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Abstract

Objective: To investigate which preventive measures runners use when preparing for a half- or full-marathon and whether the use of these measures at baseline and during the preparation-period differs between runners who sustained no/non-substantial running-related injuries (NSIRs) or substantial running-related injuries (SIRs). Design: Prospective cohort study. Setting: 16-week period before the Utrechtmarathon. Participants: Runners who subscribed for the half- or full-marathon. Main outcome measures: The occurrence of RRIs was registered every 2-weeks, using the Dutch version of the Oslo Sport Trauma Research Center (OSTRC) questionnaire on Health Problems. The OSTRC was used to differentiate between runners with SIRs (question 2/3 score>12) and NSIRs (question 2/3 score<13). The use of different preventive measures, was registered every 4-weeks. Results: 51.6% of the runners reported at least one RRI in the 12-months prior to this study (history of RRIs). The SIRs with a history of RRIs more often asked for running shoe advice than NSIRs with a history of RRIs (67.9%vs43.4%, P < 0.05); 18.9% of the SIRs with a history of RRIs used supportive materials for knee and/or ankle versus 0% of NSIRs with a history of RRIs (P < 0.05). Conclusion: SIRs with a history of RRIs might be using their preventive measures for symptom reduction or secondary prevention.

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... A study of 125 runners participating in an 18-week training program recorded a prevalence of injury of 31% after 6 weeks of training and 42% after 12 weeks [16]. A 16-week study of 46 runners training for a marathon reported a 38% prevalence of injury during training [17,18]. These injuries comes with many costs, including the direct costs of physician office visits, advanced imaging, and rehabilitation, as well as the indirect costs of absences from work and the negative health effects of chronic inactivity if severe or recurrent injuries interfere with maintaining fitness [19][20][21]. ...
... 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.
... Participants aged above 80 years were also excluded to avoid a possibility that children had submitted data on their behalf [26,27]. Although the program system set a maximum distance of 45 km per report and allowed four entries, we set a more realistic maximum distance of <45 km/day (approximately a full marathon a day) because anything more than this was considered unreasonably high (e.g., technology bug or false report) [13,28]. Out of the total 392,565 registered participants in the server, only 186,653 participants with complete data were included in this study. ...
... Moreover, the 6 datasets were divided into 5 periods and treated as a categorical variable: (i) Period 1 (21-27 February); (ii) Period 2 (28 February-8 March); (iii) Period 3 (9-15 March); (iv) Period 4 (16)(17)(18)(19)(20)(21)(22); and (v) Period 5 (23)(24)(25)(26)(27)(28)(29)(30)(31). Although the length of each period was different, we analyzed daily steps to make the steps in each period comparable. ...
Article
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Thailand’s first national steps challenge has been implemented in 2020 with the goal to raise the level of physical activity nationwide by monitoring achievements through a smartphone application. This study examined the daily step counts of participants in the first national steps challenge. Six data points from 186,653 valid participants were retrieved and analyzed in five periods using Poisson regression. The mean daily steps peaked at 3196 in Period 1, and steadily dropped to 1205 in Period 5. The daily steps per period were analyzed using the participants’ characteristics, such as the type of participant, sex, age, body mass index, and area of residence. The overall mean daily steps of the participants meant physical activity was far below the recommended level and tended to drop in later periods. The general population achieved significantly higher mean daily steps than public health officers or village health volunteers (24.0% by multivariate analysis). Participants who were female, younger (<45 years), obese (body mass index > 30), and living in rural areas had fewer mean daily steps (13.8%, 44.3%, 12.7%, and 14.7% by multivariate analysis, respectively), with statistical significance. In the future, the national steps challenge should be continuously implemented by counting all steps throughout a day, using more strategies to draw attention and raise motivation, advocating for more participants, as well as reporting the whole day step counts instead of distance.
... A history of prior injury, especially within the last year, has been repeatedly shown to be a risk factor for future injury (13,14). Runners with higher body mass indices also have been shown to be at higher risk for injury (3,13). ...
Article
Running is a popular form of exercise that is easily accessible to various populations; endurance running, defined as distances beyond 5 km, continues to grow within the sport. Endurance running-related injuries are common in the lower extremities and are primarily overuse related. A multitude of risk factors for injury exist, including extrinsic factors, such as running distance and frequency, and intrinsic factors, such as biomechanics and nutrition status. Training and rehabilitation techniques vary with a general focus on strengthening and gradual increase in activity, but evidence is mixed, and it is difficult to generalize programs across different running populations. Management of specific running groups, including youth runners, is an area in which additional research is needed. New treatments, such as orthobiologics and wearable technology, have promising potential to optimize performance and recovery and minimize injury. However, they need to be further evaluated with high-quality studies.
... For the purpose of this study, non-endurance athletes were those athletes who did not report an endurance sport as their primary sport. Questions included in the section on the characteristics of the athletes were adapted from previously published studies [19][20][21]. ...
Article
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Background Studies on the benefits of lower extremity compression garments (CGs) have focused on their effects on post-exercise recovery and performance improvement. Less is known about why athletes actually use CGs, the frequency with which they use them, and perceived benefits from using CGs. The purpose of this study was to investigate which athletes use CGs, why athletes use CGs, when CGs are worn by athletes, and, in case of an injury or injury prevention, for which injuries CGs are used. Methods This cross-sectional study involved 512 athletes who used lower extremity CGs. Athletes completed a questionnaire on the type of CGs they used, and when and why they used them. They also reported their sports participation, past and current sports injuries, and the perceived benefits of using CGs. Results 88.1% ( n =451) of the athletes were endurance athletes and 11.9% ( n =61) were non-endurance athletes. Endurance and non-endurance athletes reported running (84.7%, n =382) and obstacle course racing (24.6%, n =15) the most frequently as primary sports, respectively. The most-used CG was the compression sock (59.2%, n =303). In total, 47.5% ( n =246) of the athletes used a CG primarily to prevent re-injury and 14.5% ( n =74) to reduce symptoms of a current sports injury. Other primary reported aims were primary prevention (13.6%), post-exercise recovery (14.3%), sports performance improvement (8.8%), and to look good (0.2%). The point prevalence of past and current sports injuries among all athletes was 84.2 and 20.2%, respectively. The most common current sports injuries were shin and calf injuries. Many athletes “always” or “often” used their CGs during training (56.8%, n =279) and competitions (72.9%, n =264). Furthermore, almost 90% of the athletes that aimed to prevent re-injury by using CGs reported that CGs contributed to secondary injury prevention. Conclusion 88% of the CG-users were endurance athletes, of which 85% were runners. All athletes mainly used CGs to prevent injury recurrence, but also to reduce symptoms of a current sports injury. A majority of the athletes reported positive perceived effects from the CGs. CGs were used more during than after sports participation.
... However, conflicting evidence exists for other risk factors, such as age and sex [3,10,13], training distance [4,5,7,10], running experience [14], body mass index (BMI) [15], and orthosis use [5,16]. Previous studies that attempted to reduce running injuries focused on preconditioning, warmup/cooldown, shoe type modification, and a directed, graduated training program [17,18]. Therefore, many studies reported different theoretical concepts. ...
Article
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Many studies exist on the incidence and related risk factors of running injuries, such as those obtained during marathons. However, in gorge-terrain marathons, an insufficient number of reports exist in the relevant literature. Therefore, this study aimed to explore the incidence of musculoskeletal injuries occurring in participants in the 2013 to 2018 Taroko Gorge Marathons in Taiwan and the distribution of running injuries and related influencing factors. A total of 718 runners who entered the physiotherapy station presented with records of treatment and injuries and filled out a running-related injury and self-training questionnaire for further statistical analysis. The association between risk factors and injury were evaluated by logistic regression. The injured areas on the lower extremities after the gorge marathon were as follows: 28% in the knees, 20% in the posterior calves, 13% in the thighs, 10% in the ankles, and 8% in the feet. The analysis of injury-related risk factors showed that male athletes demonstrated a higher risk of thigh injury than female athletes (OR = 2.42, p = 0.002). Underweight runners exhibited a higher risk of thigh injury (OR = 3.35, p = 0.006). We conclude that in the gorge marathon the rates of knee, calf, thigh, and foot injuries are significantly increased. Medical professionals, coaches, and runners may use the findings of this study to reduce the potential risk of running injuries in marathons.
... The effects are kept for up to five hours after the end of the immersion period in cold water (10-15 °C for approximately 5-7 min) 16,17 . Finally, a third type of ultramarathon technique is stretching 18 . These are also used during tests, and examples of applications are prevention of delayed onset muscle soreness (DOMS) 19 and cases of pain related to the medial tibial stress syndrome and exercise-associated muscle cramps 20 . ...
Article
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Aims: To analyze the effects of physical therapy procedures in reducing acute pain in runners. A second aim was to investigate the impact of weather conditions on the number of physical therapy visits during the Ultramarathon Rio24 h. Methods: This retrospective study was performed at the Physical Education Center Admiral Adalberto Nunes (CEFAN). Medical records were analyzed. The participants were athletes that were attended by the Physical therapy team during three editions of the Ultramarathon Rio24 h. The variation in the Visual Analog Scale score (VAS) before and after each treatment were analyzed. After the evaluation procedure, another professional had decided the best procedure for the assessed athlete: massotherapy, cryotherapy by immersion, or stretching. An ANOVA was performed to assess which procedures produce pain reduction immediately after the procedure. Results: A total of 1,995 care services (228 in women) were performed in 602 athletes (84 women). Analyzing the treatments that used only one modality (n = 512 visits), the final pain decreased significantly over the initial pain for the three treatments. It was verified that massotherapy, cryotherapy, and stretching promote significant intragroup differences, with no intergroup differences. The environmental conditions were not associated with the number of visits. Conclusion: Massotherapy, cryotherapy, and stretching are effective treatments for acute pain reduction during ultramarathons. The weather conditions are not associated with the number of physical therapy visits.
Article
Marathoner’s are athletes in every aspect and have an intension to improve their personal best in each phase of a competition. The achievement of the marathoners does not have any threshold level or saturation level to reach. Every time their requirement is to achieve their personal best of previous races. The existing model only deals with lesser and static parameters. In this paper, an effective motivational recommendation system is proposed to give a motivation point when they reach a saturation level mentally. In this model, a deep learning model namely Recurrent Neural Network is used for recommendation system. Using this particular recommendation system, the marathoner athlete can achieve his/her personal best and give a tough competition during the run. The deep learning model takes into consideration of plenty of parameters as mentioned in the article and generate a customised output according to the user. The proposed model has been interpreted in several aspects and the performance is effective when compared with the factors without motivation. In this model, all the dataset used are collected from ground level and the results are significant in every aspect.
Article
With marathon-running grew in popularity, the effect of long-distance running on plantar pressure has been more attractive. It has been proposed that long-distance running influences the deviation in the center of pressure (COP) during standing and the changes to plantar pressure during walking. The objective of this study was to observe the effects on the COP motion amplitude of static standing and the plantar pressure distribution of walking after long-distance running. The influence of a 10-km run on changes to plantar pressure was assessed during standing and walking. Plantar pressure was measured before and immediately after running. In the study, seven males and five females participated in barefoot tests of static standing and dynamic walking. In the static standing tests, COP was measured under the following four ordered conditions: (1) bipedal, eyes open, standing; (2) bipedal, eyes closed, standing; (3) unipedal, eyes open, standing and (4) unipedal, eyes closed, standing. Under each condition, the data was collected while a stable standing posture for 10 s. In the dynamic walking tests, the contact duration and plantar pressure were recorded. The standing tests results revealed no significant differences between males and females while slight differences before vs. after running. Running for a single time had no effect on COP deviation during standing. The walking tests results revealed an initial landing on the lateral heel. After landing on the lateral heel, the females quickly transferred to the medial heel. The movement of the pressure to the medial heel was slower in males than females. After running, the pressure of females was more inward, while that of males was more outward under the metatarsal zones in the propulsion phase.
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Background Running is a popular sport with high injury rates. Although risk factors have intensively been investigated, synthesized knowledge about the differences in injury rates of female and male runners is scarce. Objective To systematically investigate the differences in injury rates and characteristics between female and male runners. Methods Database searches (PubMed, Web of Science, PEDro, SPORTDiscus) were conducted according to PRISMA guidelines using the keywords “running AND injur*”. Prospective studies reporting running related injury rates for both sexes were included. A random-effects meta-analysis was used to pool the risk ratios (RR) for the occurrence of injuries in female vs. male runners. Potential moderators (effect modifiers) were analysed using meta-regression. Results After removal of duplicates, 12,215 articles were screened. Thirty-eight studies were included and the OR of 31 could be pooled in the quantitative analysis. The overall injury rate was 20.8 (95% CI 19.9–21.7) injuries per 100 female runners and 20.4 (95% CI 19.7–21.1) injuries per 100 male runners. Meta-analysis revealed no differences between sexes for overall injuries reported per 100 runners (RR 0.99, 95% CI 0.90–1.10, n = 24) and per hours or athlete exposure (RR 0.94, 95% CI 0.69–1.27, n = 6). Female sex was associated with a more frequent occurrence of bone stress injury (RR (for males) 0.52, 95% CI 0.36–0.76, n = 5) while male runners had higher risk for Achilles tendinopathies (RR 1. 86, 95% CI 1.25–2.79, n = 2). Meta-regression showed an association between a higher injury risk and competition distances of 10 km and shorter in female runners (RR 1.08, 95% CI 1.00–1.69). Conclusion Differences between female and male runners in specific injury diagnoses should be considered in the development of individualised and sex-specific prevention and rehabilitation strategies to manage running-related injuries.
Article
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Background Studies on the benefits of lower extremity compression garments (CGs) have focused on their effects on post-exercise recovery and performance improvement. Less is known about why athletes actually use CGs, the frequency with which they use them, and perceived benefits from using CGs. The purpose of this study was to investigate which athletes use CGs, why athletes use CGs, when CGs are worn by athletes, and, in case of an injury or injury prevention, for which injuries CGs are used. Methods This cross-sectional study involved 512 athletes who used lower extremity CGs. Athletes completed a questionnaire on the type of CGs they used, and when and why they used them. They also reported their sports participation, past and current sports injuries, and the perceived benefits of using CGs. Results 88.1% ( n =451) of the athletes were endurance athletes and 11.9% ( n =61) were non-endurance athletes. Endurance and non-endurance athletes reported running (84.7%, n =382) and obstacle course racing (24.6%, n =15) the most frequently as primary sports, respectively. The most-used CG was the compression sock (59.2%, n =303). In total, 47.5% ( n =246) of the athletes used a CG primarily to prevent re-injury and 14.5% ( n =74) to reduce symptoms of a current sports injury. Other primary reported aims were primary prevention (13.6%), post-exercise recovery (14.3%), sports performance improvement (8.8%), and to look good (0.2%). The point prevalence of past and current sports injuries among all athletes was 84.2 and 20.2%, respectively. The most common current sports injuries were shin and calf injuries. Many athletes “always” or “often” used their CGs during training (56.8%, n =279) and competitions (72.9%, n =264). Furthermore, almost 90% of the athletes that aimed to prevent re-injury by using CGs reported that CGs contributed to secondary injury prevention. Conclusion 88% of the CG-users were endurance athletes, of which 85% were runners. All athletes mainly used CGs to prevent injury recurrence, but also to reduce symptoms of a current sports injury. A majority of the athletes reported positive perceived effects from the CGs. CGs were used more during than after sports participation.
Article
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Background Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. Objective Our aim was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps. Methods Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include a control group/condition, prospective data collection, and a quantitative injury outcome measure. ResultsA total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes. Studies predominantly evaluated the preventive effect of various training programmes targeted at the ‘pre-event’ phase (n = 73) and the use of equipment to avoid injury in the ‘event phase’ (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5). Conclusions Valuable insight into the extent of the evidence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention.
Article
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Stretching, either prior to exercise or at the end, or both, is typically carried out by all individuals undertaking sporting activity whether they be elite or recreational athletes. The many forms of stretching available to the athlete, either passive or active, have long been thought to improve performance, decrease injury and generally be advantageous to the athlete. This review examines the current state of the literature and evaluates what athletes can and should do with respect to this controversial topic.
Article
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Background Runners at various levels of performance and specializing in different events (from 800 m to marathons) wear compression socks, sleeves, shorts, and/or tights in attempt to improve their performance and facilitate recovery. Recently, a number of publications reporting contradictory results with regard to the influence of compression garments in this context have appeared. Objectives To assess original research on the effects of compression clothing (socks, calf sleeves, shorts, and tights) on running performance and recovery. Method A computerized research of the electronic databases PubMed, MEDLINE, SPORTDiscus, and Web of Science was performed in September of 2015, and the relevant articles published in peer-reviewed journals were thus identified rated using the Physiotherapy Evidence Database (PEDro) Scale. Studies examining effects on physiological, psychological, and/or biomechanical parameters during or after running were included, and means and measures of variability for the outcome employed to calculate Hedges’g effect size and associated 95 % confidence intervals for comparison of experimental (compression) and control (non-compression) trials. Results Compression garments exerted no statistically significant mean effects on running performance (times for a (half) marathon, 15-km trail running, 5- and 10-km runs, and 400-m sprint), maximal and submaximal oxygen uptake, blood lactate concentrations, blood gas kinetics, cardiac parameters (including heart rate, cardiac output, cardiac index, and stroke volume), body and perceived temperature, or the performance of strength-related tasks after running. Small positive effect sizes were calculated for the time to exhaustion (in incremental or step tests), running economy (including biomechanical variables), clearance of blood lactate, perceived exertion, maximal voluntary isometric contraction and peak leg muscle power immediately after running, and markers of muscle damage and inflammation. The body core temperature was moderately affected by compression, while the effect size values for post-exercise leg soreness and the delay in onset of muscle fatigue indicated large positive effects. Conclusion Our present findings suggest that by wearing compression clothing, runners may improve variables related to endurance performance (i.e., time to exhaustion) slightly, due to improvements in running economy, biomechanical variables, perception, and muscle temperature. They should also benefit from reduced muscle pain, damage, and inflammation.
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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.
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Participation in endurance running such as half-marathon (21-km) and marathon (42-km) has increased over the last decades. We compared 147 recreational male half-marathoners and 126 recreational male marathoners to investigate similarities or differences in their anthropometric and training characteristics. The half-marathoners were heavier (P < 0.05), had longer legs (P < 0.001), thicker upper arms (P < 0.05), a thicker thigh (P < 0.01), a higher sum of skinfold thicknesses (P < 0.01), a higher body fat percentage (P < 0.05) and a higher skeletal muscle mass (P < 0.05) than the marathoners. They had fewer years of experience (P < 0.05), completed fewer weekly training kilometers (P < 0.001), and fewer weekly running hours (P < 0.01) compared to the marathoners. For halfmarathoners, body mass index (P = 0.011), percent body fat (P = 0.036) and speed in running during training (P < 0.0001) were related to race time (r 2 #61; 0.47). For marathoners, percent body fat (P #61; 0.001) and speed in running during training (P < 0.0001) were associated to race time (r 2 #61; 0.47). When body mass index was excluded for the half-marathoners in the multi-variate analysis, r 2 decreased to 0.45, therefore body mass index explained only 2% of the variance of half-marathon performance. Percent body fat was significantly and negatively related to running speed during training in both groups. To summarize, half-marathoners showed differences in both anthropometry and training characteristics compared to marathoners that could be related to their lower training volume, most probably due to the shorter race distance they intended to compete. Both groups of athletes seemed to profit from low body fat and a high running speed during training for fast race times.
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Background: Current methods for injury registration in sports injury epidemiology studies may substantially underestimate the true burden of overuse injuries due to a reliance on time-loss injury definitions. Objective: To develop and validate a new method for the registration of overuse injuries in sports. Methods: A new method, including a new overuse injury questionnaire, was developed and validated in a 13-week prospective study of injuries among 313 athletes from five different sports, cross-country skiing, floorball, handball, road cycling and volleyball. All athletes completed a questionnaire by email each week to register problems in the knee, lower back and shoulder. Standard injury registration methods were also used to record all time-loss injuries that occurred during the study period. Results: The new method recorded 419 overuse problems in the knee, lower back and shoulder during the 3-month-study period. Of these, 142 were classified as substantial overuse problems, defined as those leading to moderate or severe reductions in sports performance or participation, or time loss. Each week, an average of 39% of athletes reported having overuse problems and 13% reported having substantial problems. In contrast, standard methods of injury registration registered only 40 overuse injuries located in the same anatomical areas, the majority of which were of minimal or mild severity. Conclusion: Standard injury surveillance methods only capture a small percentage of the overuse problems affecting the athletes, largely because few problems led to time loss from training or competition. The new method captured a more complete and nuanced picture of the burden of overuse injuries in this cohort.
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Shoe manufacturers market motion control, stability, and cushioned shoes for plantar shapes defined as low, normal, and high, respectively. This assignment procedure is presumed to reduce injuries by compensating for differences in running mechanics. Assigning running shoes based on plantar shape will not reduce injury risk in Marine Corps basic training. Randomized controlled clinical trial; Level of evidence, 1. After foot examinations, Marine Corps recruits in an experimental group (E: 408 men, 314 women) were provided motion control, stability, or cushioned shoes for plantar shapes indicative of low, medium, or high arches, respectively. A control group (C: 432 men, 257 women) received a stability shoe regardless of plantar shape. Injuries during the 12 weeks of training were determined from outpatient visits obtained from the Defense Medical Surveillance System. Other known injury risk factors (eg, fitness, smoking, prior physical activity) were obtained from a questionnaire, existing databases, or the training units. Cox regression indicated little difference in injury risk between the E and C groups among men (hazard ratio [E/C] = 1.01; 95% confidence interval, 0.82-1.24) or women (hazard ratio [E/C] = 0.88; 95% confidence interval, 0.70-1.10). This prospective study demonstrated that assigning shoes based on the shape of the plantar foot surface had little influence on injuries even after considering other injury risk factors.
Article
Objective: To describe the incidence, prevalence, and impact of running-related injuries (RRIs) and illness symptoms in half marathon and marathon runners during the 16-week period before the Utrecht Marathon. Methods: In this prospective cohort study, we used the Oslo Sports Trauma Research Center questionnaire to register RRIs and illness symptoms every 2 weeks during the 16-week study period. When an injury or illness occurred, questions were added regarding its nature. We calculated the incidence proportion (the number of new cases divided by the number of runners at risk) and the period prevalence (the number of existing and new cases within a 2-week period, divided by the total number of runners at risk during that period). Results: Of the 161 included runners, 9 out of 10 reported an RRI or illness symptom at some time during the study period. In any 2-week period, 5.6% to 14.8% of the runners reported a new RRI, and 6.3% to 13.8% of the runners reported a new illness symptom. The prevalence of RRIs ranged from 29.2% to 43.5%, and the prevalence of illness symptoms ranged from 28.3% to 71.2%. The most prevalent RRIs were in the lower leg (prevalence range, 5.4%-12.3%) and knee (prevalence range, 2.7%-9.3%). The most prevalent illness symptoms were rhinorrhea/sneezing (prevalence range, 3.9%-12.7%) and coughing (prevalence range, 3.9%-11.9%). The incidence and prevalence of illness symptoms peaked at the same time as the influenza-like illness epidemic of the winter of 2015-2016. Conclusion: Nine out of every 10 runners reported an RRI or illness symptom in the lead-up to a half or full marathon. In any 2-week period, up to 1 in 7 runners reported a new RRI or illness symptom. Level of evidence: 2b. J Orthop Sports Phys Ther, Epub 18 Jun 2019. doi:10.2519/jospt.2019.8473.
Article
To determine risk factors for running injuries during the Lage Landen Marathon Eindhoven 2012. Prospective cohort study. Population-based study. This study included 943 runners. Running injuries after the Lage Landen Marathon. Sociodemographic and training-related factors as well as lifestyle factors were considered as potential risk factors and assessed in a questionnaire 1 month before the running event. The association between potential risk factors and injuries was determined, per running distance separately, using univariate and multivariate logistic regression analysis. In total, 154 respondents sustained a running injury. Among the marathon runners, in the univariate model, body mass index ≥ 26 kg/m(2) , ≤ 5 years of running experience, and often performing interval training, were significantly associated with running injuries, whereas in the multivariate model only ≤ 5 years of running experience and not performing interval training on a regular basis were significantly associated with running injuries. Among marathon runners, no multivariate model could be created because of the low number of injuries and participants. This study indicates that interval training on a regular basis may be recommended to marathon runners to reduce the risk of injury. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Article
Unlabelled: The sex difference in marathon performance increases with age and place of the finisher, even at the elite level. Sociological factors may explain the increased sex gap, but there is limited empirical evidence for specific factors. Purpose: The purposes of this study were to determine the sex difference in velocity for the marathon across the place of finisher (1st-10th place) with advanced age and (2) to determine the association between the sex difference in participation (ratio of men-to-women finishers) and the sex difference in running velocity. Methods: Running times of the first 10 placed men and women in the 5-yr age brackets between 20 and 79 yr and the number of men and women who finished the New York City marathon were analyzed for a 31-yr period (1980-2010). Results: The sex difference in running velocity increased between the 1st and the 10th place because of a greater relative drop in velocity of women than men (P < 0.001). The sex difference increased with advanced age and decreased across the 31 yr, but more for the older age groups (P < 0.001). The number of women finishers also increased relative to men for the 31 yr, but more in the older age groups (P < 0.001). Importantly, approximately 34% of the sex difference in velocity among the first-place finishers was associated with the ratio of men-to-women finishers (r = 0.58, r² = 0.34, P < 0.001). Conclusions: The greater sex difference in velocity that occurs with age and with increased place was primarily explained by the lower number of women finishers than men. These data provide evidence that lower participation rates and less depth among women competitors can amplify the sex difference in running velocity above that due to physiological sex differences alone.
Article
To investigate the distribution of lower extremity running injuries and their associated factors. Descriptive and exploratory study. 1004 participants of the 2005 ING Taipei International Marathon. We used a self-developed questionnaire to collect data of previous running injuries and applied multivariate logistic regression modeling to examine relationships between these injuries and associated factors. Of the 893 valid questionnaires, 396 (44.4%) reported having previous lower extremity pain related to running. Knee joint pain was the most common problem (32.5%). Hip pain was associated with the racing group, training duration, and medial arch support. Use of knee orthotics (P = 0.002) and ankle braces (P = 0.007) was related to a higher rate of knee and ankle pain. Participants of the full marathon group who practiced on a synthetic track had a higher incidence of ankle pain. A training duration of >60 min was linked to an increased rate of foot pain (P = 0.003). Our data indicated that running injuries were associated with training duration and use of orthotics. Clinicians can use this information in treating or preventing running associated injuries and pain.
Article
The popularity of running is still growing. As participation increases, running-related injuries also increase. Until now, little is known about the predictors for injuries in novice runners. Predictors for running-related injuries (RRIs) will differ between male and female novice runners. Cohort study; Level of evidence, 2. Participants were 532 novice runners (226 men, 306 women) preparing for a recreational 4-mile (6.7-km) running event. After completing a baseline questionnaire and undergoing an orthopaedic examination, they were followed during the training period of 13 weeks. An RRI was defined as any self-reported running-related musculoskeletal pain of the lower extremity or back causing a restriction of running for at least 1 week. Twenty-one percent of the novice runners had at least one RRI during follow-up. The multivariate adjusted Cox regression model for male participants showed that body mass index (BMI) (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.05-1.26), previous injury in the past year (HR, 2.7; 95% CI, 1.36-5.55), and previous participation in sports without axial load (HR, 2.05; 95% CI, 1.03-4.11) were associated with RRI. In female participants, only navicular drop (HR, 0.85; 95% CI, 0.75-0.97) remained a significant predictor for RRI in the multivariate Cox regression modeling. Type A behavior and range of motion (ROM) of the hip and ankle did not affect risk. Male and female novice runners have different risk profiles. Higher BMI, previous injury, and previous sports participation without axial loading are important predictors for RRI in male participants. Further research is needed to detect more predictors for female novice runners.
Article
Novice runners often seek advice from a physician about training responsibly. Common concerns include sudden cardiac arrest, advice on running injuries and how to avoid these events. Cardiologic screening and ergometry are only beneficial if the athlete has a high-risk profile. In the world of running, there are many myths regarding the prevention ofinjuries. Many recommendations on the use of running shoes, supportive insoles, running on soft or hard surfaces and the value of stretching have been made based on empirical evidence. The actual effects of these recommendations on injury prevention, however, have not been evaluated sufficiently. The value of preventive examination of structural and locomotor elements is also unclear at this time. Progression of training load in which the duration and intensity of training increases by less than 10% per week, appears to be the most reasonable way to prevent running injuries.
Article
With the increase in the number of multinational and multicultural research projects, the need to adapt health status measures for use in other than the source language has also grown rapidly. 1,4,27 Most questionnaires were developed in English-speaking countries, 11 but even within these countries, researchers must consider immigrant populations in studies of health, especially when their exclusion could lead to a systematic bias in studies of health care utilization or quality of life. 9,11 The cross-cultural adaptation of a health status selfadministered questionnaire for use in a new country, culture, and/or language necessitates use of a unique method, to reach equivalence between the original source and target versions of the questionnaire. It is now recognized that if measures are to be used across cultures, the items must not only be translated well linguistically, but also must be adapted culturally to maintain the content validity of the instrument at a conceptual level across different cultures. 6,11‐13,15,24 Attention to this level of detail allows increased confidence that the impact of a disease or its treatment is described in a similar manner in multinational trials or outcome evaluations. The term “cross-cultural adaptation” is used to encompass a process that looks at both language (translation) and cultural adaptation issues in the process of preparing a questionnaire for use in another setting. Cross-cultural adaptations should be considered for several different scenarios. In some cases, this is more obvious than in others. Guillemin et al 11 suggest five different examples of when attention should be paid to this adaptation by comparing the target (where it is going to be used) and source (where it was developed) language and culture. The first scenario is that it is to be used in the same language and culture in which it was developed. No adaptation is necessary. The last scenario is the opposite extreme, the application of a questionnaire in a different culture, language and country—moving the Short Form 36-item questionnaire from the United States (source) to Japan (target) 7 which would necessitate translation and cultural adaptation. The other scenarios are summarized in Table 1 and reflect situations when some translation and/or adaptation is needed. The guidelines described in this document are based on a review of cross-cultural adaptation in the medical, sociological, and psychological literature. This review led to the description of a thorough adaptation process designed to maximize the attainment of semantic, idiomatic, experiential, and conceptual equivalence between the source and target questionnaires. 13 . Further experience in cross-cultural adaptation of generic and diseasespecific instruments and alternative strategies driven by different research groups 18 have led to some refinements
Article
To describe the baseline characteristics of participants starting a 25-week marathon training program, and their relationship to injury risk factors. Prospective survey. Community-based marathon training program. 1,548 of 2,314 registrants for the Houston Fit Marathon Training Program (mean age 35.8 +/- 9.3 years, mean body mass index 24.3 +/- 3.9, 63% female). 4-page survey administered at registration. Running experience, training practices, demographics, chronic medical problems and previous injuries. Females were more likely to be classified as underweight and males as overweight or obese (p < 0.0001). The mean number of years of running experience was 6.2 +/- 6.2. Most (87.5%) planned to train at a 9-minute mile or slower pace. 52.3% of the participants had not previously trained for a marathon. In the 3 months prior to starting the program 16.1% had been sedentary. Those runners who had not previously completed a marathon and not previously trained with Houston Fit had a higher prevalence of baseline training techniques that could be risk factors for injury. During the previous 3 years, 38.1% reported having an injury, and 35% of all injuries were still symptomatic at the start of the program. Training programs for the marathon attract more female athletes and those with less running and marathon experience. The prevalence of being overweight or obese is 35.6%. 16.1% are sedentary during the 3 months before starting this program. Training programs must take measures to establish baseline fitness, to educate on injury prevention training techniques, and to set appropriate fitness goals. The research study shows that many patients wanting to start a marathon training program are relatively untrained and inexperienced with reference to endurance running. These patients will need special care and education so as to minimize injury and maximize the effect on their physical activity habits.
Article
The aim of this study is to identify risk factors for lower extremity injuries in male marathon runners. A random sample of 1500 recreational male marathon runners was drawn. Possible risk factors were obtained from a baseline questionnaire 1 month before the start of the marathon. Information on injuries sustained shortly before or during the marathon was obtained using a post-race questionnaire. Of the 694 male runners who responded to the baseline and post-race questionnaire, 28% suffered a self-reported running injury on the lower extremities in the month before or during the marathon run. More than six times race participation in the previous 12 months [odds ratio (OR) 1.66; confidence interval (CI) 1.08-2.56], a history of running injuries (OR 2.62; CI 1.82-3.78), high education level (OR 0.73; CI 0.51-1.04) and daily smoking (OR 0.23; CI 0.05-1.01) were associated with the occurrence of lower extremity injuries. Among the modifiable risk factor studies, a training distance <40 km a week is a strong protective factor of future calf injuries, and regular interval training is a strong protective factor for knee injuries. Other training characteristics appear to have little or no effect on future injuries.
Running related injuries: The effect of a preconditioning program and biomechanical risk factors
  • S W Bredeweg
Bredeweg, S. W. (2014). Running related injuries: The effect of a preconditioning program and biomechanical risk factors. PhD Thesis. University of Groningen.
Injuries in runners; a systematic review on risk factors and sex differences
  • M Walther
  • I Reuter
  • T Leonhard
  • M Engelhardt
  • D Y Wen
  • J C Puffer
  • T P Schmalzried
Walther, M., Reuter, I., Leonhard, T., & Engelhardt, M. (2005). Injuries and response to overload stress in running as a sport. Orthop€ ade, Der, 34(5), 399e404. Wen, D. Y., Puffer, J. C., & Schmalzried, T. P. (1998). Injuries in runners: A prospective study of alignment. Clinical Journal of Sport Medicine, 8(3), 187e194. van der Worp, M., Ten Haaf, D. S., van Cingel, R., & de Wijer, A. (2015). Nijhuis-van der Sanden MW, Staal JB. Injuries in runners; a systematic review on risk factors and sex differences. PLoS One, 10(2). e0114937.