What are the Main Running-Related Musculoskeletal Injuries?
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).
The aim of this study is to systematically review studies on the incidence and prevalence of the main specific RRMIs.
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.
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%).
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.
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- Van Middelkoop M, Kolkman J, Van Ochten J, et al. Risk factors for lower extremity injuries among male marathon runners. Scand J Med Sci Sports 2008 Dec; 18(6): 691–7. CrossRef
- Taunton JE, Ryan MB, Clement DB, et al. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med 2002 Apr; 36 (2): 95–101. CrossRef
- Williams PT. Relationship of distance run per week to coronary heart disease risk factors in 8283 male runners: the National Runners’ Health Study. Arch Intern Med 1997 Jan; 157(2): 191–8. CrossRef
- Satterthwaite P, Norton R, Larmer P, et al. Risk factors for injuries and other health problems sustained in a marathon. Br J Sports Med 1999 Feb; 33(1): 22–6. CrossRef
- van Gent RN, Siem D, van Middelkoop M, et al. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med 2007 Aug; 41(8): 469–80. CrossRef
- Van Middelkoop M, Kolkman J, Van Ochten J, et al. Prevalence and incidence of lower extremity injuries in male marathon runners. Scand J Med Sci Sports 2008 Apr; 18(2): 140–4. CrossRef
- Bovens AM, Janssen GM, Vermeer HG, et al. Occurrence of running injuries in adults following a supervised training program. Int J Sports Med 1989 Oct; 10 (3 Suppl.): 186–90S. CrossRef
- Buist I, Bredeweg SW, Bessem B, et al. Incidence and risk factors of running-related injuries during preparation for a 4-mile recreational running event. Br J Sports Med 2010 Jun; 44(8): 598–604. CrossRef
- Lun V, Meeuwisse WH, Stergiou P, et al. Relation between running injury and static lower limb alignment in recreational runners. Br J Sports Med 2004 Oct; 38(5): 576–80. CrossRef
- Lysholm J, Wiklander J. Injuries in runners. Am J Sports Med 1987 Mar–Apr; 15(2): 168–71. CrossRef
- Rauh MJ, Koepsell TD, Rivara FP, et al. Epidemiology of musculoskeletal injuries among high school cross-country runners. Am J Epidemiol 2006 Jan; 163(2): 151–9. CrossRef
- Wen DY, Puffer JC, Schmalzried TP. Injuries in runners: a prospective study of alignment. Clin J Sport Med 1998 Jul; 8(3): 187–94. CrossRef
- James SL, Bates BT, Osternig LR. Injuries to runners. Am J Sports Med 1978 Mar–Apr; 6(2): 40–50. CrossRef
- Knobloch K, Yoon U, Vogt PM. Acute and overuse injuries correlated to hours of training in master running athletes. Foot Ankle Int 2008 Jul; 29(7): 671–6. CrossRef
- Marti B, Vader JP, Minder CE, et al. On the epidemiology of running injuries: the 1984 Bern Grand-Prix study. Am J Sports Med 1988 May–Jun; 16(3): 285–94. CrossRef
- Maughan RJ, Miller JD. Incidence of training-related injuries among marathon runners. Br J Sports Med 1983 Sep; 17(3): 162–5. CrossRef
- Satterthwaite P, Larmer P, Gardiner J, et al. Incidence of injuries and other health problems in the Auckland Citibank marathon, 1993. Br J Sports Med 1996 Dec; 30(4): 324–6. CrossRef
- Taunton JE, Ryan MB, Clement DB, et al. A prospective study of running injuries: the Vancouver sun run “in training” clinics. Br J Sports Med 2003 Jun; 37 (3): 239–44. CrossRef
- Walter SD, Hart LE, McIntosh JM, et al. The Ontario cohort study of running-related injuries. Arch Intern Med 1989 Nov; 149(11): 2561–4. CrossRef
- Hoeberigs JH. Factors related to the incidence of running injuries: a review. Sports Med 1992 Jun; 13(6): 408–22. CrossRef
- Bahr R. No injuries, but plenty of pain? On the methodology for recording overuse symptoms in sports. Br J Sports Med 2009 Dec; 43(13): 966–72. CrossRef
- Hoy D, March L, Blyth F, et al. Assessing risk of bias in studies measuring the prevalence of low back pain: modification of an existing quality assessment tool and assessment of its inter-rater reliability. Proceedings of the Melbourne International Forum XI, Primary Care Research on Low Back Pain; 2011 Mar 15–18; Melbourne (VIC). Low Back Pain Forum, 2011.
- Pileggi P, Gualano B, Souza M, et al. Incidencia e fatores de risco de lesões osteomioarticulares em corredores: um estudo de coorte prospectivo. Rev Bras Educ Fis Esporte 2010 Out–Dez; 24(4): 453–62.
- Jakobsen BW, Kroner K, Schmidt SA, et al. Prevention of injuries in long-distance runners. Knee Surg Sports Traumatol Arthrosc 1994; 2(4): 245–9. CrossRef
- Jacobs SJ, Berson BL. Injuries to runners: a study of entrants to a 10,000 meter race. Am J Sports Med 1986 Mar–Apr; 14(2): 151–5. CrossRef
- McKean KA, Manson NA, Stanish WD. Musculoskeletal injury in the masters runners. Clin J Sport Med 2006 Mar; 16(2): 149–54. CrossRef
- Fallon KE. Musculoskeletal injuries in the ultramarathon: the 1990 Westfield Sydney to Melbourne run. Br J Sports Med 1996 Dec; 30(4): 319–23. CrossRef
- Hutson MA. Medical implications of ultra marathon running: observations on a six day track race. Br J Sports Med 1984 Mar; 18(1): 44–5. CrossRef
- Scheer BV, Murray A. Al Andalus ultra trail: an observation of medical interventions during a 219-km, 5-day ultramarathon stage race. Clin J Sport Med 2011 Sep; 21(5): 444–6. CrossRef
- Clement DB, Taunton JE, Smart GW, et al. A survey of overuse running injuries. Phys Sportsmed 1981; 9(5): 47–58.
- Macera CA, Pate RR, Powell KE, et al. Predicting lower-extremity injuries among habitual runners. Arch Intern Med 1989 Nov; 149(11): 2565–8. CrossRef
- Di Caprio F, Buda R, Mosca M, et al. Foot and lower limb diseases in runners: assessment of risk factors. J Sports Sci Med 2010; 9(4): 587–96.
- Beck BR, Osternig LR. Medial tibial stress syndrome: the location of muscles in the leg in relation to symptoms. J Bone Joint Surg Am 1994 Jul; 76(7): 1057–61.
- Craig DI. Medial tibial stress syndrome: evidence-based prevention. J Athl Train 2008 May–Jun; 43(3): 316–8. CrossRef
- Garth Jr WP, Miller ST. Evaluation of claw toe deformity, weakness of the foot intrinsics, and posteromedial shin pain. Am J Sports Med 1989 Nov–Dec; 17(6): 821–7. CrossRef
- Michael RH, Holder LE. The soleus syndrome: a cause of medial tibial stress (shin splints). Am J Sports Med 1985 Mar–Apr; 13(2): 87–94. CrossRef
- Moen MH, Tol JL, Weir A, et al. Medial tibial stress syndrome: a critical review. Sports Med 2009; 39(7): 523–46. CrossRef
- Mubarak SJ, Gould RN, Lee YF, et al. The medial tibial stress syndrome: a cause of shin splints. Am J Sports Med 1982 Jul–Aug; 10(4): 201–5. CrossRef
- Nielsen RO, Buist I, Sorensen H, et al. Training errors and running related injuries: a systematic review. Int J Sports Phys Ther 2012 Feb; 7(1): 58–75.
- Selvanetti A, Cipolla M, Puddu G. Overuse tendon injuries: basic science and classification. Oper Tech Sports Med 1997; 5(3): 110–7. CrossRef
- Benazzo F, Zanon G, Maffulli N. An operative approach to aquilles tendinopathy. Sports Med Arthrosc 2000; 8(1): 96–101. CrossRef
- Arndt AN, Komi PV, Bruggemann GP, et al. Individual muscle contributions to the in vivo achilles tendon force. Clin Biomech (Bristol, Avon) 1998 Oct; 13(7): 532–41. CrossRef
- Grau S, Maiwald C, Krauss I, et al. What are causes and treatment strategies for patellar-tendinopathy in female runners? J Biomech 2008; 41(9): 2042–6. CrossRef
- Irving DB, Cook JL, Menz HB. Factors associated with chronic plantar heel pain: a systematic review. J Sci Med Sport 2006 May; 9 (1–2): 11–22. CrossRef
- Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc 2003 May–Jun; 93(3): 234–7.
- Hunt GC, Sneed T, Hamann H, et al. Biomechanical and histiological considerations for development of plantar fasciitis and evaluation of arch taping as a treatment option to control associated plantar heel pain: a single-subject design. Foot 2004; 14(3): 147–53. CrossRef
- Wearing SC, Smeathers JE, Sullivan PM, et al. Plantar fasciitis: are pain and fascial thickness associated with arch shape and loading? Phys Ther 2007 Aug; 87(8): 1002–8. CrossRef
- Lieberman DE, Venkadesan M, Werbel WA, et al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature 2010 Jan; 463(7280): 531–5. CrossRef
- Arroll B, Edwards A. Runner’s knee: what is it and what helps? Br J Gen Pract 1999 Feb; 49(439): 92–3.
- Pinshaw R, Atlas V, Noakes TD. The nature and response to therapy of 196 consecutive injuries seen at a runners’ clinic. S Afr Med J 1984 Feb; 65(8): 291–8.
- Pecina M, Bilic R, Buljan M. The iliotibial band friction syndrome (runner’s knee). Acta Orthop Iugoslavica 1984; 15(3): 90–2.
- Van Den Eeckhaut A, Walgraeve N, De Geeter F. Bone SPECT findings in runner’s knee. Clin Nucl Med 2003 Jun; 28(6): 492–3.
- Visnes H, Bahr R. The evolution of eccentric training as treatment for patellar tendinopathy (jumper’s knee): a critical review of exercise programmes. Br J Sports Med 2007 Apr; 41(4): 217–23. CrossRef
- Grana WA, Kriegshauser LA. Scientific basis of extensor mechanism disorders. Clin Sports Med 1985 Apr; 4(2): 247–57.
- Powers CM. Rehabilitation of patellofemoral joint disorders: a critical review. J Orthop Sports Phys Ther 1998 Nov; 28(5): 345–54.
- Verhagen E, van Mechelen W. Sports injury research. 1st ed. New York: Oxford, 2010.
- Herbert R, Jamtvedt G, Mead J, et al. Pratical evidence-based physiotherapy. 1st ed. Amsterdam: Elsevier, 2007.
- Hoher J, Bach T, Munster A, et al. Does the mode of data collection change results in a subjective knee score? Self-administration versus interview. Am J Sports Med 1997 Sep–Oct; 25(5): 642–7. CrossRef
- McHorney CA, Kosinski M, Ware Jr JE. Comparisons of the costs and quality of norms for the SF-36 health survey collected by mail versus telephone interview: results from a national survey. Med Care 1994 Jun; 32(6): 551–67. CrossRef
- Fuller CW, Ekstrand J, Junge A, et al. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Br J Sports Med 2006 Mar; 40(3): 193–201. CrossRef
- Twellaar M, Verstappen FT, Huson A. Is prevention of sports injuries a realistic goal? A four-year prospective investigation of sports injuries among physical education students. Am J Sports Med 1996 Jul-Aug; 24(4): 528–34. CrossRef
- Junge A, Dvorak J. Influence of definition and data collection on the incidence of injuries in football. Am J Sports Med 2000; 28(5 Suppl.): 40–6S.
- Van Mechelen W, Twisk J, Molendijk A, et al. Subject-related risk factors for sports injuries: a 1-yr prospective study in young adults. Med Sci Sports Exerc 1996 Sep; 28(9): 1171–9. CrossRef
- Hopkins WG, Marshall SW, Quarrie KL, et al. Risk factors and risk statistics for sports injuries. Clin J Sport Med 2007 May; 17(3): 208–10.
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- What are the Main Running-Related Musculoskeletal Injuries?
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- 1. São Paulo Running Injury Group (SPRunIG), São Paulo, Brazil
- 2. Masters in Physical Therapy, Universidade Cidade de São Paulo-UNICID, Rua Cesário Galeno, 448/475, São Paulo, SP — CEP: 03071-000, Brazil
- 3. Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China
- 4. Musculoskeletal Division, The George Institute for Global Health, Sydney, New South Wales, Australia