Training volume and previous injury as associated factors for running-related injuries by race distance: A cross-sectional study
Keywords:Running, Epidemiology, Athletic Injuries, Etiology, Sports
Objective: This study aims to determine the relationship between weekly pre-competition running volume and the presence of running-related injuries (RRIs) by race distance. Methods: An online questionnaire was sent to 25,000 participants, 14 days following the running event. The questionnaire included the presence and topography of RRIs, previous injury in the last 12 months, running experience, training, and sociodemographic characteristics. Univariate and multivariable binomial regression was used to analyse the crude and adjusted relationship of RRI and training volumes. Results: 4380 surveys were analysed (10km, n=1316; 21km, n= 2168; 42km, n=896). The median age was 36 years. Previous injury was reported by 51.8% of the respondents. Median training volume in the previous month was 15 km/week (IQR 6-24), 30 km/week (IQR 15-40) and 45 km/week (IQR 30-60), for the 10km, 21km, and 42km distances, respectively. During the race, 14.1% reported a RRI, with 43.1% located at the knee. The multivariable analysis showed previous injury and distance as the main associated factors, whereas weekly training volume, age, and previous participation were protective. Conclusion: Race is an inciting event for developing a RRI. Running race distance is an important factor itself and should be incorporated with other modifiable risk factors in current injury models.
FundingSantiago Marathon and Prokart Productions, Mr. Roberto Urzua, Mr. Pablo Suarez and Mr. Camilo Pavez, Universidad del Desarrollo
Bahr, R., & Krosshaug, T. (2005). Understanding injury mechanisms: a key component of preventing injuries in sport. British Journal of Sports Medicine, 39(6), pp. 324-329. https://doi.org/10.1136/bjsm.2005.018341
Besomi, M., Leppe, J., Di Silvestre, M. C., & Setchell, J. (2018). SeRUN® study: Development of running profiles using a mixed methods analysis. PloS One, 13(7), p e0200389. https://doi.org/10.1371/journal.pone.0200389
Buist, I., Bredeweg, S. W., Bessem, B., Mechelen, W. V., Lemmink, K. A. P. M., & Diercks, R. L. (2010). Incidence and risk factors of running-related injuries during preparation for a 4-mile recreational running event. Brithish Journal of Sports Medicine, 44(8), pp. 598-604. https://doi.org/10.1136/bjsm.2007.044677
Clarsen, B., Rønsen, O., Myklebust, G., Flørenes, T. W., & Bahr, R. (2014). The Oslo Sports Trauma Research Center questionnaire on health problems: a new approach to prospective monitoring of illness and injury in elite athletes. British Journal of Sports Medicine, 48(9), pp. 754-760. https://doi.org/10.1136/bjsports-2012-092087
Diderisken, M., Soegaard, C., & Nielsen, R. O. (2016). Validity of Self-Reported Running Distance. Journal of Strength and Conditioning Research, 30(6), pp. 1592-1596. https://doi.org/10.1519/JSC.0000000000001244
Finch, C. (2014). A new classification scheme for the coding, analysis and reporting of the incidence and impact of subsequent sports-related injury. Journal of Science and Medicine in Sport, 18S, pp. e52-e52. https://doi.org/10.1016/j.jsams.2014.11.263
Fredericson, M., & Misra, A. K. (2007). Epidemiology and Aetiology of Marathon Running Injuries. Sports medicine (Auckland, N.Z.), 37(4), pp. 437-439. https://doi.org/10.2165/00007256-200737040-00043
Hespanhol LC Jr, Pena Costa LO, Lopes AD (2013). Previous injuries and some training characteristics predict running-related injuries in recreational runners : a prospective cohort study. Journal of Physiotherapy, 59(4), pp. 263-269. https://doi.org/10.1016/S1836-9553(13)70203-0
Hodges, P. W., & Tucker, K. (2011). Moving differently in pain: A new theory to explain the adaptation to pain. Pain, 152(SUPPL.3), pp. S90-S98. https://doi.org/10.1016/j.pain.2010.10.020
Hulme, A., Nielsen, R. O., Timpka, T., Verhagen, E., & Finch, C. (2017). Risk and Protective Factors for Middle- and Long-Distance Running-Related Injury. Sports Medicine, 47(5), pp. 869–886. https://doi.org/10.1007/s40279-016-0636-4
Jungmalm, J., Grau, S., Desai, P., Karlsson, J., & Nielsen, R. O. (2018). Study protocol of a 52-week Prospective Running INjury study in Gothenburg (SPRING). BMJ Open Sport & Exercose Medicine, 4(1), p e000394. https://doi.org/10.1136/bmjsem-2018-000394
Kluitenberg, B., van Middelkoop, M., Diercks, R., & van der Worp, H. (2015). What are the Differences in Injury Proportions Between Different Populations of Runners? A Systematic Review and Meta-Analysis. Sports Medicine (Auckland, N.Z.), 45(8):1143-1161. https://doi.org/10.1007/s40279-015-0331-x
Lopes AD, Hespanhol Jr LC, Yeung SS, Pena Costa LO. (2012). What are the main running-related musculoskeletal injuries? A Systematic Review. Sports medicine (Auckland, N.Z.), 42(10), pp. 891-905. https://doi.org/10.2165/11631170-000000000-00000
Malisoux, L., Nielsen, R. O., Urhausen, A., & Theisen, D. (2015). A step towards understanding the mechanisms of running-related injuries. Journal of Science and Medicine in Sport, 18(5), pp. 523-528. https://doi.org/10.1016/j.jsams.2014.07.014
Oestergaard Nielsen, R., Buist, I., Sørensen, H., Lind, M., & Rasmussen, S. (2012). Training Errors and Running Related Injuries: a Systematic Review. The International Journal of Sports Physical Therapy, 7(1), pp. 58-75.
Ooms, L., Veenhof, C., & de Bakker, D. H. (2013). Effectiveness of Start to Run, a 6-week training program for novice runners, on increasing health-enhancing physical activity: a controlled study. BMC Public Health, 13(1), pp. 697-697. https://doi.org/10.1186/1471-2458-13-697
Rasmussen, C. H., Nielsen, R. O., Juul, M. S., & Rasmussen, S. (2013). Weekly running volume and risk of running-related injuries among marathon runners. International Journal of Sports Physical Therapy, 8(2), pp. 111-120.
Saragiotto, B. T., Yamato, T. P., Hespanhol Junior, L. C., Rainbow, M. J., Davis, I. S., & Lopes, A. D. (2014). What are the Main Risk Factors for Running-Related Injuries? Sports Medicine, 44(8), pp. 1153-1163. https://doi.org/10.1007/s40279-014-0194-6
Toohey, L. A., Drew, M. K., Cook, J. L., Finch, C. F., & Gaida, J. E. (2017). Is subsequent lower limb injury associated with previous injury? A systematic review and meta-analysis. British Journal of Sports Medicine, 51(23), pp. 1670-1678. https://doi.org/10.1136/bjsports-2017-097500
Toohey, L. A., Drew, M. K., Fortington, L. V., Finch, C. F., & Cook, J. L. (2018). An Updated Subsequent Injury Categorisation Model (SIC-2.0): Data-Driven Categorisation of Subsequent Injuries in Sport. Sports Medicine. https://doi.org/10.1007/s40279-018-0879-3
Van Der Worp, M. P., Ten Haaf, D. S. M., Van Cingel, R., De Wijer, A., Nijhuis-Van Der Sanden, M. W. G., & Bart Staal, J. (2015). Injuries in runners; a systematic review on risk factors and sex differences. PloS One, 10(2), pp. 1-18. https://doi.org/10.1371/journal.pone.0114937
van Gent, R. N., Siem, D., van Middelkoop, M., van Os, A. G., Bierma-Zeinstra, S. M. A., Koes, B. W., & Taunton, J. E. (2007). Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review * COMMENTARY. British Journal of Sports Medicine, 41(8), pp. 469-480. https://doi.org/10.1136/bjsm.2006.033548
van Middelkoop, M., Kolkman, J., van Ochten, J., Bierma-Zeinstra, S. M. a., & Koes, B. W. (2007). Course and predicting factors of lower-extremity injuries after running a marathon. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 17(1), pp. 25-30. https://doi.org/10.1097/JSM.0b013e3180305e4d
Van Middelkoop, M., Kolkman, J., Van Ochten, J., Bierma-Zeinstra, S. M. A., & Koes, B. W. (2008). Risk factors for lower extremity injuries among male marathon runners. Scandinavian Journal of Medicine and Science in Sports, 18(6), pp. 691-697. https://doi.org/10.1111/j.1600-0838.2007.00768.x
van Poppel, D., de Koning, J., Verhagen, A. P., & Scholten-Peeters, G. G. M. (2016). Risk factors for lower extremity injuries among half marathon and marathon runners of the Lage Landen Marathon Eindhoven 2012: A prospective cohort study in the Netherlands. Scandinavian Journal of Medicine and Science in Sports, 26(2), pp. 226-234. https://doi.org/10.1111/sms.12424
van Poppel, D., Scholten-Peeters, G. G. M., van Middelkoop, M., Koes, B. W., & Verhagen, A. P. (2018). Risk models for lower extremity injuries among short- and long distance runners: A prospective cohort study. Musculoskeletal Science and Practice, 36, pp. 48-53. https://doi.org/10.1016/j.msksp.2018.04.007
Videbæk, S., Bueno, A. M., Nielsen, R. O., & Rasmussen, S. (2015). Incidence of running-related injuries per 1000 h of running in different types of runners: a systematic review and meta-analysis. Sports Medicine, 45(7), pp. 1017-1026. https://doi.org/10.1007/s40279-015-0333-8
Windt J, Gabbett TJ How do training and competition workloads relate to injury? The workload—injury aetiology model Br J Sports Med 2017;51:428-435. https://doi.org/10.1136/bjsports-2016-096040
How to Cite
Copyright (c) 2019 Journal of Human Sport and Exercise
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Each author warrants that his or her submission to the Work is original and that he or she has full power to enter into this agreement. Neither this Work nor a similar work has been published elsewhere in any language nor shall be submitted for publication elsewhere while under consideration by JHSE. Each author also accepts that the JHSE will not be held legally responsible for any claims of compensation.
Authors wishing to include figures or text passages that have already been published elsewhere are required to obtain permission from the copyright holder(s) and to include evidence that such permission has been granted when submitting their papers. Any material received without such evidence will be assumed to originate from the authors.
Please include at the end of the acknowledgements a declaration that the experiments comply with the current laws of the country in which they were performed. The editors reserve the right to reject manuscripts that do not comply with the abovementioned requirements. The author(s) will be held responsible for false statements or failure to fulfill the above-mentioned requirements.
This title is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license (CC BY-NC-ND 4.0).
You are free to share, copy and redistribute the material in any medium or format. The licensor cannot revoke these freedoms as long as you follow the license terms under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
Transfer of Copyright
In consideration of JHSE’s publication of the Work, the authors hereby transfer, assign, and otherwise convey all copyright ownership worldwide, in all languages, and in all forms of media now or hereafter known, including electronic media such as CD-ROM, Internet, and Intranet, to JHSE. If JHSE should decide for any reason not to publish an author’s submission to the Work, JHSE shall give prompt notice of its decision to the corresponding author, this agreement shall terminate, and neither the author nor JHSE shall be under any further liability or obligation.
Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article, except as disclosed on a separate attachment. All funding sources supporting the Work and all institutional or corporate affiliations of the authors are acknowledged in a footnote in the Work.
Each author certifies that his or her institution has approved the protocol for any investigation involving humans or animals and that all experimentation was conducted in conformity with ethical and humane principles of research.
Biomedical journals typically require authors and reviewers to declare if they have any competing interests with regard to their research.
JHSE require authors to agree to Copyright Notice as part of the submission process.