Skip to main content

Advertisement

Log in

Lower Extremity Injuries in Runners

Advances in Prediction

  • Injury Clinic
  • Published:
Sports Medicine Aims and scope Submit manuscript

Summary

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 rat 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 32km 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Blair SN, Kohl HW, Goodyear NN. Rates and risks for running and exercise injuries: studies in three populations. Research Quarterly for Exercise and Sport 58 (3): 221–228, 1987

    Google Scholar 

  • Blair SN, Kohl HW, Paffenbarger RS, Clark DG, Cooper KH, et al. Physical fitness and all-cause mortality: a prospective study of healthy men and women. Journal of the American Medical Association 262: 2395–2401, 1989

    Article  PubMed  CAS  Google Scholar 

  • Bovens AM, Janssen GME, Vermeer HGW, Hoeberigs JH, Janssen MPE, et al. Occurrence of running injuries in adults following a supervised training program. International Journal of Sports Medicine 10: S186–S190, 1989

    Article  PubMed  Google Scholar 

  • Clarkson-Smith L, Hartley AA. Relationships between physical exercise and cognitive abilities in older adults. Psychology and Aging 4 (2): 183–189, 1989

    Article  PubMed  CAS  Google Scholar 

  • Clough PJ, Shepherd J, Maughan RJ. Marathon finishers and prerace drop-outs. British Journal of Sports Medicine 23 (2): 97–101, 1989

    Article  PubMed  CAS  Google Scholar 

  • Drinkwater B, Bruemner B, Chestnut CH. Menstrual historyas a determinant of current bone density in young athletes. Journal of the American medical Association 263: 545–548, 1990

    Article  PubMed  CAS  Google Scholar 

  • Drinkwater BL, Nilson K, Ott S, Chestnut CH. Bone mineral density after resumption of menses in amenorrheic athletes. Journal of the American Medical Association 256: 380–382, 1986

    Article  PubMed  CAS  Google Scholar 

  • Dyck PJ, Classen SM, Stevens JC, O’Brien PC. Assessment of nerve damage in the feet of long-distance runners. Mayo Clinic Proceedings 62: 568–572, 1987

    Article  PubMed  CAS  Google Scholar 

  • Fields KB, Delaney M, Hinkle JS. A prospective study of type A behaviour and running injuries. Journal of Family Practice 30: 425–429, 1990

    PubMed  CAS  Google Scholar 

  • Fletcher KP, Eadie D. Prerace drop-out from the Glasgow Marathon. British Journal of Sports Medicine 20 (2): 74–76, 1986

    Article  PubMed  CAS  Google Scholar 

  • Heath GW, Kendrick JS. Outrunning the risks: a behavioural risk profile of runners. American Journal of Preventive Medicine 5 (6): 347–352, 1989

    PubMed  CAS  Google Scholar 

  • Holmich P, Christensen SW, Darre E, Jahnsen F, Hartvig T. Non-elite marathon runners: health training and injuries. British Journal of Sports Medicine 23 (3): 177–178, 1989

    Article  PubMed  CAS  Google Scholar 

  • Holmich P, Darre E, Jahnsen F, Hartvig-Jensen T. The elite marathon runner: problems during and after competition. British Journal of Sports Medicine 22 (1): 19–21, 1988

    Article  PubMed  CAS  Google Scholar 

  • Jacobs SJ, Berson BL. Injuries to runners: a study of entrants to a 10 000 meter race. American Journal of Sports Medicine 14 (2): 151–155, 1986

    Article  PubMed  CAS  Google Scholar 

  • James SL, Bates BT, Osternig LR. Injuries to runners. American Journal of Sports Medicine 6 (2): 40–50, 1978

    Article  PubMed  CAS  Google Scholar 

  • Johansson C. Injuries in elite orienteers. American Journal of Sports Medicine 14 (5): 410–415, 1986

    Article  PubMed  CAS  Google Scholar 

  • Jones BH. Overuse injuries of the lower extremities associated with marching, jogging and running: a review. Military Medicine 148 (10): 783–787, 1983

    PubMed  CAS  Google Scholar 

  • Kelley MJ. Psychological risk factors and sports injuries. Journal of Sports Medicine and Physical Fitness 30: 202–221, 1990

    PubMed  Google Scholar 

  • Konradsen L, Hansen E-MB, Sondergaard L. Long distance running and osteoarthrosis. American Journal of Sports Medicine 18 (4): 379–381, 1990

    Article  PubMed  CAS  Google Scholar 

  • Koplan JP, Powell KE, Sikes RK, Shirley RW, Campbell CC. An epidemiologic study of benefits and risks of running. Journal of the American Medical Association 248: 3118–3121, 1982

    Article  PubMed  CAS  Google Scholar 

  • Kowal DM. Nature and causes of injuries in women resulting from an endurance training program. American Journal of Sports Medicine 8: 265–268, 1980

    Article  PubMed  CAS  Google Scholar 

  • Kretsch A, Grogan R, Duras P, Allen F, Sumner J, et al. 1980 Melbourne marathon study. Medical Journal of Australia 141: 809–814, 1984

    PubMed  CAS  Google Scholar 

  • Lane NE, Bloch DA, Jones JJ, Marshall WH, Wood PD, et al. Long-distance running, bone density, and osteoarthritis. Journal of the American Medical Association 255 (9): 1147–1151, 1986

    Article  PubMed  CAS  Google Scholar 

  • Lane NE, Bloch DA, Wood PD, Fries JF. Aging, long-distance running, and the development of musculoskeletal disability: a controlled study. American Journal of Medicine 82: 772–780, 1987

    Article  PubMed  CAS  Google Scholar 

  • Larson EB, Bruce RA. Health benefits of exercise in an aging society. Archives of Internal Medicine 147: 353–356, 1987

    Article  PubMed  CAS  Google Scholar 

  • Lloyd T, Triantafyllou SJ, Baker ER, Houts PS, Whiteside JA, et al. Women athletes with menstrual irregularity have increased musculoskeletal injuries. Medicine and Science in Sports and Exercise 18: 374–379, 1986

    Article  PubMed  CAS  Google Scholar 

  • Lysholm J, Wiklander J. Injuries in runners. American Journal of Sports Medicine 15 (2): 168–171, 1987

    Article  PubMed  CAS  Google Scholar 

  • Macera CA, Jackson KL, Hagenmaier GW, Kronenfeld JJ, Kohl HW, et al. Age, physical activity, physical fitness, body composition, and incidence of orthopedic problems. Research Quarterly for Exercise and Sport 60 (3): 225–233, 1989a

    PubMed  CAS  Google Scholar 

  • Macera CA, Pate RR, Powell KE, Jackson KL, Kendrick JS, et al. Predicting lower extremity injuries among habitual runners. Archives of Internal Medicine 149: 2565–2568, 1989b

    Article  PubMed  CAS  Google Scholar 

  • Marti B. Benefits and risks of running among women: an pidemiologic study. International Journal of Sports Medicine 9 (2): 92–98, 1988

    Article  PubMed  CAS  Google Scholar 

  • Marti B, Knobloch M, Tschopp A, Jucker A, Howald H. Is excessive running predictive of degenerative hip disease? British Medical Journal 299: 91–93, 1989

    Article  PubMed  CAS  Google Scholar 

  • Marti B, Vader JP, Minder CE, Abelin T. On the epidemiology of running injuries: the 1984 Bern Grand-Prix study. American Journal of Sports Medicine 16 (3): 285–294, 1988

    Article  PubMed  CAS  Google Scholar 

  • Maughan RJ, Miller JDB. Incidence of training-related injuries among marathon runners. British Journal of Sports Medicine 17(3): 162–165, 1983

    Article  PubMed  CAS  Google Scholar 

  • Montgomery LC, Nelson FRT, Norton JP, Deuster PA. Orthopedic history and examination in the etiology of overuse injuries. Medicine and Science in Sports and Exercise 21 (3): 237–243, 1989

    Article  PubMed  CAS  Google Scholar 

  • Nicholl JP, Williams BT. Injuries sustained by runners during a popular marathon. British Journal of Sports Medicine 17 (1): 10–15, 1983

    Article  PubMed  CAS  Google Scholar 

  • Panush RS, Schmidt C, Caldwell JR, Edwards NL, Longley S, et al. Is running associated with degenerative joint disease? Journal of the American Medical Association 255: 1152–1154, 1986

    Article  PubMed  CAS  Google Scholar 

  • Pollock ML, Gettman LR, Milesis CA, Bah MD, Durstine L, et al. Effects of frequency and duration of training on attrition and incidence of injury. Medicine and Science in Sports and Exercise 9(1): 31–36, 1977

    CAS  Google Scholar 

  • Powell KE, Kohl HW, Caspersen CJ, Blair SN. An epidemiological perspective on the causes of running injuries. The physician and Sportsmedicine 14 (6): 100–114, 1986

    Google Scholar 

  • Powell KE, Thompson PD, Caspersen CJ, Kendrick JS. Physical activity and the incidence of coronary heart disease. Annual Review of Public Health 8: 253–287, 1987

    Article  PubMed  CAS  Google Scholar 

  • Protzman RR, Griffis CG. Stress fractures in men and women undergoing military training. Journal of Bone Surgery 59A: 825, 1977

    Google Scholar 

  • Puranen J, Ala-Ketola L, Peltokallio P, Saarela J. Running and primary osteoarthritis of the hip. British Medical Journal 2: 424–425, 1975

    Article  PubMed  CAS  Google Scholar 

  • Samet JM, Chick TW, Howard CA. Running-related morbidity: a community survey. Annals of Sports Medicine 1 (1): 30–34, 1982

    Google Scholar 

  • Walter SD, Hart LE, Mcintosh JM, Sutton JR. The Ontario cohort study of running-related injuries. Archives of Internal Medicine 149: 2561–2564, 1989

    Article  PubMed  CAS  Google Scholar 

  • Walter SD, Sutton JR, Mcintosh JM, Connolly C. The aetiology of sport injuries: a review of methodologies. Sports Medicine 2: 47–58, 1985

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Macera, C.A. Lower Extremity Injuries in Runners. Sports Medicine 13, 50–57 (1992). https://doi.org/10.2165/00007256-199213010-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-199213010-00005

Keywords

Navigation