Article

Incidence of training-related injuries among marathon runners

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Abstract

A questionnaire was sent to all 960 entrants in a major city marathon race to obtain information on training-related injuries. A total of 497 replies were received; of these 287 (58%) had incurred some form of injury during preparation for the race. Seventy-one of these individuals reported more than one injury. Almost all injuries affected the lower limb, with 113 cases (32%) involving pain or disability in the knee. More than half the injured runners (158, 55%) sought no professional advice; approximately half (146, 51%) received no treatment other than rest, which was not generally considered a form of therapy. Only 18 runners (6%) reported no improvement in their condition, while 143 individuals (51%) reported a full recovery. Injury incurred during training was thought by 98 runners (35%) to have had an adverse effect on their racing performance. These results suggest that runners preparing to compete in marathon races can expect their training to be interrupted by injury.

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... While many individuals run for health benefits, it is common for runners to experience injuries in training [1][2][3]. Marathon runners appear to be at particularly high risk of injury, both in training and during or immediately after the event [2,[4][5][6]. Compared with more experienced runners, novice runners or those who train either very little or very infrequently are at increased risk of injury [3,7,8] and experience greater levels of muscle damage after very long runs [9]. ...
... Self-reported pain in the lower extremities attributed to running that led the runner to alter training, use medication, or seek medical attention has been used as a definition of running injury [10]. Several cohort studies have examined the prevalence of injury in marathon runners over a 1-year period, with results ranging from 31 to 58% of participants experiencing 1 3 an injury over the year [4,6,11]. Characterizing the severity of sports injury has been approached in previous studies in a number of ways. ...
... Days of training or sport participation missed due to injury has commonly been used, though categories and definitions have varied [12,13]. In much of the research, running injury is classified by site, rather than by medical diagnosis, with the knee, calf, and foot being the most common areas of injury [4,6]. Clinical data can give us more detailed insight into the nature and severity of running injuries. ...
Article
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Purpose Core and plyometric training may reduce injury and enhance muscle function in some athletes, but the effects on recreational marathon runners are unknown. Thus, the purpose of this study was to compare the effects of plyometric or core training on injury, muscle damage, and training variables in marathon runners. Methods This study was a randomized-controlled trial. 34 subjects, ages 18–23 (20.7 ± 1.3) following the same marathon training program, were allocated to one of three groups for a weekly training session: core, plyometric, or no additional training (control). Subjects kept a training log throughout training. Outcomes were assessed during the 8-week run-in (RI) and 13-week marathon training (MT) periods. The plyometric and core training group subjects were assessed pre- and post-marathon for creatine kinase (CK), a marker of muscle damage. Results The plyometric group did not change in any training variables between RI and MT. The core group increased in days missed due to injury (p = 0.003) and rate of perceived exertion (RPE) (p = 0.028). The control group increased in RPE (p = 0.010) and soreness (p = 0.010). The plyometric group had lower pre-marathon CK levels than the core group (81 ± 36 vs. 136 ± 59 U/L; p = 0.042). During MT, the plyometric group missed fewer days of training (plyometric: 1.7 ± 2.9; core: 4.2 ± 5.1; control: 4.5 ± 4.8) and missed fewer days due to injury (plyometric: 1.2 ± 2.6; core: 2.7 ± 5.1, control; 4.1 ± 4.9) but the differences were not significant. Conclusions A weekly plyometric training session may be superior to core or no additional training in improving training variables of recreational marathon runners.
... De igual manera se ha estudiado cómo la exposición a condiciones extremas de calor y humedad tiene un impacto adverso en el organismo (Cheuvront y Haymes, 2001;Kim et al, 2014). Se tiene conocimiento que exponer al cuerpo a grandes esfuerzos durante tiempos prolongados afecta la salud desde múltiples aristas (Fredericson y Misra, 2007;Hanssen et al., 2011;Kyrolainen et al., 2000;Maughan y Miller, 1983;Neilan et al., 2006;Nieman et al., 2002;Rae et al., 2010;Satterthwaite et al., 1996;Siegel, Silverman, y Lopez, 1980;Van Middelkoop, Kolkman, Van Ochten, Bierma-Zeinstra, y Koes, 2008;Warhol, Siegel, Evans, y Silverman, 1985;Yared y Wood, 2009). A pesar de la existencia de los estudios anteriores, en la comunidad científica nacional e internacional no han indagado qué aspectos a nivel neuromuscular podrían modificarse posteriores a un maratón en condiciones extremas de calor y humedad en atletas aficionados. ...
... El desempeño durante un evento de resistencia como la maratón se puede ver comprometido por múltiples factores y pueden aparecer serias consecuencias adversas para la salud durante la carrera o el entrenamiento (Fredericson y Misra, 2007;Hanssen et al., 2011;Kyrolainen et al., 2000;Maughan y Miller, 1983;Neilan et al., 2006;Nieman et al., 2002;Rae et al., 2010;Satterthwaite et al., 1996;Siegel, Silverman, y Lopez, 1980;Van Middelkoop, Kolkman, Van Ochten, Bierma-Zeinstra, y Koes, 2008;Warhol, Siegel, Evans, y Silverman, 1985;Yared y Wood, 2009). ...
... Algunos factores como el calor y la mala hidratación pueden causar problemas de salud y suelen aparecer con relativa alta frecuencia en corredores, dependiendo de las condiciones ambientales y comportamientos riesgosos de los participantes de este tipo de eventos (Howe y Boden, 2007;Roberts, 2000). Otros como lesiones, daño muscular y dolor están muy relacionadas al entrenamiento, investigaciones sugieren que el 50% de los corredores de maratón experimentan alguna lesión relacionada al entrenamiento y/o durante o inmediatamente posterior al evento (Fredericson y Misra, 2007;Maughan y Miller, 1983;Van Middelkoop et al., 2008). El 90% de los corredores experimentan algún problema específico de salud durante la maratón o la semana posterior (Satterthwaite et al., 1999), algunos de estos problemas no son serios, se refieren ampollas, dolor muscular, aumento de tensión muscular, las cuales persisten durante la semana posterior o incluso más, un pequeño número de corredores (6%) tienen complicaciones requiriendo atención médica inmediata. ...
... Two studies included runners who were followed during one season of training and race participation. 9,13 In one of the studies, runners wished to be notified of upcoming road races, but their exact training programme or race attendance was unknown. 14 The proportions of subjects analysed ranged from 41.8% to 100%. ...
... 9,12,14,19,[21][22][23][24] In other studies in which non-lower-extremity injuries were also described and included in the overall incidence number, the reported incidence for injuries varied from 26.0% to 92.4%. 10,11,13,17,18,20,25 The predominant site of lower extremity injuries was the knee, for which the location specific incidence ranged from 7.2% to 50.0%. Injuries of the lower leg (shin, Achilles tendon, calf, and heel), foot (also toes), and upper leg (hamstring, thigh, and quadriceps) were common, ranging from 9.0% to 32.2%, 5.7% to 39.3%, and 3.4% to 38.1%, respectively. ...
... The main outcome measure for this study was a self-reported running injury. The injury definition was elaborated on the injury definition of Macera et al. 13 A running injury was defined as "An injury to muscles, joints, tendons, and/or bones of the lower extremities (hip, groin, thigh, knee, lower leg, ankle, foot, toe) that the participant attributed to running." The problem had to be severe enough to cause a reduction in distance, speed, duration, or frequency of running. ...
Article
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Running is one of the most accessible sports, and probably for this reason, is practiced by many persons all over the world. However, besides the positive health effects of running there are some concerns about the high incidence of running injuries, especially to the lower extremities. The results of a systematic review on lower extremity injuries of long-distance runners showed an incidence of running injuries ranging from 19.4% to 79.3%. The results of the Rotterdam marathon revealed a one-year prevalence of 48.3%. The incidence of lower extremity injuries occurring during the marathon was 18.2%; most of these injuries occurred in the calf, knee and thigh. The following factors were associated with the occurrence of lower extremity injuries: participating more than six times in a race in the previous 12 months (OR 1.66), a history of running injuries (OR 2.62), high education level (OR 0.73) and daily smoking (OR 0.23). Among the modifiable risk factors studied, a training distance less than 40 kilometres a week is a strong protective factor of future calf injuries, and regular interval training is a strong protective factor for knee injuries. At 3-months follow-up, 25.5% of the 165 injured runners reported persistent complaints; they had little pain during exercise and almost no pain in rest. Of all 165 male runners, 16.4% visited a general practitioner because of their running injury and 24.2% visited a physiotherapist. Non-musculoskeletal co-morbidities at baseline are related to poor recovery, whereas recovery is also location specific.
... The outcomes of this research may provide relevant insight for coaches, runners, and clinicians on how the physical and mental aspects of running influence injury and performance. With the high rate of injury during marathon training (21,33), evaluating running and mental skills preparation for marathon training may provide unique practical suggestions about how to better avoid injury and maximize performance. Specifically, having a greater understanding of what type of running and mental skills preparation contributes to an injury-free training cycle and maximizes performance will allow coaches, runners, and clinicians to make more informed decisions on training schedules. ...
... 23,193.95) and 23% faster than those who were running 31-40 miles$wk 21 (n = 9, 254.33 6 49.96 minutes; mean difference: 77.29 minutes, 95% CI 29.74, 124.85; Figure 2B). Runners who reported running 5-6 d$wk 21 pretraining were 36% faster (n = 5, 225.76 6 24.14 minutes) than those who were running 2-3 d$wk 21 Figure 2C). ...
... runners nationwide who finished a marathon in the previous 2 years, runners reported running approximately 4.4 d$wk 21 for an average of 29.4 miles (26). Similar to this nationwide survey, the majority of runners in our study reported running 3-4 d$wk 21 for an average of 20-30 miles$wk 21 leading up to their marathon. Unlike our study, however, the nationwide survey did not capture training preparation information. ...
Article
There has been a considerable increase in the number of participants running marathons over the past several years. The 26.2 mile race requires physical and mental stamina to successfully complete. However, studies have not investigated how running and mental skills preparation influence injury and performance. The purpose of our study was to describe the training and mental skills preparation of a typical group of runners as they began a marathon training program, assess the influence of training and mental skills preparation on injury incidence, and examine how training and mental skills preparation influence marathon performance. Healthy adults (N=1957) participating in an 18-week training program for a fall 2011 marathon were recruited for the study. One hundred twenty-five runners enrolled and received four surveys: pre-training, 6-weeks, 12-weeks, post-training. The pre-training survey asked training and mental skills preparation questions. The 6- and 12-week surveys asked about injury incidence. The post-training survey asked about injury incidence and marathon performance. Tempo runs during training preparation had a significant positive relationship to injury incidence in the 6-week survey (ρ (93) = 0.26, P=0.01). Runners who reported incorporating tempo and interval runs, running more miles/week, and running more days/week in their training preparation ran significantly faster than those reporting less tempo and interval runs, miles/week, and days/week (P≤0.05). Mental skills preparation did not influence injury incidence or marathon performance. To prevent injury, as well as maximize performance, while marathon training, it is important to that coaches and runners ensure a solid foundation of running fitness and experience exists, followed by gradually building volume, and then strategically incorporating runs of various speeds and distances.
... The incidence of running-related injuries is high and worrisome (Maughan and Miller, 1983;van Gent et al., 2007;. A meta-analysis reported a weighted incidence of 1 running-related injury per 1000 km of running in novice and recreational runners (Videbaek et al., 2015), while the yearly incidence of a lower extremity injury in long-distance runners can be as high as 79% (van Gent et al., 2007). ...
... Such an endurance challenge can only be completed if the marathoner remains injury free. The incidence of running-related injuries associated with a single marathon is, unfortunately, already high (Maughan and Miller, 1983;. Conceptually, the exceeding of the load tolerance of biological material due to an applied load results in injury (Kalkhoven et al., 2020). ...
Thesis
Running is a gross-motor skill and a popular physical activity, though it comes with a risk of injury. Gait retraining is performed with the intent on managing the risk of running injury. The peak tibial acceleration may be linked with running injuries and is suitable as input for biofeedback. So far, retraining programs with the use of biofeedback on peak tibial acceleration have been bound to a treadmill. Therefore, the objective of this doctoral thesis was to evaluate the effectiveness of a novel music-based biofeedback system on peak tibial acceleration in the context of gait retraining in a training environment. This system is wearable and has lightweight sensors to attach to the lower leg. The sensor first records the tibial acceleration. Then, a processing unit detects the acceleration spike for direct auditory biofeedback. Studies 1 to 5 covered the measurement of peak tibial accelerations, the design of the music-based feedback, and the effectiveness evaluation of the biofeedback system for impact reduction in a training center. In study 1 the peak tibial acceleration of a group of distance runners was reliable in the same test and repeatable in a re-test. The peak tibial accelerations increased with running speed and were correlated with the maximum vertical loading rate of the ground reaction force, which is an impact characteristic derived in the biomechanics laboratory. The developed peak detection algorithm identified the peak tibial acceleration in real-time. The music-based feedback was developed in study 2. The music was superimposed with perceptible pink noise. The noise intensity could be linked to a biological parameter such as the peak acceleration tibial. The tempo of the music synchronized with the cadence of the runner to motivate the runner and allowed for a user-induced change in cadence in response to the biofeedback. Studies 3 to 5 examined the effectiveness of music-based biofeedback on the peak tibial peak in a training environment. We demonstrated that smaller peak values are achievable with the aid of the validated biofeedback system. In study 3, ten runners with high peak tibial acceleration were subjected to biofeedback on the momentary peak tibial acceleration. The group was able to reduce their peak tibial acceleration by 27% or 3 g in the biofeedback condition. Study 4 evaluated the initial learning effect within a single session at ~11.5 km/h. The main change in peak acceleration occurred after approximately 8 minutes of biofeedback. However, there was substantial between-subject variation in time which ranged from 4 to 1329 gait cycles. Study 5 confirmed the effectiveness of the biofeedback in a quasi-randomized study with control group. The experimental group received the biofeedback in a 3-week retraining program comprising of biofeedback faded in time. The control group received tempo-synchronized music as placebo. A running speed of approximately 10 km/h was maintained session after session via speed feedback. All runners completed the running program consisting of 6 sessions. The peak acceleration decreased by 26% or 3 g in the experimental group. The smaller peak values in studies 3-5 must have resulted from a movement alteration, although there was no significant change in running cadence at the group level. Studies 6 to 9 give insight into possible strategies for low(er) peak tibial acceleration in level running. In study 6, we discovered that peak tibial accelerations depend on the manner of heel striking. Specifically, a more pronounced heel landing was correlated with smaller axial (1D) and resultant (3D) peak tibial accelerations. The multicenter results of study 7 showed greater resultant peak acceleration in non-rearfoot strikes compared with heel strikes. This greater acceleration was due to an abrupt horizontal deceleration of the lower leg. In study 8, we described and compared the running mechanics of a successful long-distance runner with low (impact) load and a high load capacity. A pronounced heel strike in conjunction with long stance and short flight phases characterized a low-impact runner who successfully completed 100 marathons in 100 days. Study 9 documented adaptations post-biofeedback in a lab center. There was no clear relationship between the changes in peak tibial acceleration and in running cadence, which confirmed the results of the data captured in the training center. Casuistry showed visually detectable changes in the curve of the vertical ground reaction force. A runner with high peak tibial acceleration peaks changed to a more pronounced rearfoot strike or changed to a non-rearfoot strike pattern to reduce the axial peak tibial acceleration. These results suggest the existence of different distal strategies for impact reduction elicited by biofeedback. Our experiments opened the possibility of impact reduction with the use real-time auditory biofeedback that is perceptible and motivating. Two motor strategies were discovered to run with less peak tibial acceleration. We hope these findings offer encouragement for runners, coaches and clinicians who wish to target a form of low(er) impact running. The biofeedback system effectively modified the running form and has great ecological value due to the portable hardware and energy source for outdoor usage. User-oriented biofeedback systems should become available for the consumer and the patient if proven useful for respectively injury reduction and injury management. Overall, this doctoral thesis contributed to a better understanding of impact severity in distance running and its reduction in a gait retraining context with the use of real-time music-based biofeedback.
... Studies reporting proportion of injury incidence Altman and Davis (2016 Macintyre et al. (1991) 46 Maughan and Miller (1983) 56 Jacobs and Berson (1986) ...
... Studies reporting proportion of injury incidence Altman and Davis (2016 Macintyre et al. (1991) 46 Maughan and Miller (1983) 56 Jacobs and Berson (1986) ...
Article
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Objective: Running-related musculoskeletal injuries (RRMIs), especially stemming from overuse, frequently occur in runners. This study aimed to systematically review the literature and determine the incidence and prevalence proportion of RRMIs by anatomic location and specific pathology. Methods: An electronic database search with no date beginning restrictions was performed in SPORTDiscus, PubMed, and MEDLINE up to June 2020. Prospective studies were used to find the anatomic location and the incidence proportion of each RRMI, whereas retrospective or cross-sectional studies were used to find the prevalence proportion of each RRMI. A separate analysis for ultramarathon runners was performed. Results: The overall injury incidence and prevalence were 40.2% ± 18.8% and 44.6% ± 18.4% (mean ± SD), respectively. The knee, ankle, and lower leg accounted for the highest proportion of injury incidence, whereas the knee, lower leg, and foot/toes had the highest proportion of injury prevalence. Achilles tendinopathy (10.3%), medial tibial stress syndrome (9.4%), patellofemoral pain syndrome (6.3%), plantar fasciitis (6.1%), and ankle sprains (5.8%) accounted for the highest proportion of injury incidence, whereas patellofemoral pain syndrome (16.7%), medial tibial stress syndrome (9.1%), plantar fasciitis (7.9%), iliotibial band syndrome (7.9%), and Achilles tendinopathy (6.6%) had the highest proportion of injury prevalence. The ankle (34.5%), knee (28.1%), and lower leg (12.9%) were the 3 most frequently injured sites among ultramarathoners. Conclusion: The injury incidence proportions by anatomic location between ultramarathoners and non-ultramarathoners were not significantly different (p = 0.798). The pathologies with the highest incidence proportion of injuries were anterior compartment tendinopathy (19.4%), patellofemoral pain syndrome (15.8%), and Achilles tendinopathy (13.7%). The interpretation of epidemiological data in RRMIs is limited due to several methodological issues encountered.
... Medical research involving marathon running has primarily focused on race-day injuries and medical emergencies; as many as 30% of runners experience a race injury [4][5][6][7][8]. Training-related running injuries in marathon runners have been measured primarily using cross-sectional surveys, finding 30-58% of runners experience some form of injury during training [9][10][11][12]. Few prospective observational studies have been done in runners training for a marathon and none specifically in first-time marathon runners [13][14][15]. ...
... time marathon runners is comparable to other studiesthat have included more experienced runners [9][10][11][12]17,18]. By reducing injuries among those training for their first marathon, not only can medical utilization be decreased, but new healthy habits involving regular exercise can be sustained, which may have lifelong positive implications. ...
Article
Objectives To determine how baseline characteristics of first-time marathon runners and training patterns are associated with risk of injuries during training and the race. Methods First-time adult marathon runners who were registered for the 2017 New York City Marathon were monitored starting 12 weeks prior to the race. Baseline data collection included demographics and running experience. Running frequency, distance, and injury occurrence were self-reported using online surveys every 2 weeks. Results A total of 720 runners participated of which 675 completed the study. There were 64/675 (9.5%) who had major injuries during training or the race that preventing starting or finishing the race. An additional 332 (49.2%) had minor injuries interfering with training and/or affecting race performance. Injury incidence was not significantly different based on age or sex. Runners who completed a half marathon prior to the study were less likely to report getting injured [multivariable odds ratio (OR) 0.40, (0.22, 0.76), p=0.005]. Runners who averaged <4 training runs per week during the study were less likely to report getting injured compared to those who averaged ≥4 per week [relative risk 1.36, (1.13-1.63), p=0.001]. Longest training run distance during the study was inversely associated with race-day injury incidence [OR 0.87 (0.81, 0.94), p<0.001]. Conclusion Injuries are common among first-time marathon runners. We found that risk of injury during training was associated with lack of half marathon experience and averaging ≥4 training runs per week. Longer training runs were associated with a lower incidence of race-day injuries. These results can inform the development of targeted injury-prevention interventions.
... According to a review of Van Gent et al. (2007) the overall incidence of lower extremity injuries in long distance runners in preparation to or during a marathon varied from 19 to 79 %. In other studies in which non-lower-extremity injuries were also described and included, the reported incidence for injuries ranged from 26 to 92 % (Bennell et al. 1996;Bovens et al. 1989;Kretsch et al. 1984;Lun et al. 2004;Macera et al. 1989Macera et al. , 1991Maughan and Miller 1983;Satterthwaite et al. 1999;Walter et al. 1989;Wen 2007). To note here, that older, more experienced runners were shown to be less affected by injury (Marti et al. 1988;Taunton et al. 2003). ...
... While men were seen to have hamstring and calf problems more often than women, women tended to have hip problems more than men (Satterthwaite et al. 1999) (Fig. 2.4). Additional complaints for both sexes included tibial stress syndrome, plantar fasciitis, Achilles tendonitis (Maughan and Miller 1983), thigh muscle soreness, blistered feet, chaffing, abrasions, malaise, lateral ankle sprains, alimentary disorders and extreme exhaustion (Satterthwaite et al. 1996(Satterthwaite et al. , 1999Taunton et al. 2003). ...
Chapter
This book section starts with an introduction towards the historical development of modern marathon running with respect to number of participants, gender and age distribution and the world record marathon times. This encompasses the development of the mean running velocities, details about the applied stride characteristics (e.g. stride rate, stride length), the applied strike patterns (e.g. forefoot strike vs. heel strike), the prevalence and causes of running related injuries. The second part gives an overview about general biomechanical principles which are relevant in running. In particular, specific definitions (phase definition of the running cycle, strike patterns), force components and the mathematical basics with respect to running energetics, joint loading, leg stiffness etc. are presented. The final part gives an overview about the state of the art knowledge about performance and injury related aspects with respect to marathon running from a biomechanical perspective. Special attention is paid to anthropometrics, running technique related aspects, fatigue effects and footwear.
... The elite marathon runner is characterised by a low body weight.Fig. 1 shows graphically the divergence from the ideal weight as it is described by Natvig (1980). DISCUSSION In this study the weekly mileage was twice the mileage found in previous studies concerning long distance running (Maughan et al, 1983; Jacobs et al, 1986), an illustration of the very hard work necessary to perform marathon running at elite level. Nearly all warm up before competition, but only half the runners do it before training. ...
... o difference between the group who used a special diet before the run and those who did not, probably because an athlete who performs such a demanding weekly training programme must use a regular diet that to nonathletes would seem special (Sharman et al, 1984). Forty-three per cent had suffered injuries severe enough to prevent them from training. Maughan and Miller (1983) have in an open entry marathon found an incidence of training related injuries of 58%. This difference might be due to the very thorough prophylaxis performed by the elite marathon runner concerning warming up and down, stretching, protection of the skin and feet etc. (Table 11). Several studies (Sutton et al, 1972; Wyndham et al, 1969; ...
Article
Full-text available
Two questionnaires were given to the participants of the Danish national marathon championship to obtain information on health, training habits, previous injuries and the medical problems sustained during and after the competition. All 60 participants replied to both questionnaires. The elite runner is training between 90-150 km per week, using one daily training session. He is generally careful about stretching and warming up and down. Forty-three per cent of runners sustained injuries in the last year that prevented them from training, but only 3% needed to stay off work. The most common reasons for not completing the race were exhaustion and injuries to the lower extremities. Sixty-one per cent of the runners who did not drink at all refreshment stations dropped out, whereas only 27% of those who did dropped out. There was no difference in relation to results or medical problems between the group who used a special diet before the run and those who did not. The major medical problems were gastrointestinal disturbances, skin lesions and pain or cramps in the lower extremities. No serious injuries were reported.
... 8 9 Estimates of the incidence of injury associated with training for and participating in a marathon range from 30% to 58%. [10][11][12][13][14] This high incidence of injuries comes with costs, including direct costs of medical care as well as indirect costs of the negative health effects from a decrease in fitness level due to severe or recurrent injuries. [15][16][17] Training volume is one of the few modifiable factors associated with injury in multiple studies and populations. ...
Article
Objective Training patterns are commonly implicated in running injuries. The purpose of this study was to measure the incidence of injury and illness among marathon runners and the association of injuries with training patterns and workload. Methods Runners registered for the New York City Marathon were eligible to enrol and prospectively monitored during the 16 weeks before the marathon, divided into 4-week ‘training quarters’ (TQ) numbered TQ1–TQ4. Training runs were tracked using Strava, a web and mobile platform for tracking exercise. Runners were surveyed at the end of each TQ on injury and illness, and to verify all training runs were recorded. Acute:chronic workload ratio (ACWR) was calculated by dividing the running distance in the past 7 days by the running distance in the past 28 days and analysed using ratio thresholds of 1.3 and 1.5. Results A total of 735 runners participated, mean age 41.0 (SD 10.7) and 46.0% female. Runners tracked 49 195 training runs. The incidence of injury during training was 40.0% (294/735), and the incidence of injury during or immediately after the marathon was 16.0% (112/699). The incidence of illness during training was 27.2% (200/735). Those reporting an initial injury during TQ3 averaged less distance/week during TQ2 compared with uninjured runners, 27.7 vs 31.9 miles/week (p=0.018). Runners reporting an initial injury during TQ1 had more days when the ACWR during TQ1 was ≥1.5 compared with uninjured runners (injured IQR (0–3) days vs uninjured (0–1) days, p=0.009). Multivariable logistic regression for training injuries found an association with the number of days when the ACWR was ≥1.5 (OR 1.06, 95% CI (1.02 to 1.10), p=0.002). Conclusion Increases in training volume ≥1.5 ACWR were associated with more injuries among runners training for a marathon. These findings can inform training recommendations and injury prevention programmes for distance runners.
... The most common types of injuries in runners are patellofemoral conflict, iliotibial band syndrome or fatigue fractures of the tibia and metatarsal bones [6,7]. Workouts in endurance sports are usually associated with longer training durations that involve repetitive movements, which increase the risk of an overuse injury [8,9]. There are many causes of running-related injuries, but the biomechanics of running play a significant role in their formation. ...
Article
Full-text available
Objective: The main goal of this study was to determine the correlation between running pattern and the lower limb injuries in long-distance runners. Materials and methods: The study comprised 23 long-distance runners (7 women, 16 men). The research used a questionnaire and video-analysis of running technique on a treadmill. The running on the treadmill was recorded from 3 views. Recordings were assessed in slow-motion. The following features were assessed: a foot strike pattern, a tibia angle at loading response, the maximum knee flexion angle during the stance phase, the maximum hip extension during the late stance phase, the maximum heel eversion angle, the distance between the knees and the pelvic drop angle. The subjects were divided into two groups-without previous trauma and with a history of previous trauma of a particular part of the lower limb.
... The incidence of running-related injuries associated with a single marathon is, unfortunately, already high. 2,3 Conceptually, the exceeding of the load tolerance of biological material due to an applied load results in injury. 4 Multiple loading-related variables have been prospectively associated with running injuries, 5À8 often depending on the investigated population and the follow-up methodology. ...
Article
Full-text available
Background: An extraordinary long-term running performance may benefit from low dynamic loads and a high load-bearing tolerance. An extraordinary runner (age = 55 years, height = 1.81 m, mass = 92 kg) scheduled a marathon a day for 100 consecutive days. His running biomechanics and bone density were investigated to better understand successful long-term running in the master athlete. Methods: Overground running gait analysis and bone densitometry were conducted before the marathon-a-day challenge and near its completion. The case's running biomechanics were compared pre-challenge to 31 runners who were matched by a similar foot strike pattern. Results: The case's peak vertical loading rate (Δx̄ = –61.9 BW/s or –57%), peak vertical ground reaction force (Δx̄ = –0.38 BW or –15%), and peak braking force (Δx̄ = –0.118 BW or –31%) were remarkably lower (p < 0.05) than the control group at ∼3.3 m/s. The relatively low loading-related magnitudes were attributed to a remarkably high duty factor (0.41) at the evaluated speed. The foot strike angle of the marathoner (29.5°) was greater than that of the control group, affecting the peak vertical loading rate. Muscle powers in the lower extremity were also remarkably low in the case vs. controls: peak power of knee absorption (Δx̄ = –9.16 W/kg or –48%) and ankle generation (Δx̄ = –3.17 W/kg or –30%). The bone mineral density increased to 1.245 g/cm² (+2.98%) near completion of the challenge, whereas the force characteristics showed no statistically significant change. Conclusion: The remarkable pattern of the high-mileage runner may be useful in developing or evaluating load-shifting strategies in distance running.
... MO=male only, FO=female only. Maughan and Miller (1983) Collins et al. (1989) Mechelen et al. (1993) Jakobsen et al. (1994) Wen et al. (1998) (2016) Junior et al. (2016) Table 1. ...
Article
Running is associated with a higher risk of overuse injury than other forms of aerobic exercise such as walking, swimming and cycling. An accurate description of the proportion of running injuries per anatomical location and where possible, per specific pathology, for both genders is required. The aim of this review was to determine the proportion of lower limb running injuries by anatomical location and by specific pathology in male and female runners (≥800m - ≤ marathon). The preferred reporting items for systematic reviews and meta-analyses guidelines were followed for this review. A literature search was performed with no re-striction on publication year in Web of Science, Scopus, Sport-Discus, PubMed, and CINAHL up to July 2017. Retrospective, cross-sectional, prospective and randomised-controlled studies which surveyed injury data in runners were included. 36 studies were included to report the overall proportion of injury per ana-tomical location. The overall proportion of injury by specific pathology was reported from 11 studies. The knee (28%), ankle-foot (26%) and shank (16%) accounted for the highest proportion of injury in male and female runners, although the proportion of knee injury was greater in women (40% vs. 31%). Relative to women, men had a greater proportion of ankle-foot (26% vs. 19%) and shank (21% vs. 16%) injuries. Patellofemoral pain syndrome (PFPS; 17%), Achilles tendinopathy (AT; 10%) and medial tibial stress syndrome (MTS; 8%) accounted for the high-est proportion of specific pathologies recorded overall. There was insufficient data to sub-divide specific pathology between gen-ders. The predominate injury in female runners is to the knee. Male runners have a more even distribution of injury between the knee, shank and ankle-foot complex. There are several methodo-logical issues, which limit the interpretation of epidemiological data in running injury.
... Despite the numerous benefits of running, there is also a significant risk for injury at some point in a runner's career (Marti, Vader, Minder, & Abelin, 1988;Van Gent et al., 2007). Anywhere from 27% to 79% of distance runners will experience an overuse injury over the course of a year (Lun, Meeuwisse, Stergiou, & Stefanyshyn, 2004;Marti et al., 1988;Maughan & Miller, 1983). Some of the most common running injuries include patellofemoral pain syndrome (PFPS-anterior knee pain), iliotibial band friction syndrome (ITBFS-lateral knee pain) and stress fractures (a fracture of the bone resulting from repetitive loading) (Taunton et al., 2002;Zadpoor & Nikooyan, 2011). ...
Article
Hill running is often used as a foundational training mechanism to build strength and speed. Distance runners in particular are at an increased likelihood of encountering steep hills during training runs. There is limited research regarding downhill running, and there is no research available on the biomechanics of females specifically during downhill running. The purpose of this study was to quantify the differences in loading when running downhill at different grades compared to a level surface in female distance runners to determine the potential risk for injury. Fifteen female distance runners (age: 23.5 ± 4.9 y), who ran 56.3 ± 20.9 km a week participated in this study. Participants ran on a force-instrumented treadmill at 4.0 m/s for 2 min at 0%, −5%, −10%, −15%, and −20% grades, with 5 min of rest between conditions. Study findings showed increased impact forces (p < 0.001), and increased loading rates (p < 0.001) with increasing downhill grades compared to level. These results indicate a significantly greater risk of overuse injury to the lower extremity with steeper downhill grades. Individuals need to be aware of these risks to plan and implement training programmes that will increase performance while minimising injury risk.
... The incidence of running-related musculoskeletal overuse injuries in previous studies ranged from 20 to 79 % [39]. The lower leg, foot, and ankle, especially the Achilles tendon and tibia, are commonly affected in running-related injuries [19,24,26,38]. On the basis of material fatigue, large forces applied to injured regions will decrease the number of cycles to failure [3]. ...
Article
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Permissions and Reprints Abstract Ground reaction force is often used to predict the potential risk of injuries but may not coincide with the forces applied to commonly injured regions of the foot. This study examined the forces applied to the foot, and the associated moment arms made by three foot strike patterns. 10 male runners ran barefoot along a runway at 3.3 m/s using forefoot, midfoot, and rearfoot strikes. The Achilles tendon and ground reaction force moment arms represented the shortest distance between the ankle joint axis and the line of action of each force. The Achilles tendon and joint reaction forces were calculated by solving equations of foot motion. The Achilles tendon and joint reaction forces were greatest for the forefoot strike (2 194 and 3 137 N), followed by the midfoot strike (1 929 and 2 853 N), and the rearfoot strike (1 526 and 2 394 N). The ground reaction force moment arm was greater for the forefoot strike than for the other foot strikes, and was greater for the midfoot strike than for the rearfoot strike. Meanwhile, there were no differences in the Achilles tendon moment arm among all foot strikes. These differences were attributed mainly to differences in the ground reaction force moment arm among the three foot strike patterns. Key word running - moment arm - Achilles tendon force - joint reaction force - musculoskeletal injury
... Overuse and traumatic injuries are common in runners with incidence estimates ranging from 19% to 79% (1)(2)(3)(4)(5). High impact forces and high and low arches have been considered risk factors for injury targeted by the footwear industry with cushioned, motion control, and stabilizing shoes designed to decrease injuries (6). ...
Article
Background: Minimalist running is increasing in popularity based upon a concept that it can reduce impact forces and decrease injury rates. The purpose of this investigation is to identify the rate and severity of injuries in runners transitioning from traditional to minimalist footwear. The secondary aims were to identify factors correlated with injuries. Methods: Fourteen habitually shod (traditional running shoes) participants were enrolled for this prospective study investigating injury prevalence during transition from traditional running shoes to 5-toed minimalist shoes. Participants were uninjured, aged between 22-41 years, and ran at least twenty kilometers per week in traditional running shoes. Participants were given industry recommended guidelines for transition to minimalist footwear and fit with a 5-toed minimalist running shoe. They completed weekly logs for identification of injury, pain using Visual Analogue Scale (VAS), injury location, and severity. Foot strike pattern and impact forces were collected using 3D motion analysis at baseline, 4 weeks, and 12 weeks. Injuries were scored according to a modified Running Injury Severity Score (RISS). Results: Fourteen runners completed weekly training and injury logs over an average of 30 weeks. Twelve of 14 (86%) runners sustained injuries. Average injury onset was 6 weeks (range 1-27 weeks). Average weekly mileage of 23.9 miles/week prior to transition declined to 18.3 miles/week after the transition. The magnitude of the baseline impact transient peak in traditional shoes and in minimalist shoes negatively correlated with RISS scores (r= -0.45, p=.055 and r= -0.53, p=.026, respectively). Conclusion: High injury rates occurred during the transition from traditional to minimalist footwear. Non-compliance to transition guidelines and high injury rates suggest the need for improved education. High impact transient forces unexpectedly predicted lower modified RISS scores in this population.
... Epidemiological studies of running injuries found the knee to be the most frequent site of injuries (Clement, Taunton, Smart, & McNicol, 1981;Maughan & Miller, 1983;Brunet, Cook, Brinker, & Dickinson, 1990) with chondromalacia patella, pain on the undersurface of the patella, as one of the most frequent knee injuries. Tab. 1 summarises the results from four epidemiological studies (James, Bates, & Osternig, 1978;Clement, Taunton, Smart, & McNicol, 1981;Bennell & Crossley, 1996;Ballas, Tytko, & Cookson, 1997) that attempted to identify the source of lower-extremity injuries in running. ...
Book
Sports biomechanics describes human movement from a performance enhancement and an injury reduction perspective. In this respect, the purpose of sports scientists is to support coaches and physicians with reliable information about athletes' technique. The lack of methods allowing for in-field athlete evaluation as well as for accurate joint force estimates represents, to date, the main limitation to this purpose. The investigations illustrated in the present thesis aimed at providing a contribution towards the development of the above mentioned methods. Two complementary approaches were adopted: a Low Resolution Approach - related to performance assessment - where the use of wearable inertial measurement units is exploited during different phases of sprint running, and a High Resolution Approach - related to joint kinetics estimate for injury prevention - where subject-specific, non-rigid constraints for knee joint kinematic modelling used in multi-body optimization techniques are defined. Results obtained using the Low Resolution Approach indicated that, due to their portability and inexpensiveness, inertial measurement systems are a valid alternative to laboratory-based instrumentation for in-field performance evaluation of sprint running. Using acceleration and angular velocity data, the following quantities were estimated: trunk inclination and angular velocity, instantaneous horizontal velocity and displacement of a point approximating the centre of mass, and stride and support phase durations. As concerns the High Resolution Approach, results indicated that the length of the anterior cruciate and lateral collateral ligaments decreased, while that of the deep bundle of the medial collateral ligament increased significantly during flexion. Variations of the posterior cruciate and the superficial bundle of the medial collateral ligament lengths were concealed by the experimental indeterminacy. A mathematical model was provided that allowed the estimate of subject-specific ligament lengths as a function of knee flexion and that can be integrated in a multi-body optimization procedure.
... A time-loss definition was used in 50 studies [3, 5-7, 16, 18, 20-28, 39-42, 44-46, 51, 54-58, 61, 62, 64-68, 71, 72, 74, 80-83, 86, 88-92, 94, 95]. Twenty studies used a medicalattention definition [17, 29-31, 35, 36, 60, 63, 69, 70, 75-79, 84, 85, 87, 96, 97], 11 registered pain-related injuries [6,7,16,32,49,52,53,63,73,80,93] and in 11 studies, the injury definition was not specified [19,33,34,37,38,43,47,48,50,59,62]. All study characteristics are presented in Electronic Supplementary Material Appendix S3. ...
Article
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Many runners suffer from injuries. No information on high-risk populations is available so far though. The aims of this study were to systematically review injury proportions in different populations of runners and to compare injury locations between these populations. An electronic search with no date restrictions was conducted up to February 2014 in the PubMed, Embase, SPORTDiscus and Web of Science databases. The search was limited to original articles written in English. The reference lists of the included articles were checked for potentially relevant studies. Studies were eligible when the proportion of running injuries was reported and the participants belonged to one or more homogeneous populations of runners that were clearly described. Study selection was conducted by two independent reviewers, and disagreements were resolved in a consensus meeting. Details of the study design, population of runners, sample size, injury definition, method of injury assessment, number of injuries and injury locations were extracted from the articles. The risk of bias was assessed with a scale consisting of eight items, which was specifically developed for studies focusing on musculoskeletal complaints. A total of 86 articles were included in this review. Where possible, injury proportions were pooled for each identified population of runners, using a random-effects model. Injury proportions were affected by injury definitions and durations of follow-up. Large differences between populations existed. The number of medical-attention injuries during an event was small for most populations of runners, except for ultra-marathon runners, in which the pooled estimate was 65.6 %. Time-loss injury proportions between different populations of runners ranged from 3.2 % in cross-country runners to 84.9 % in novice runners. Overall, the proportions were highest among short-distance track runners and ultra-marathon runners. The results were pooled by stratification of studies according to the population, injury definition and follow-up/recall period; however, heterogeneity was high. Large differences in injury proportions between different populations of runners existed. Injury proportions were affected by the duration of follow-up. A U-shaped pattern between the running distance and the time-loss injury proportion seemed to exist. Future prospective studies of injury surveillance are highly recommended to take running exposure and censoring into account.
... The relatively high incidence of injuries during training was probably due to the bad technique, low fitness and large amount of over training by the high level of achievement footballers. Zelisko et al (1982), Ekstrand et al (1983) and Maughan & Miller (1983) also reported training related injuries in footballers, basketballers and marathon runners and ascribed them to the wrong techniques and poor fitness level of athletes. While comparing the occurrence of injuries between lower and upper limbs, no signifancant differences of injuries were found between the low and the high level of achievement footballers. ...
Article
The primary aim of the investigation was to compare the occurrence of injuries to footballers at low and high level of achievement with regard to various stages viz. ground conditions, location, field positions, training and competition. Information on injuries was collected from members of eight Indian football teams which were participating in the All India Mayor Trophy football tournament by questionnaires. In all 98 injuries were observed, 40 related to the low achievement and 58 to the high achievement group of footballers. A significant difference in the occurrence of injuries between the two achievement groups of footballers was found. Occurrence of injuries due to field conditions and position of playing were also found to be significantly different in the two achievement groups. No significant differences in injury occurrence were found between group of footballers with respect to location. Significant difference in the occurrence of injuries were observed in the groups with respect to the frequency of competition and training periods (t=2.46, p<.05) of footballers. While comparing causes and nature of injuries, no significant differences were found between the low and the high level of achievement footballers. The high level of achievement footballers revealed more injuries than the low level of achievement footballers. Those football players directly involved in attack or defence are more likely to be injured. Lower limb injuries were found to be predominant. The results of the study provide a useful insight into the injuries in relation to the field position, nature and location of injury in competitive football players.
... Furthermore , our population exists of recreational runners and various running distances. Most other studies concern marathon runners or short-distance runner, but not both, and have a short follow-up (Maughan & Miller, 1983; Satterthwaite et al., 1996; Rauh et al., 2000 Rauh et al., , 2006 McKean et al., 2006; van Middelkoop et al., , 2008 Chakravarty et al., 2008; Knobloch et al., 2008; Buist et al., 2010 ). Therefore, our results can be better generalized to the majority of runners. ...
Article
To describe the incidence, 12-month prevalence, and course of lower extremity injuries that occurred during and after the Amgen Singelloop Breda in 2009. The design was based on a prospective cohort study with a population-based setting. In total, 3605 registered runners received a web-based baseline questionnaire of which 713 participants completed and returned it. Information about previous injuries, training programs, and demographic data were gathered at baseline. Site and intensity of running injuries and occurrence of new injuries were obtained from five post-race questionnaires. The main outcome measurement was lower extremity injury. The incidence of running injuries during the Amgen Singelloop Breda itself was 7.8%; most of these injuries occurred in the calf muscle, thigh, and knee joint. Three-month incidence of injuries during follow-up varied between 13.5% and 16.3%. During the 12-month follow-up period, 277 new running injuries were reported. Runners who ran more than 10 km are more susceptible to injury in comparison with runners who ran short distances (10 km or less). In total, 69.1% of running injuries resolves within 10 days. Running injuries are very common among recreational runners. Injuries mostly occur in the knee, thigh, and calf muscle.
... Les études rapportant des données sur les blessures en courses à pied ou en pratique de l'athlétisme hors stade (10 km, semi-marathon, marathon ou marche athlétique) [28][29][30][31][32][33] n'ont pas été inclues dans cette revue de la littérature. En effet, van Gent et al. [29] ont réalisé une revue exhaustive de cette thématique, qui est mieux connue en termes de fréquence et d'incidence, mais aussi au niveau des facteurs de risque. ...
Article
Objectives Sports injuries have an important impact on the sport and in daily life. Although athletics is known and performed on five continents, few is known about epidemiological data such as frequency, incidence, diagnosis or risk factors of injuries in athletics. In this context, consideration on strategies of sports injury prevention in athletics should be conducted. Current knowledge Sports injury surveillance by epidemiological studies is a preliminary step necessary in the clinical research on sports injury prevention. This is permitted by an agreed and validated methodolgy. Currently, the musculoskeletal lesions related to the track and field practice are common. The great diversity of these lesions reflects the diversity of disciplines, the constraints are different between the explosive disciplines (sprints, hurdles, jumps, throws) and endurance disciplines (middle and long distance). There was a predominance of lesions of thigh and hamstrings in the disciplines of sprint/hurdles, the Achilles tendon in jumps and sprints/hurdles, and chronic knee injuries and stress fractures in middle-distance. Conclusion Preventive measures which target the most frequent pathologies should be introduced. However, these data appear insufficient to fully understand the specific injury according to disciplines, and to understand the risk factors and injury mechanisms. Therefore, prospective epidemiological studies, and studies focused on specific populations or pathologies, are needed to improve strategies for the prevention of injuries in track and field.
... In other studies on marathon runners, the knee was also found to be the location predominantly affected by injuries, followed by the foot. 7,13,15,29,30 The present study has several limitations: First, the incidence of the injuries was obtained retrospectively via a self-reported questionnaire. Self-reporting may impact accuracy and introduce recall or reporting bias. ...
Article
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The purpose of this study was to investigate if the risk of injury declines with increasing weekly running volume before a marathon race. The study was a retrospective cohort study on marathon finishers. Following a marathon, participants completed a web-based questionnaire. The outcome of interest was a self-reported running-related injury. The injury had to be severe enough to cause a reduction in distance, speed, duration or frequency of running for at least 14 days. Primary exposure was self-reported average weekly volume of running before the marathon categorized into below 30 km/week, 30 to 60 km/week, and above 60 km/week. A total of 68 of the 662 respondents sustained an injury. When adjusting for previous injury and previous marathons, the relative risk (RR) of suffering an injury rose by 2.02 [95% CI: 1.26; 3.24], p < 0.01, among runners with an average weekly training volume below 30 km/week compared with runners with an average weekly training volume of 30-60 km/week. No significant differences were found between runners exceeding 60 km/week and runners running 30-60 km/week (RR=1.13 [0.5;2.8], p=0.80). Runners may be advised to run a minimum of 30 km/week before a marathon to reduce their risk of running-related injury. 2b.
... [5] Studies have been conducted to identify what are the most common injuries among runners. [2,6,8,[12][13][14][15][16][17][18][19] However, because of a large heterogeneity in the studies performed (e.g. RRMI definition, type of runners, injury classification and/or diagnosis), the literature does not provide a clear direction on the most incidental and/or prevalent RRMIs. ...
Article
Full-text available
Background: Musculoskeletal injuries occur frequently in runners and despite many studies about running injuries conducted over the past decades it is not clear in the literature what are the main running-related musculoskeletal injuries (RRMIs). Objective: The aim of this study is to systematically review studies on the incidence and prevalence of the main specific RRMIs. Methods: An electronic database search was conducted using EMBASE (1947 to October 2011), MEDLINE (1966 to October 2011), SPORTDiscus(1975 to October 2011), the Latin American and Caribbean Center on Health Sciences Information (LILACS) [1982 to October 2011] and the Scientific Electronic Library Online (SciELO) [1998 to October 2011] with no limits of date or language of publication. Articles that described the incidence or prevalence rates of RRMIs were considered eligible. Studies that reported only the type of injury, anatomical region or incomplete data that precluded interpretation of the incidence or prevalence rates of RRMIs were excluded. We extracted data regarding bibliometric characteristics, study design, description of the population of runners, RRMI definition, how the data of RRMIs were collected and the name of each RRMI with their rates of incidence or prevalence. Separate analysis for ultra-marathoners was performed. Among 2924 potentially eligible titles, eight studies (pooled n = 3500 runners) were considered eligible for the review. In general, the articles had moderate risk of bias and only one fulfilled less than half of the quality criteria established. Results: A total of 28 RRMIs were found and the main general RRMIs were medial tibial stress syndrome (incidence ranging from 13.6% to 20.0%; prevalence of 9.5%), Achilles tendinopathy (incidence ranging from 9.1% to 10.9%; prevalence ranging from 6.2% to 9.5%) and plantar fasciitis (incidence ranging from 4.5% to 10.0%; prevalence ranging from 5.2% to 17.5%). The main ultra-marathon RRMIs were Achilles tendinopathy (prevalence ranging from 2.0% to 18.5%) and patellofemoral syndrome (prevalence ranging from 7.4% to 15.6%). Conclusion: This systematic review provides evidence that medial tibia stress syndrome, Achilles tendinopathy and plantar fasciitis were the main general RRMIs, while Achilles tendinopathy and patellofemoral syndrome were the most common RRMIs for runners who participated in ultra-marathon races.
... The injuries noted are those that might be expected considering the training demands associated with marathon running and correspond to those noted by Maughan and Miller (1983) in runners who actually took part in the 1982 Aberdeen Marathon. It is also worth noting the high incidence of non-running injuries amongst the prerace drop-outs. ...
Article
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This study examines the reasons given for non-participation in the 1984 Aberdeen Milk Marathon by those people who entered for the race but did not run. The major reason was found to be injury during training. The future running plans of the sample were also investigated and it was found that the vast majority aimed to continue marathon running. Around two-thirds of the sample had decided not to run at least two weeks before the day of the race. A third of the respondents indicated that they would have taken part in the race had there been a half marathon option.
Chapter
The popularity of the half and full marathon has grown rapidly in recent years. Medical encounters during these events can be categorized into either musculoskeletal, dermatologic, or medical issues. While most musculoskeletal issues are due to overuse injuries, the most common acute musculoskeletal injuries during these events are acute muscle strains. Dermatologic issues occur frequently; blisters are the most common complaint. Medical issues during a race can range from benign to life-threatening. Clinicians should be aware of sudden cardiac arrest, exercise associated hyponatremia, and severe heat or cold illness, as these are potentially life-threatening conditions that may occur during marathon events. Overall, the marathon presents a unique challenge to clinicians who must be ready to treat a wide variety of conditions over a large physical area on race day.
Article
Background Lower extremity overuse injuries are common among runners, especially first-time marathoners. Hip abductor and quadriceps strengthening is often recommended to reduce running-related injuries. Hypothesis A 12-week strength training program would decrease the rate of overuse injuries resulting in marathon noncompletion and improve race finishing time. Study Design Randomized trial. Level of Evidence Level 2. Methods Twelve weeks before the New York City Marathon, first-time marathon runners age 18 years and older were randomized into a strength training group or an observation group. The strength training group was instructed to perform a 10-minute program 3 times weekly using written and video instruction. This program targeted the quadriceps, hip abductor, and core muscle groups. Injuries were self-reported through biweekly surveys, with major injuries being those that resulted in marathon noncompletion and minor injuries being those that impaired training or race performance. Results A total of 720 runners were enrolled (mean age, 35.9 ± 9.4 years; 69.4% female), of whom 583 runners started the marathon and 579 completed it. The incidence of major injury was 8.9% and minor injury was 48.5%. Fifty two of 64 major injuries were overuse, of which 20 were bone stress injuries. The incidence of overuse injury resulting in marathon noncompletion was 7.1% in the strength training group and 7.3% in the observation group (risk ratio, 0.97; 95% CI, 0.57-1.63; P = 0.90). The mean finishing time was 5 hours 1 ± 60 minutes in the strength training group and 4 hours 58 ± 55 minutes in the observation group ( P = 0.35). Conclusion There is a high prevalence of injury among first-time marathon runners, but this self-directed strength training program did not decrease overuse injury incidence resulting in marathon noncompletion. Clinical Relevance Prevention strategies such as strength training need to be developed and evaluated through clinical trials to reduce the high prevalence of overuse injuries in runners, especially for high-risk populations such as first-time marathon runners.
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Hawassa City Communities Lifestyle and Challenges to Do Regular Physical Activity and Exercise the Case of Administrative Civil Servants, Ethiopia Mequanent Shikabaw (MSc)1 Lecturer: University of Gondar, Sport Science Department, Ethiopia Email: mokieshi49@gmail.com Wondwosen Gizaw (MSc)2 Lecturer: Hawassa University, Sport Science Department, Ethiopia Abstract The main purpose of the study is to evaluate Hawassa administrative city community’s lifestyle and challenges to do regular physical activities and Exercise. Therefore, an explanatory mixed methods design is employed. The target population was Hawassa city administrative civil servants, 6626 in number in 2017, and study sample were selected by using multistage sampling techniques so that from 35 governmental civil service offices 500 (248 are females and 252 are males)civil servants were recruited and grouped randomly in to Teachers’, Office workers’, Lawyers, Health workers’, Engineers’, and Runners (Guards, messengers and janitor) based on the nature of work they have.Data was collected through questionnaire, focus group discussion (FGD) and field observation supported with secondary data from previous study, journals, articles, and books. Then both descriptive statistics and inferential tools in which logistic regression were employed to analyses the collected data. From the first 500 distributed questionnaire, 466 samples were returned the questionnaire properly. As a result, predominant Civil Servant Communities daily routine seem to accommodate health lifestyle in terms of smoking, alcohol usage and balanced diet. But most of them are physically inactive due to using technological outlets, work position, lack of equipment, negative perception, negative background on physical activity, personal behaviour, lack of parental and peer support, and environment or inconvenient residence area. Therefore, gender, regular physical exercise program participation, and the daily routines are directly associated with lifestyle of respondents at 0.05 level of significance. Whereas, age, work experience, exercise background, usage of balanced diet, and hypokinetic problem does not associate with lifestyle of respondents. Key terms: Lifestyle, Regular physical activity, Exercise, Balanced diet, Smoking etc
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Shin splints, an exercise-induced form of lower leg pain, is a common complaint among athletes. Considered an overuse injury that compromises the dense and tough fascial attachments of the tibialis posterior and/or tibialis anterior muscles from the tibia, it responds well to a multiphase treatment plan that incorporates plyometric strengthening and conditioning exercises. Plyometrics may be safely introduced as early as the third or functional phase of recovery. A progressive plyometric program that emphasizes a gradual development of eccentric stress loading to the musculoskeletal components of the deep posterior and anterior muscle compartments of the lower leg is described.
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Laufverletzungen [32] O r t h o p ä d i e s c h u h t e c h n i k 1 / 2 0 0 5 Der Laufsport erfreut sich unbegrenzt großer Beliebtheit. Dabei ist Laufsport längst nicht mehr eine Domäne von leistungsorientierten jungen Sportlern, sondern wird in allen Altersklassen betrieben. Betrachtet man die Starterlisten der großen Stadtmarathonveranstaltungen über die letzten Jahre so zeigt sich, dass insbesondere der Anteil der über 50-jährigen Läufer kontinuierlich ansteigt. Dies ist sicher insbesondere auch eine Folge der demographischen Entwicklung in unserem Land. Die folgende Studie wurde angefertigt um der Frage nachzugehen inwieweit laufassoziierte Verletzungen einen Bezug zum Alter des Sportlers haben.
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Running is at this moment one of the most popular sports in The Netherlands. However, besides the positive health effects of running there are some concerns about the high incidence of running injuries. The Rotterdam Marathon Study was set up to investigate the incidence, risk factors and course of running injuries occurred shortly before and during the marathon. Information on injuries, risk factors and course were obtained from participants using questionnaires. The incidence of injuries during the marathon was 18.2%; most of these injuries occurred in the calf, knee and thigh. The median pain intensity immediately after the marathon (scale 0-101 was 2 points at rest and 4.5 points versus 4.5 points during physical exercise. Runners with a history of running injuries (OR 2.62; 95% CI 1.82-3.78] are at higher risk to incur a new injury. At 3-months follow-up, 25.5% of the injured runners reported persistent complaints.
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A década de 70 foi marcada por grandes mudanças no comportamento social e consequentemente muitas pessoas no mundo começaram a praticar exercícios físicos de forma regular, procurando receber os benefícios de saúde e qualidade de vida conhecidos na época. Os corredores do passado praticavam a corrida ainda de forma rudimentar se comparados aos conhecimentos de biomecânica, fisiologia, nutrição, treinamento e prevenção que conhecemos hoje. A corrida continua a ser o esporte de escolha de milhares de pessoas pelo mundo devido a razões básicas, como a conveniência de poder praticá-la em muitos lugares, a relativa facilidade de execução e os benefícios de saúde que ela promove. A prática da corrida como atividade física tem demonstrado ao longo do tempo notórios benefícios cardiovasculares, no aumento da longevidade e na preservação da qualidade de vida. A corrida também assumiu o papel de uma dos esportes individuais que mais cresce anualmente no mundo todo. O fenômeno mundial da corrida atrai cada vez mais jovens em busca de saúde, prazer, relacionamentos e competição. As estatísticas de lesões na corrida, porém, passaram a abranger um número cada vez mais amplo de novas lesões com gravidades variadas. A corrida regular praticada a longo prazo também desencadeia uma série de adaptações músculo-esqueléticas, podendo gerar benefícios nos tecidos musculares, tendinosos, ósseos, ligamentares e cartilaginosos. Tais benefícios são representados pelo fortalecimento dos tecidos, incrementos na força, coordenação, propriocepção, resistência, equilíbrio e na flexibilidade, dentre outros. A literatura ainda busca respostas definitivas sobre as consequências da corrida a curto, médio e longo prazo e também sobre as reais implicações dos fatores de risco intrínsecos e extrínsecos na geração de lesões músculo-esqueléticas.
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Injuries are common in the various disciplines that make up the sport of athletics. Diagnosis depends on an accurate history and competent examination, possibly assisted by imaging techniques such as ultrasound, magnetic resolution imaging and computerized tomography. It is also important to consider the influence of various intrinsic and extrinsic factors in deciding on the mechanism of injury. Most acute injuries relate to overstretching of soft tissue, whereas overuse injuries reflect repetitive microtrauma with degenerative or inflammatory consequences. Steroid injections should be restricted to situations where inflammation predominates. Surgery may be required for specific acute injuries and when supervised rehabilitation over 6 months fails to resolve chronic injury. Following surgery, physical and psychological rehabilitation should be carefully planned.
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Using a survey questionnaire design, we investigated the incidence, site, and nature of jogging injuries among all participants of a popular 16 km race. The response rate was 83.6%. Of 4,358 male joggers, 45.8% had sustained jogging injuries during the 1 year study period, 14.2% had required medical care, and 2.3% had missed work because of jogging injuries. Occur rence of jogging injuries was independently associated with higher weekly mileage (P < 0.001), history of previous running injuries (P < 0.001), and competitive training motivation (P = 0.03). Higher mileage was also associated with more frequent medical consultations due entirely to jogging-related injuries. In 33 to 44 year olds (N = 1,757), the number of years of running was inversely related to incidence of injuries (P = 0.02). Injuries were not significantly related to race running speed, training surface, characteristics of running shoes, or relative weight. Achillodynia and calf muscle symptoms were the two most common overuse injuries and occurred significantly more often among older run ners with increased weekly mileage. We conclude that jogging injuries are frequent, that the number of firmly established etiologic factors is low, and that, in recom mending jogging, moderation should be the watchword.
Article
During one year 4398 injured athletes were treated at the casualty wards of Aarhus, Denmark; 156 were practicing track and field disciplines. In the same period 54 track athletes of a Danish sport club were followed in order to register any lesion incurred during sports activity. Thirty-one athletes (57%) had 35 injuries, giving an injury incidence of 1.8 per 1000 hours of practice. At follow-up after 1 year, 13% of all athletes still had complaints, and none of them had returned to former sports activity. Jumpers had overuse symptoms correlated to take-off, and sprains or fractures related to downstrokes. Runners had a higher risk of overuse injuries than jumpers, especially involving the Achilles tendon and the plantar aponeurosis. Young athletes had a higher injury incidence per time than older participants; and women had higher injury risk than men.
Article
Minimalist runners have been shown to have a different gait pattern with lower impact forces than habitually shod runners. Running in minimalist footwear has been promoted as a means of reducing or eliminating running injuries by returning to a more natural gait. Ten experienced runners, age 21 to 57 (mean, 43) years, were identified with injuries within 1 year of transition from traditional to minimalist running footwear. Patients were interviewed to determine their running history, injury history, transition to minimalist footwear, and their new injury including its treatment and recovery. Ten patients who ran with traditional footwear ran an average of 25.9 (range, 6 to 45) miles/week for an average of 18.9 (range, 1 to 40) years presented with injuries 2.8 (range 1 to 10) months after switching to minimalist footwear. Their injuries included eight metatarsal stress fractures, a calcaneal stress fracture, and a plantar fascia rupture. All patients had a successful recovery and returned to their previous level of running. Injuries including stress fractures and plantar fascia rupture have been observed in minimalist runners.
Article
Three years of registration of training, injuries, infections and stretching behaviour among national class orienteers is presented. Twenty-three runners were included for a 1- to 3-year period. Twenty-eight male-years and 27 female-years were analysed. A total of 219 injuries and infections were registered: 55 (25%) acute injuries, 71 (32%) overuse injuries and 93 (42%) infections. Overuse injuries were found to be the major problem, as these injuries affected training for an average of 35 days per runner per year, compared with 7 days caused by acute injuries and 10 days caused by infections. The acute injuries were mainly direct traumas and ankle distorsions. Overuse injuries affecting die knee region were the most numerous, but rear foot injuries affected training the most. An increase in training load was found in the last weeks before overuse injuries and infections. Stretching could not be found to prevent injuries.
Article
To evaluate whether a high body mass index (BMI) predisposes marathon/half-marathon participants to lower extremity injuries. Consenting adult participants at the 2008 National Marathon to Fight Breast Cancer were enrolled in this observational study. The primary outcome measure was prevalence of self-reported lower extremity injury, during both training and race participation, with respect to BMI. There were 194 subjects with complete data: 139 females (72%) and 55 males. Forty-six percent of females and 51% of males ran the full marathon (P = .63). Median BMI was 23.7 kg/m(2) for females and 26.2 kg/m(2) for males (P = .001). Eleven (24%) females in BMI tertile 1 (T1) suffered a training injury, while 9 (18%) from T2 and 4 (9%) from T3 suffered injuries (P = .072; OR 0.89; 95% CI 0.78 to 1.01). Twenty-six (19%) females suffered an injury during the race. Females in T1 were more likely to suffer a race-related injury (P = .038; OR 0.87; 95% CI 0.77 to 0.99). Females were 13% less likely to suffer a race-related injury with each 1-unit increase in BMI. Rates of injury did not differ by BMI tertile in males. A high BMI did not impart an increased risk of lower extremity injury during training or race participation.
Article
Hyperthermia is characterized by an increase of body core temperature due to exogenous heat exposure and/or endogenous heat production. Contrary to fever the hypothalamic-controlled temperature set point remains unchanged. To demonstrate that exercise-induced hyperthermia is a common phenomenon in childhood. We describe a 5-year-old boy, who attended our outpatient clinic with a 6-month observation period of exercise-induced hyperthermia with rectal temperatures up to 39.0 degrees C. Characteristically temperature dropped to normal values after cessation of exercise. In eight children aged 5-8, tympanic and rectal temperatures were measured before and after exercise. The rectal temperature increases frequently after exercise (p < 0.001), whereas tympanic temperature did not (p = 0.2). Benign hyperthermia should be considered in children with increased body temperature of unknown sources. The site of temperature measurement might be critical in the identification of this condition.
Article
Recreational and competitive running is practised by many individuals to improve cardiorespiratory function and general well-being. The major negative aspect of running is the high rate of injuries to the lower extremities. Several well-designed population-based studies have found no major differences in injury rates between men and women; no increasing effect of age on injuries; a declining injury rate with more years of running experience; no substantial effect of weight or height; an uncertain effect of psychological factors; and a strong effect of previous injury on future injuries. Among the modifiable risk factors studied, weekly distance is the strongest predictor of future injuries. Other training characteristics (speed, frequency, surface, timing) have little or no effect on future injuries after accounting for distance run. More studies are needed to address the effects of appropriate stretching practices and abrupt change in training patterns. For recreational runners who have sustained injuries, especially within the past year, a reduction in running to below 32 km per week is recommended. For those about to begin a running programme, moderation is the best advice. For competitive runners, great care should be taken to ensure that prior injuries are sufficiently healed before attempting any racing event, particularly a marathon.
Article
The term incidence is interpreted in many different ways in the literature. Running injury epidemiology should include denominator-based incidence rates, in which the number of new injuries observed during 1 year is related to the population of runners at risk. In 10 studies with denominator-based incidences selected from the literature, the annual incidence rates of injured runners vary from 24 to 65%. Comparison of denominator-based incidence rates from different studies requires a discussion of the denominator and of the numerator; i.e. the study population and the definition of running injury. Injury definitions differ from one study to another. Study populations are particular subgroups of the total running population and they differ from one study to another. Subgroups may differ in origin: volunteers, runners from a mailing list or entrants of a road race. Incidence rates are higher among supervised volunteers than among listed runners, and higher among both these groups than among race-entrants. The choice from the universe of the running population and the used injury definition are methodological issues. Incidence is dependently associated with the prevalence of predisposing running injury factors. There is consistent epidemiological support for the role of a few aetiological factors; i.e. higher mileage per week, previous running injury, higher running speed and lesser running experience. Higher mileage per week is probably the strongest predictor. In the selected injury studies, mileage per week differs from one study population to another. Differences in mileage per week do not explain differences in incidence rate between these studies. In conclusion, caution must be taken when comparing annual incidence rates of different studies. Methodological issues are at least as important as aetiological factors. Study populations may refer to different selections of the universe of the running population. The lengths of observation periods and 'running injury' definitions may differ from one study to another.
Article
We examined two general measures of morbidity, musculoskeletal problems and respiratory symptoms, among participants of a 42 km race. We compared the morbidity experience of these participants to runners racing shorter distance events (5 km and 10 km) on the same day. Male marathon runners were almost twice as likely (and female marathon runners four times as likely) to report a lower extremity musculoskeletal problem in the month after the race as nonmarathon runners. Although adjusting for other factors did not change the crude odds ratio for either men or women, logistic regression results indicated that the strongest factor associated with lower extremity musculoskeletal problems in the month after the marathon was the report of a musculoskeletal problem in the year before the marathon. Neither male nor female marathon runners reported an excess of respiratory symptoms compared to those who ran shorter distances. However, a report of respiratory symptoms in the month before the race was statistically associated with respiratory symptoms in the month after the race. These results suggest that runners who have had lower extremity musculoskeletal problems in the year before, or those who have recently experienced respiratory symptoms, should use caution when preparing for and recovering from racing events.
Article
The race statistics, whether conditions and incidence of medical problems for the six consecutive years of the Glasgow Marathon are reviewed. The results suggest that the popularity of marathon running is declining but that the competitors are becoming more experienced, seeking medical assistance earlier and, as a result, experiencing fewer and less serious problems at the finish. The effect of weather conditions on the runners' performance is discussed.
Article
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A questionnaire was given to all participants of the Wonderful Copenhagen Marathon 1986 regarding demographic information, health, training, previous injuries and methods used to prevent these. A total load of 2158 Danish runners participated and 1426 (68 per cent) replied. Fifty per cent of the runners were training 30-60 km per week and 25 per cent more than 60 km per week. Forty-one per cent were members of running clubs. The runners were equally distributed between all social groups. Most runners were slim (mean BMI 22.3 +/- 1.87 (SD)), healthy, non-smokers who rarely suffered from serious injuries, but 31 per cent had had injuries that prevented them from training during the last year. Nearly all performed stretching exercises and methods to avoid injuries. Fifty per cent of the runners tried to optimize their performance by changing their diet in the days before the run. Seventeen per cent used the classical high carbohydrate diet and 33 per cent other special diets.
Article
Two hundred fifty-seven high school track athletes from 17 teams were observed prospectively for one com plete season (77 days) to study the incidence and types of injuries and to establish the relationship among inju ries, duration of training, and individual performance ability. One hundred seventy-four (68%) of the athletes were male and 83 (33%) were female. A total of 41 injuries was observed over this period of time. One injury occurred for every 5.8 males and every 7.5 females. On the average, an injury resulted in 8.1 days of missed practice, 8.7 days for males and 6.6 days for females. Sprinting events were responsible for 46% of all injuries. The majority (83%) of injuries in volved the lower extremities. Management of these injuries varied greatly. A direct correlation was noted between performance level of the athlete and incidence of injuries. The aver age noninjured athlete ranked at the 57.4 percentile based on best seasonal performance while the average injured athlete ranked at the 75.4 percentile. This direct relationship was present for both sexes and within all events, although some variation was noted within these separate groups.
Article
More than 100 open-entry long-distance running events are planned in Britain this year. We report on the nature and volume of casualties that occurred in the 1982 Sheffield marathon: these data may help in planning supporting medical services for such events.