. CONCLUSIONS: We found that BAP lower than PRs from the latter half of track season to the road race season.

Research protocol to evaluate the effectiveness of shockwave therapy, photobiomodulation and physical therapy in the management of non-insertional Achilles tendinopathy in runners: a randomised control trial with elective cross-over design

BackgroundAchilles tendinopathy (AT) is a common overuse injury in runners. While the mainstay of treatment for AT is tendon loading exercises (physical therapy and exercise programme (EXER)), some patients have...

Do the General Public and Health Care Professionals Think That Running Is Bad for the Knees? A Cross-sectional International Multilanguage Online Survey.

Background:Running is a popular sport with widely recognized health benefits. Given the high rates of knee injury in runners and the growing prevalence of knee osteoarthritis (KOA), it may be useful to assess perceptions about running and knee joint health.Purpose:The objectives of this study were to (1) explore and compare the perceptions of the general public (PUB) and health care professionals (HCPs) on the topic of running and knee health and (2) explore recommendations about running and knee health provided by HCPs.Study Design:Cross-sectional study.Methods:We conducted an online survey between June 18 and October 1, 2020. The questionnaire included questions on running and knee health, and HCPs were asked about their typical recommendations and level of confidence in providing recommendations on the topic. Perceptions (proportions) were compared between the PUB and HCPs using the chi-square test.Results:In total, 4521 responses (PUB, n = 2514; HCPs, n = 2007) were analyzed. A greater proportion of HCPs perceived regular running as healthy for knees (86% vs 68%; P < .001). More of the PUB than HCPs (P < .001) believed that running frequently (29% vs 13%), long distances (54% vs 45%), and on hard surfaces (60% vs 36%) increased the risk of developing KOA. Running for those with KOA was perceived by the PUB as posing an increased risk of getting more knee pain (48%) and needing joint replacement surgery (38%), more so than by HCPs (26% and 17%, respectively). The majority of HCPs reported being relatively confident in providing evidence-based recommendations about running and knee health and mostly recommended that runners with KOA modify training parameters instead of quit.Conclusion:More HCPs perceived running as healthy for knees when compared with the PUB. Most HCPs felt confident in providing evidence-based recommendations about running and knee health.

Running on empty: a longitudinal global study of psychological well-being among runners during the COVID-19 pandemic

ObjectivesThere are indications that the COVID-19 pandemic has had a profound negative effect on psychological well-being. Here, we investigated this hypothesis using longitudinal data from a large global cohort of...