Course and Predicting Factors of Lower-Extremity Injuries After Running a Marathon

Department of General Practice, Erasmus Medical Centre, 3000 CA Rotterdam, The Netherlands.
Clinical Journal of Sport Medicine (Impact Factor: 2.27). 02/2007; 17(1):25-30. DOI: 10.1097/JSM.0b013e3180305e4d
Source: PubMed


To investigate in recreational runners the 3 month prognosis of and medical consumption caused by running injuries occurring shortly before or during a marathon. Possible prognostic factors for persistent complaints were also evaluated.
Prospective cohort study.
Rotterdam, the Netherlands.
One hundred sixty-five recreational marathon runners who reported a new running injury in the month before or during the Rotterdam Marathon 2005 and who were available for follow-up. ASSESSMENT OF DETERMINANTS: Demographic, running (training distance, frequency and duration, experience, etc), lifestyle (other sports, smoking), and injury-related factors were collected at baseline.
Persistent complaints of running injuries occurring in the month before or during the Rotterdam marathon at 3 month follow-up. Potential prognostic factors for persistent complaints were analyzed by multivariate logistic regression.
At 3 month 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, 27 (16.4%) visited a general practitioner because of their running injury and 40 (24.2%) visited a physiotherapist (218 times in total). Persistent complaints at 3 month follow-up were associated with non-musculoskeletal comorbidities [odds ratio (OR), 3.23; confidence interval (CI), 1.24-8.43], and calf injuries (OR, 0.37; CI, 0.13-1.05).
One quarter of the runners had persistent complaints of their marathon-related running injury at 3 month follow-up. However, the clinical and social consequences of the injuries seem to be relatively mild. Non-musculoskeletal comorbidities at baseline are related to poor recovery, whereas recovery is also location specific.

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Available from: Marienke van Middelkoop, Aug 14, 2014
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    • "An additional strength was the use of an early clinical examination to diagnose each injury. In many studies, participants report their injury by mail or telephone without attending an examination[3], [17], [18]. By doing so, the possibility to identify the diagnoses sustained by each injured participant becomes limited. "
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    ABSTRACT: Objectives: Describe the diagnoses and the time to recovery of running-related injuries in novice runners. Design: Prospective cohort study on injured runners. Method: This paper is a secondary data analysis of a 933-person cohort study (DANO-RUN) aimed at characterizing risk factors for injury in novice runners. Among those sustaining running-related injuries, the types of injuries and time to recovery is described in the present paper. All injured runners were diagnosed after a thorough clinical examination and then followed prospectively during their recovery. If they recovered completely from injury, time to recovery of each injury was registered. Results: A total of 254 runners were injured. The proportion of runners diagnosed with medial tibial stress syndrome was 15%, 10% for patellofemoral pain, 9% for medial meniscal injury, 7% for Achilles tendinopathy and 5% for plantar fasciitis. Among the 220 runners (87%) recovering from their injury, the median time to recovery was 71 days (minimum = 9 days, maximum = 617 days). Conclusions: Medial tibial stress syndrome was the most common injury followed by patellofemoral pain, medial meniscal injury and Achilles tendinopathy. Half of the injured runners were unable to run 26500 meters without pain after 10 weeks. Almost 5% of the injured runners received surgical treatment.
    Full-text · Article · Jun 2014 · PLoS ONE
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    • "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, 2006; McKean et al., 2006; van Middelkoop et al., 2007, 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. "
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    ABSTRACT: 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.
    Full-text · Article · Aug 2013 · Scandinavian Journal of Medicine and Science in Sports
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    • "Multivariate methods are susceptible to producing problematic results if too few RRIs are available relative to the number of risk factors analyzed in the model. As a result, several studies that used this type of analysis first examined the independent link of potential risk factors with RRIs and only factors univariately associated with an RRI were entered into the multivariate model [7,12-14]. To account for the multifactorial nature of RRIs this univariate selection of potential risk factors is undesirable [15]. "
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    ABSTRACT: Running is associated with desirable lifestyle changes. Therefore several initiatives have been undertaken to promote running. Exact data on the health effects as a result of participating in a short-term running promotion program, however, is scarce. One important reason for dropout from a running program is a running-related injury (RRI). The incidence of RRIs is high, especially in novice runners. Several studies examined potential risk factors for RRIs, however, due to the often underpowered studies it is not possible to reveal the complex mechanism leading to an RRI yet.The primary objectives are to determine short- and long-term health effects of a nationwide "Start to Run" program and to identify determinants for RRIs in novice runners. Secondary objectives include examining reasons and determinants for dropout, medical consumption and economical consequences of RRIs as a result of a running promotion program.Methods/design: The NLstart2run study is a multi-center prospective cohort study with a follow-up at 6, 12, 24 and 52 weeks. All participants that sign up for the Start to Run program in 2013, which is offered by the Dutch Athletics Federation, will be asked to participate in the study.During the running program a digital running log will be completed by the participants every week to administer exposure and running related pain. After the running program the log will be completed every second week. An RRI is defined as any musculoskeletal ailment of the lower extremity or back that the participant attributed to running and hampers running ability for at least one week. The NLstart2run study will provide insight into the short- and long-term health effects as a result of a short-term running promotion program. Reasons and determinants for dropout from a running promotion program will be examined as well. The study will result in several leads for future RRI prevention and as a result minimize dropout due to injury. This information may increase the effectiveness of future running promotion programs and will thereby contribute positively to public health.Trial registration: The Netherlands National Trial Register NTR3676. The NTR is part of the WHO Primary Registries.
    Full-text · Article · Jul 2013 · BMC Public Health
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