Factors Associated With Half- and Full-Marathon Race-Related Injuries: A 3-Year Review

Injury patterns and healthcare utilisation by runners of the New York City Marathon

Objectives

The purpose of this study was to describe injury patterns and healthcare utilisation of marathon runners.

Methods

This was a previously reported 16-week prospective observational study of runners training for the New York City Marathon. Runners completed a baseline survey including demographics, running experience and marathon goal. Injury surveys were collected every 4 weeks during training, as well as 1 week before and 1 week after the race. Injury details collected included anatomic location, diagnosis, onset, and treatment received.

Results

A total of 1049 runners were enrolled. Injuries were reported by 398 (38.4%) during training and 128 (14.1%) during the marathon. The overall prevalence of injury was 447/1049 (42.6%). Foot, knee and hip injuries were most common during training, whereas knee, thigh and foot injuries were most common during the race. The most frequent tissue type affected was the category of muscle, tendon/fascia and bursa. The prevalence of overuse injuries increased, while acute injuries remained constant throughout training. Hamstring injuries had the highest prevalence of diagnosis with 38/564 injuries (6.7%). Of the 447 runners who reported an injury, 224 (50.1%) received medical care. Physical therapy was the most common medical care received with 115/1037 (11.1%) runners during training and 44/907 (4.9%) postrace.

Conclusion

Runners training and participating in a marathon commonly experience injuries, especially of the foot and knee, which often are overuse soft tissue injuries. Half of the injured runners sought out medical care for their injury. Understanding the patterns of injuries affecting marathon runners could help guide future injury prevention efforts.

Gender differences in footwear characteristics between half and full marathons in China: a cross-sectional survey

There are concerns about the risk of injuries caused by marathons in China. Since male and female runners have different injury risks, gender differences in running shoe functionality should be further complemented. A supervised questionnaire survey of 626 marathon runners was collected. The questionnaire was categorized into four sections: (1) participant profile, (2) importance of shoe properties, (3) functional evaluation of shoe properties and (4) importance ranking of shoe properties. The Mann-Whitney U test, Fisher's exact test of cross tabulation and Chi-square test, and two-way ANOVA were used to analyze the results of this survey. The significance level was set at P < 0.05. The full marathon participants were older than the half marathon participants. There was no gender difference in the importance of shoe features to elite runners. In addition, women are more concerned about upper elasticity and have higher requirements for running shoes than men. Women were more focused on injury prevention, while men were more focused on running performance. Heel cushioning was identified by all participants as the most important running shoe feature. There were no gender differences between elite players' demand for running shoes, but significant gender differences were found between genders at other running levels.

Aetiological Factors of Running-Related Injuries: A 12 Month Prospective "Running Injury Surveillance Centre" (RISC) Study

BACKGROUND

Running-related injuries (RRIs) are a prevalent issue for runners, with several factors proposed to be causative. The majority of studies to date are limited by retrospective study design, small sample sizes and seem to focus on individual risk factors in isolation. This study aims to investigate the multifactorial contribution of risk factors to prospective RRIs.

METHODS

Recreational runners (n = 258) participated in the study, where injury history and training practices, impact acceleration, and running kinematics were assessed at a baseline testing session. Prospective injuries were tracked for one year. Univariate and multivariate Cox regression was performed in the analysis.

RESULTS

A total of 51% of runners sustained a prospective injury, with the calf most commonly affected. Univariate analysis found previous history of injury < 1 year ago, training for a marathon, frequent changing of shoes (every 0-3 months), and running technique (non-rearfoot strike pattern, less knee valgus, greater knee rotation) to be significantly associated with injury. The multivariate analysis revealed previous injury, training for a marathon, less knee valgus, and greater thorax drop to the contralateral side to be risk factors for injury.

CONCLUSION

This study found several factors to be potentially causative of injury. With the omission of previous injury history, the risk factors (footwear, marathon training and running kinematics) identified in this study may be easily modifiable, and therefore could inform injury prevention strategies. This is the first study to find foot strike pattern and trunk kinematics to relate to prospective injury.

Effects of compression running pants and treadmill running stages on knee proprioception and fatigue-related physiological responses in half-marathon runners

Background: Knee injury is common in half-marathon runners, however, the effect of compression running pants on fatigue and knee proprioception remains unclear. Objectives: The study aims to investigate whether wearing compression running pants (CRP) and treadmill running stages affect knee proprioception and fatigue-related physiological responses during half-marathon running. Methods: Eighteen half-marathon runners completed two self-paced 21 km treadmill running trials, once wearing CRP and once wearing loose running shorts (LRS). For each 21 km run, RPE, heart rate, blood lactic acid, and knee flexion proprioception were assessed before starting, and after each 7 km stage. Results: Data analysis revealed no difference between CRP and LRS conditions in heart rate, RPE, or blood lactic acid. Repeated measures ANOVA showed a significant garment condition main effect whereby wearing CRP was associated with higher knee proprioceptive acuity (p = 0.006). Polynomial trend analysis showed a significant linear downwards trend in proprioceptive acuity across the four measurement occasions (p = 0.048). Stage analysis showed that wearing CRP was associated with better knee proprioception at running distances of 14 km (p = 0.007, 95%CI = -0.054, -0.010) and 21 km (p = 0.016, 95%CI = -0.051, -0.006). Conclusion: Compression running pants provide an overall positive effect on knee proprioception, particularly after 14 km and 21km, which may reduce the probability of knee injury. CRP had no significant effect on physiological measures in half-marathon running.

Factors associated with injuries in first-time marathon runners from the New York City marathon

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.

An analysis of self-reported upper and lower limb injuries in Polish obstacle course races participants

BACKGROUND

Obstacle course racing (OCR) is characterized by various distance, terrain, obstacles and weather conditions. We hypothesized that various specific factors could increase the probability of traumas, especially limb injuries.

METHODS

An online questionnaire survey was conducted among OCR participants in Poland. The questionnaire consisted of 5 sets of questions: demographic parameters, participating in obstacle course races last year, characteristic of the trainings, participant-assessed race safety and injury characteristics.

RESULTS

We analyzed the data collected from 153 obstacle course races participants: 95 men (62.1%) and 58 women (37.9%), mean age 30.3±7.4 years. Forty-two respondents (27.4%) reported race-related extremity injury. In univariable analysis the risk of limb injuries increased with longer time per week devoted to training sessions with obstacles (P=0.025) and participating in higher number of obstacle course races last year (P=0.006). Furthermore, training in groups during preparation was associated with a higher risk of limb trauma (P=0.015). Moreover, people doing more running interval sessions per week (P=0.0343) and spending more time on interval training sessions per week - both run (P=0.0098) and other than run (P=0.0063) are more prone to suffer limb injuries in OCR.

CONCLUSIONS

The prevalence of limb injuries in OCR is elevated and it is desirable to be reduced by establishment and elimination above mentioned risk factors. Further researches are needed for deepening the knowledge of injuries in OCR.

High-intensity interval versus moderate-intensity continuous half-marathon training programme for middle-aged women

PURPOSE

To test the effectiveness on recreational female middle-aged runners of a programme of high-intensity interval training (HIIT) for a half-marathon race contrasted to a conventional moderate-intensity continuous training (MICT).

METHODS

Twenty recreational female runners (40 ± 7 years) followed MICT or HIIT schedules for training a half-marathon. The MICT group trained a mean of 32 km/week at intensities below 80% VO₂max. The HIIT group ran 25 km/week at intensities between 80 and 100% VO₂max, combined with uphill running and resistance training. Women following HIIT ran 21% less distance and invested 17% less time than those from MICT group. All the women were evaluated at the beginning and end of the training and participated in the same half-marathon run.

RESULTS

Women following both schedules reduced their previous finishing times by 2-3%, which for HIIT group would have meant rising up to 90 positions out of 1454 participants in the local half-marathon race. The high intensity performed during series of high power output (200 m and 400 m) and resistance sessions in HIIT programme promoted changes that allowed modifying efficiency at high workloads. At the same time, the HIIT training programme elicited changes in oxygen uptake and transport as indicated the cardiorespiratory parameters obtained during recovery in lab tests. Moreover, HIIT registered a 14% baseline decrease in heart rate contrasting to the not significant 6% decrease in MICT.

CONCLUSIONS

Runners following HIIT training obtained similar registers as with a traditional MICT schedule, expending less time and running shorter distances, yet improving their anaerobic and aerobic power.