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Nielsen R, Ramskov D, Blacket CT, Malisoux L. Running-Related Injuries Among More Than 7000 Runners in 87 Different Countries: The Garmin-RUNSAFE Running Health Study. J Orthop Sports Phys Ther 2024; 54:133-141. [PMID: 37970820 DOI: 10.2519/jospt.2023.11959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE: To describe the cumulative injury proportion after 1000 and 2000 km of running among runners from 87 countries worldwide using wearable devices. Secondly, examine if the cumulative injury proportion differed between runners from different countries. DESIGN: Cohort study with an 18-month follow-up. METHODS: Runners aged ≥18 years who were familiar with the English language, and who were using a Garmin sports watch that supported tracking of running were eligible for inclusion. The exposure was residential country; self-reported running-related injury was the primary outcome. A generalized linear model was used to estimate the cumulative injury proportion for each country and the cumulative risk difference between the countries (country with the lowest risk used as reference). Data were analyzed at 1000 and 2000 km. RESULTS: The proportions of injured runners among the 7605 included runners from 87 different countries were 57.6% [95% CI: 56.9%, 59.0%] at 1000 km and 69.8% [95% CI: 68.3%, 71.4%] at 2000 km. Runners from the Czech Republic (40.3% [95% CI: 28.7%, 51.9%]), Austria (41.1% [95% CI: 25.9%, 52.2%]), and Germany (41.9% [95% CI: 36.0%, 47.9%]) had the lowest cumulative injury proportions at 1000 km, whereas Ireland (75.4% [95% CI: 60.4%, 90.4%]), Great Britain and Northern Ireland (73.2% [95% CI: 69.3%, 77.1%]), and Finland (67.5% [95% CI: 47.2%, 87.7%]) had the highest proportions. At 2000 km, Poland (47.7% [95% CI: 36.0%, 59.4%]), Slovenia (52.2% [95% CI: 28.5%, 75.8%]), and Croatia (54.2% [95% CI: 35.6%, 72.7%]) had the lowest proportions of injured runners. The highest cumulative injury proportions were reported in Great Britain and Northern Ireland (83.6% [95% CI: 79.6%, 87.6%]) and the Netherlands (78.3% [95% CI: 70.6%, 85.9%]). CONCLUSION: More than half of the population of adult runners from 87 countries using wearable devices sustained a running-related injury during follow-up. There were considerable between-country differences in injury proportions. J Orthop Sports Phys Ther 2024;54(2):1-9. Epub 16 November 2023. doi:10.2519/jospt.2023.11959.
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Rasmussen J, Skejø S, Waagepetersen RP. Predicting Tissue Loads in Running from Inertial Measurement Units. SENSORS (BASEL, SWITZERLAND) 2023; 23:9836. [PMID: 38139682 PMCID: PMC10747732 DOI: 10.3390/s23249836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/28/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Runners have high incidence of repetitive load injuries, and habitual runners often use smartwatches with embedded IMU sensors to track their performance and training. If accelerometer information from such IMUs can provide information about individual tissue loads, then running watches may be used to prevent injuries. METHODS We investigate a combined physics-based simulation and data-based method. A total of 285 running trials from 76 real runners are subjected to physics-based simulation to recover forces in the Achilles tendon and patella ligament, and the collected data are used to train and test a data-based model using elastic net and gradient boosting methods. RESULTS Correlations of up to 0.95 and 0.71 for the patella ligament and Achilles tendon forces, respectively, are obtained, but no single best predictive algorithm can be identified. CONCLUSIONS Prediction of tissues loads based on body-mounted IMUs appears promising but requires further investigation before deployment as a general option for users of running watches to reduce running-related injuries.
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Affiliation(s)
- John Rasmussen
- Department of Materials and Production, Aalborg University, Fibigerstraede 16, 9220 Aalborg East, Denmark
| | - Sebastian Skejø
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark;
- Research Unit for General Practice, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
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Bosnina F, Padhiar N, Miller S, Girotra K, Massoura C, Morrissey D. Developing a diagnostic framework for patients presenting with Exercise Induced Leg Pain (EILP): a scoping review. J Foot Ankle Res 2023; 16:82. [PMID: 37990284 PMCID: PMC10662794 DOI: 10.1186/s13047-023-00680-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/31/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Numerous conditions are grouped under the generic term exercise-induced leg pain (EILP), yet clear diagnostic guidelines are lacking. This scoping review was conducted to clarify the definition and diagnostic criteria of nine commonly occurring EILP conditions. METHODS Three online databases were searched from inception to April 2022 for any English language original manuscripts identifying, describing, or assessing the clinical presentation and diagnostic criteria of the nine most common conditions that cause EILP. We included manuscripts considering all adults with any reported diagnostic criteria for EILP in any setting. Methodological quality was assessed using the Mixed Method Appraisal tool. Condition definitions were identified and categorised during data charting. Twenty-five potential elements of the history, 24 symptoms, 41 physical signs, 21 investigative tools, and 26 overarching diagnostic criteria, were identified and coded as counts of recommendation per condition, alongside qualitative analysis of the clinical reasoning. Condition definitions were constructed with 11 standardised elements based on recent consensus exercises for other conditions. RESULTS One hundred nineteen retained manuscripts, of which 18 studied multiple conditions, had a median quality of 2/5. A combination of the history, pain location, symptoms, physical findings, and investigative modalities were fundamental to identify each sub-diagnosis alongside excluding differentials. The details differed markedly for each sub-diagnosis. Fifty-nine manuscripts included data on chronic exertional compartment syndrome (CECS) revealing exertional pain (83% history), dull aching pain (76% symptoms), absence of physical signs (78% physical findings) and elevated intercompartment pressure (93% investigative modality). Twenty-one manuscripts included data on medial tibial stress syndrome (MTSS), revealing persistent pain upon discontinuation of activity (81% history), diffuse medial tibial pain (100% pain location), dull ache (86% symptoms), diffuse tenderness (95% physical findings) and MRI for exclusion of differentials (62% investigative modality). Similar analyses were performed for stress fractures (SF, n = 31), popliteal artery entrapment syndrome (PAES, n = 22), superficial peroneal nerve entrapment syndrome (SPNES, n = 15), lumbar radiculopathy (n = 7), accessory/low-lying soleus muscle syndrome (ALLSMS, n = 5), myofascial tears (n = 3), and McArdle's syndrome (n = 2). CONCLUSION Initial diagnostic frameworks and definitions have been developed for each condition of the nine most common conditions that cause EILP, suitable for clinical consideration and consensus confirmation.
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Affiliation(s)
- Fatma Bosnina
- Sports & Exercise Medicine, William Harvey Research Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Nat Padhiar
- Sports & Exercise Medicine, William Harvey Research Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
- London Sportswise, London, UK.
| | - Stuart Miller
- Sports & Exercise Medicine, William Harvey Research Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Krishna Girotra
- Sports & Exercise Medicine, William Harvey Research Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Chrysovalanto Massoura
- Sports & Exercise Medicine, William Harvey Research Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Dylan Morrissey
- Sports & Exercise Medicine, William Harvey Research Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Barts Health NHS Trust Physiotherapy Department, London, UK
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Lacey A, Whyte E, O’Keeffe S, O’Connor S, Burke A, Moran K. The Running Injury Continuum: A qualitative examination of recreational runners' description and management of injury. PLoS One 2023; 18:e0292369. [PMID: 37792711 PMCID: PMC10550191 DOI: 10.1371/journal.pone.0292369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023] Open
Abstract
INTRODUCTION A critical step in understanding and preventing running-related injuries (RRIs) is appropriately defining RRIs. Current definitions of RRIs may not represent the full process of injury development, failing to capture lower levels of injury that many athletes continue to train through. Understanding runners' description and management of the injury development process may allow for a more appropriate examination of all levels of injury. This study aimed to examine recreational runners' description and management of the injury development process. METHODS A qualitative focus group study was undertaken. Seven semi-structured focus groups with male (n = 13) and female (n = 18) recreational runners took place. Focus groups were audio and video recorded, and transcribed verbatim. Transcripts were reflexively thematically analysed. A critical friend approach was taken to data coding. Multiple methods of trustworthiness were executed. RESULTS Runners describe injury on a nine-level continuum, ranging from injury-free to career-ending injury. There are lower and higher levels of injury. Each level of injury is described across four categories of descriptors; physical description, outcome (effect on running and daily life), psychological description, and management. CONCLUSION The Running Injury Continuum is a tool that can be used for injury surveillance (for healthcare professionals and researchers) and for research investigating RRI risk factors. Healthcare professionals, researchers and coaches must ensure they monitor the development of all levels of RRIs, across all categories of descriptors. Runners need to be educated regarding appropriate self-management strategies for lower level injuries, with access to evidence-based information being a critical management tool.
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Affiliation(s)
- Aisling Lacey
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, Dublin, Ireland
| | - Enda Whyte
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Sinéad O’Keeffe
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Siobhán O’Connor
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Aoife Burke
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Kieran Moran
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, Dublin, Ireland
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
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Dillon S, Burke A, Whyte EF, O’Connor S, Gore S, Moran KA. Running towards injury? A prospective investigation of factors associated with running injuries. PLoS One 2023; 18:e0288814. [PMID: 37590281 PMCID: PMC10434952 DOI: 10.1371/journal.pone.0288814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 07/04/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Given the high incidence and heavy burden of running related injuries, large-scale, prospective multifactorial investigations examining potential risk factors are warranted. This study aimed to identify factors associated with running related injuries and to evaluate their potential in injury screening. STUDY DESIGN Prospective cohort study. MATERIALS AND METHODS Two hundred and seventy-four recreational runners were recruited. Clinical measures (strength, range of motion, foot position), injury and training history (via questionnaire), impact loading (via accelerometery) and running technique measures were collected at baseline. Runners were tracked for injury for one year via fortnightly check-ins. A binary logistic regression, (injury versus no injury), was performed for each variable univariably, and then adjusting for age, sex and mileage. A multivariable regression was also performed to evaluate the model's discriminative ability. RESULTS Of the 225 runners included in the final analysis 52% experienced a running related injury. Injury history in the past year, less navicular drop, and measures of running technique (knee, hip, and pelvis kinematics) were associated with increased odds of injury (p < .05). The multivariable logistic regression model was statistically significant, χ2(11) = 56.45, p < .001, correctly classifying 74% of cases with a sensitivity and specificity of 72% and 76%, respectively. The area under the receiver operating characteristic curve was 0.79 (CI95% = 0.73-0.85), demonstrating acceptable discriminative ability. CONCLUSIONS This study found a number of clinical and running technique factors to be associated with prospective running related injuries among recreational runners. With the exception of injury history, the factors identified as being significantly associated with injury may be modifiable and therefore, could form the basis of interventions. Range of motion, spatiotemporal parameters and strength measures were not associated with injury and thus their utilisation in injury prevention practices should be reconsidered.
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Affiliation(s)
- Sarah Dillon
- School of Allied Health, University of Limerick, Limerick, Ireland
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, Athletic Therapy and Training, Dublin City University, Dublin, Ireland
| | - Aoife Burke
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, Athletic Therapy and Training, Dublin City University, Dublin, Ireland
| | - Enda F. Whyte
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, Athletic Therapy and Training, Dublin City University, Dublin, Ireland
| | - Siobhán O’Connor
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, Athletic Therapy and Training, Dublin City University, Dublin, Ireland
| | - Shane Gore
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, Dublin City University, Dublin, Ireland
| | - Kieran A. Moran
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, Athletic Therapy and Training, Dublin City University, Dublin, Ireland
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Ross BJ, Lupica GM, Dymock ZR, Miskimin C, Mulcahey MK. Sex-related differences in hip and groin injuries in adult runners: a systematic review. PHYSICIAN SPORTSMED 2023; 51:107-120. [PMID: 34905425 DOI: 10.1080/00913847.2021.2016355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Hip/groin running-related injuries (RRIs) are relatively uncommon. It is unclear if runners of either sex are disproportionately affected. Our objective was to systematically review differences in hip/groin RRIs between males and females. DATA SOURCES A structured and comprehensive search of four medical literature databases was performed (PubMed, Embase, Ovid Medline, and CINAHL). Terms searched were as follows: risk, epidemiology, hip injury, groin injury, overuse injury, running, sprinting, and track and field. STUDY SELECTION Studies reporting sex-specific data on hip/groin RRIs in adult runners were included. Data was extracted and reviewed independently by two authors. STUDY APPRAISAL AND DATA SYNTHESIS Sex-specific injury rates, risk factors, and return to sport (RTS) following hip/groin RRI were extracted. Risk of bias was assessed using the Joanna-Briggs Institute Critical Appraisal Tool. RESULTS Ten studies with 7,353 total runners were included: 2,315 (47%) males and 2,559 (53%) females. The mean age of the included runners was 37.3 ± 8.9 years and the mean weekly running distance was 10.4 ± 8.4 km. Hip/groin injuries comprised 10.1% (491/4,874) of total RRIs, including 6.3% of RRIs sustained by males and 11.0% by females. Three studies reported significantly higher rates of hip/groin RRIs in female runners. One study reported significantly higher rates of gluteus medius and adductor RRIs for females and males, respectively. One study identified female sex as an independent risk factor for hip/groin RRIs. Three studies reported on RTS after hip/groin RRIs: the pooled RTS rate was 81.4% (57/70) at 1 to 368 days after injury. LIMITATIONS Data was pooled when possible; however, there was considerable clinical, methodological, and statistical heterogeneity across studies. CONCLUSIONS Hip/groin RRIs comprise a greater percentage of total injuries among injured female runners relative to males. Females may be at a higher risk for sustaining hip/groin RRIs though more research on risk factors and RTS is needed.
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Affiliation(s)
| | | | - Zakari R Dymock
- Department of Physical Medicine & Rehabilitation, University of Kentucky College of Medicine, Lexington
| | - Cadence Miskimin
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans
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Lacey A, Whyte E, O’Keeffe S, O’Connor S, Moran K. A qualitative examination of the factors affecting the adoption of injury focused wearable technologies in recreational runners. PLoS One 2022; 17:e0265475. [PMID: 35793284 PMCID: PMC9258862 DOI: 10.1371/journal.pone.0265475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Understanding the perceived efficacy and ease of use of technologies will influence initial adoption and sustained utilization. The objectives of this study were to determine the metrics deemed important by runners for monitoring running-related injury (RRI) risk, and identify the facilitators and barriers to their use of injury focused wearable technologies. Methods A qualitative focus group study was undertaken. Nine semi-structured focus groups with male (n = 13) and female (n = 14) recreational runners took place. Focus groups were audio and video recorded, and transcribed verbatim. Transcripts were thematically analysed. A critical friend approach was taken to data coding, and multiple methods of trustworthiness were executed. Results Excessive loading and inadequate recovery were deemed the most important risk factors to monitor for RRI risk. Other important factors included training activities, injury status and history, and running technique. The location and method of attachment of a wearable device, the design of a smartphone application, and receiving useful injury-related information will affect recreational runners’ adoption of injury focused technologies. Conclusions Overtraining, training-related and individual-related risk factors are essential metrics that need to be monitored for RRI risk. RRI apps should include the metrics deemed important by runners, once there is supporting evidence-based research. The difficulty and/or ease of use of a device, and receiving useful feedback will influence the adoption of injury focused running technologies. There is a clear willingness from recreational runners to adopt injury focused wearable technologies whilst running.
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Affiliation(s)
- Aisling Lacey
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, Dublin, Ireland
- * E-mail:
| | - Enda Whyte
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Sinéad O’Keeffe
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Siobhán O’Connor
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Kieran Moran
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, Dublin, Ireland
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Valencia O, Weinstein A, Salas R, Guzmán-Venegas R, Arvanitidis M, Martinez-Valdes E. Temporal differences in the myoelectric activity of lower limb muscles during rearfoot and forefoot running: A statistical parametric mapping approach. Eur J Sport Sci 2022; 23:983-991. [PMID: 35593659 DOI: 10.1080/17461391.2022.2081094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The aim of this study was to apply statistical parametric mapping (SPM) to compare temporal changes in EMG amplitude between rearfoot (RF) and forefoot (FF) running techniques. Eleven recreational runners ran on a treadmill at a self-selected speed, once using a RF strike pattern and once using a FF strike pattern (randomized order). The myoelectric activity of five lower limb muscles [rectus femoris (RFe), biceps femoris (BF), tibialis anterior (TA), medial and lateral gastrocnemius (MG and LG)] was evaluated, using bipolar electromyography (EMG). EMG data from the RF and FF running techniques was then processed and posteriorly compared with SPM, dividing the analysis of the running cycle into stance and swing phases. The MG and LG muscles showed higher activation during FF running at the beginning of the stance phase and at the end of the swing phase. During the end of the swing phase the TA muscle's EMG amplitude was higher, when the RF running technique was used. A higher level of co-activation between the gastrocnemius and TA muscles was observed at the end of the swing phase during RF running. The myoelectric behaviour of the RFe and BF muscles was similar during both running techniques. These findings highlight the importance of SPM for the accurate assessment of differences in muscle activity during running and strongly suggest that these two running techniques predominately reflect adjustments of the leg and not the thigh muscles.
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Affiliation(s)
- Oscar Valencia
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo, Escuela de Kinesiología. Universidad de los Andes, Santiago, Chile.,Escuela de Ingeniería Civil Biomédica, Universidad de Valparaíso, Chile
| | | | - Rodrigo Salas
- Escuela de Ingeniería Civil Biomédica, Universidad de Valparaíso, Chile
| | - Rodrigo Guzmán-Venegas
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo, Escuela de Kinesiología. Universidad de los Andes, Santiago, Chile
| | - Michail Arvanitidis
- School of Sport, Exercise and Rehabilitation Sciences, Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), College of Life and Environmental Sciences, University of Birmingham, United Kingdom
| | - Eduardo Martinez-Valdes
- School of Sport, Exercise and Rehabilitation Sciences, Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), College of Life and Environmental Sciences, University of Birmingham, United Kingdom.,Centro de Investigación en Fisiología del Ejercicio (CIFE), Universidad Mayor, Santiago, Chile
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Jardim RAC, Monteiro RL, Landre CB, Pegorari MS, Iosimuta NCR, Matos AP. Isokinetic ankle muscle strength is reduced in recreational runners with medial tibial stress syndrome and is not associated with pain. MOTRIZ: REVISTA DE EDUCACAO FISICA 2022. [DOI: 10.1590/s1980-657420220003122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Cloosterman KLA, Fokkema T, de Vos RJ, Bierma-Zeinstra SMA, van Middelkoop M. Consequences and Prognosis of Running-Related Knee Injuries Among Recreational Runners. Clin J Sport Med 2022; 32:e83-e89. [PMID: 32941372 DOI: 10.1097/jsm.0000000000000861] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 04/21/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the consequences and prognostic factors of running-related knee injuries (RRKIs) among recreational runners. DESIGN Prospective cohort study. SETTING This study is part of a randomized-controlled trial (RCT) on running injury prevention among recreational runners. At baseline during registration for a running event (5-42 km), demographic and training variables were collected. Participants who reported a new RRKI during follow-up were sent a knee-specific questionnaire at 16 months (range 11.7-18.6) after baseline. PARTICIPANTS One hundred thirty-eight runners who reported a new RRKI during the RCT on injury prevention responded to the knee-specific questionnaire. ASSESSMENT OF RISK FACTORS To determine the association between potential prognostic factors and time to recovery of an RRKI, a Cox regression analysis was performed. MAIN OUTCOME MEASURES Time to recovery and prognostic factors of RRKIs. RESULTS At 16 months after registration, 71.0% of the participants reported full recovery, with a median time to recovery of 8.0 weeks. Most participants reported iliotibial band syndrome (23.2%) or osteoarthritis (OA)/degenerative meniscopathy (23.2%) as cause of their injury. Male sex was associated with a shorter time to recovery [hazard ratio (HR) 1.84; 95% confidence interval (CI), 1.14-2.97], while suffering knee OA was associated with a longer time to recovery (HR 0.17; 95% CI, 0.06-0.46). CONCLUSIONS Nonrecovered participants adjusted running speed more often and had knee imaging more often than recovered participants. At follow-up, one-third of the participants were not recovered. This emphasizes the need for injury prevention programs for runners. More knowledge on the role of running in knee OA seems important, given the high number of participants with knee OA symptoms.
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Affiliation(s)
- Kyra L A Cloosterman
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; and
| | - Tryntsje Fokkema
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; and
| | - Robert-Jan de Vos
- Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; and
- Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; and
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Friede MC, Innerhofer G, Fink C, Alegre LM, Csapo R. Conservative treatment of iliotibial band syndrome in runners: Are we targeting the right goals? Phys Ther Sport 2021; 54:44-52. [PMID: 35007886 DOI: 10.1016/j.ptsp.2021.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Iliotibial band syndrome (ITBS) is presumably caused by excessive tension in the iliotibial band (ITB) leading to compression and inflammation of tissues lying beneath it. Usually managed conservatively, there is a lack of scientific evidence supporting the treatment recommendations, and high symptom recurrence rates cast doubt on their causal effectiveness. This review discusses the influence of common physiotherapeutic measures on risk factors contributing to tissue compression beneath the ITB. METHODS The potential pathogenic factors are presented on the basis of a simple biomechanical model showing the forces acting on the lateral aspect of the knee. Existent literature on the most commonly prescribed physiotherapeutic interventions is critically discussed against the background of this model. Practical recommendations for the optimization of physiotherapy are derived. RESULTS According to biomechanical considerations, ITBS may be promoted by anatomical predisposition, joint malalignments, aberrant activation of inserting muscles as well as excessive ITB stiffness. Hip abductor strengthening may correct excessive hip adduction but also increase ITB strain. Intermittent stretching interventions are unlikely to change the ITB's length or mechanical properties. Running retraining is a promising yet understudied intervention. CONCLUSIONS High-quality research directly testing different physiotherapeutic treatment approaches in randomized controlled trials is needed.
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Affiliation(s)
- Miriam C Friede
- Carinthia University of Applied Sciences, Department of Physiotherapy, Klagenfurt, Austria.
| | - Gunnar Innerhofer
- University of Innsbruck, Department of Sport Science, Innsbruck, Austria
| | - Christian Fink
- Gelenkpunkt Sports and Joint Surgery, Innsbruck, Austria; University for Health Sciences, Medical Informatics and Technology, Research Unit for Orthopaedic Sports Medicine and Injury Prevention, Hall, Austria
| | - Luis M Alegre
- University of Castilla-La Mancha, GENUD Toledo Research Group, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Robert Csapo
- University of Vienna, Department of Sport Science, Vienna, Austria
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Brund RBK, Waagepetersen R, O. Nielsen R, Rasmussen J, Nielsen MS, Andersen CH, de Zee M. How Precisely Can Easily Accessible Variables Predict Achilles and Patellar Tendon Forces during Running? SENSORS 2021; 21:s21217418. [PMID: 34770725 PMCID: PMC8587337 DOI: 10.3390/s21217418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 11/23/2022]
Abstract
Patellar and Achilles tendinopathy commonly affect runners. Developing algorithms to predict cumulative force in these structures may help prevent these injuries. Importantly, such algorithms should be fueled with data that are easily accessible while completing a running session outside a biomechanical laboratory. Therefore, the main objective of this study was to investigate whether algorithms can be developed for predicting patellar and Achilles tendon force and impulse during running using measures that can be easily collected by runners using commercially available devices. A secondary objective was to evaluate the predictive performance of the algorithms against the commonly used running distance. Trials of 24 recreational runners were collected with an Xsens suit and a Garmin Forerunner 735XT at three different intended running speeds. Data were analyzed using a mixed-effects multiple regression model, which was used to model the association between the estimated forces in anatomical structures and the training load variables during the fixed running speeds. This provides twelve algorithms for predicting patellar or Achilles tendon peak force and impulse per stride. The algorithms developed in the current study were always superior to the running distance algorithm.
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Affiliation(s)
- René B. K. Brund
- Sport Sciences–Performance and Technology, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (M.S.N.); (C.H.A.); (M.d.Z.)
- Correspondence: ; Tel.: +45-6024-8860
| | | | - Rasmus O. Nielsen
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark;
- Research Unit for General Practice, 8000 Aarhus, Denmark
| | - John Rasmussen
- Department of Materials and Production, Aalborg University, 9220 Aarhus, Denmark;
| | - Michael S. Nielsen
- Sport Sciences–Performance and Technology, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (M.S.N.); (C.H.A.); (M.d.Z.)
| | - Christian H. Andersen
- Sport Sciences–Performance and Technology, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (M.S.N.); (C.H.A.); (M.d.Z.)
| | - Mark de Zee
- Sport Sciences–Performance and Technology, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (M.S.N.); (C.H.A.); (M.d.Z.)
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Running-related injury: How long does it take? Feasibility, preliminary evaluation, and German translation of the University of Wisconsin running and recovery index. Phys Ther Sport 2021; 52:204-208. [PMID: 34607122 DOI: 10.1016/j.ptsp.2021.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The University of Wisconsin Running Injury and Recovery Index (UWRI) was developed as an evaluative patient-reported outcome measure of perceived running ability and recovery after running-related injuries. To date, the questionnaire was not translated into German language and studies on its clinical feasibility and validity are sparse. DESIGN Prospective cohort study. SETTING Outpatient sports medicine clinic. PARTICIPANTS The UWRI questionnaire was translated to German language using a state-of-the art back-translation method including three translators and two back-translators. Clinical feasibility and validation were assessed in 14 injured runners. MAIN OUTCOME MEASURES UWRI total score, running volume. RESULTS The translation process was completed without major discrepancies. Feasibility and preliminary evaluation were demonstrated in a cohort of 14 injured runners. The UWRI total score significantly improved throughout 12 weeks of recovering from running-related injuries (p < 0.001). Relative running volume significantly correlated with UWRI score (p < 0.001). CONCLUSION The University of Wisconsin Running Injury and Recovery Index was successfully translated into the German language. Its usage may hold promise for better rehabilitation surveillance following running-related injuries.
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Mitchell PK, Moffit TJ, Montgomery MM, Pamukoff DN. Running kinetics and femoral trochlea cartilage characteristics in recreational and collegiate distance runners. J Sports Sci 2021; 40:89-95. [PMID: 34494939 DOI: 10.1080/02640414.2021.1976492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Recreational running can benefit knee cartilage, but the relationship between competitive running and knee cartilage is unclear. We compared femoral cartilage between collegiate runners, recreational runners, and controls; and evaluated the association between running amount, running kinetics and femoral cartilage characteristics. Thirty collegiate runners, 30 recreational runners, and 30 controls completed ultrasound imaging of the femoral cartilage and running gait analysis. Outcomes included cartilage thickness, and echo-intensity from the medial and lateral femoral condyles; and the peak external knee flexion (KFM) and knee adduction moments. Cartilage outcomes were compared via one-way MANOVA. The associations between running kinetics, running amount, and femoral cartilage characteristics were assessed via linear regression models adjusted for sex. No differences were found in cartilage outcomes between groups (p = 0.067). Among recreational runners, a larger peak KFM was associated with lower medial femoral cartilage echo-intensity (ΔR2 = 0.176, Δp = 0.014). In collegiate runners, a greater self-reported running amount was associated with higher medial femoral cartilage (ΔR2 = 0.117, Δp = 0.046) and lateral cartilage (ΔR2 = 0.121, Δp = 0.042) echo-intensity. Cartilage did not differ between groups, but the association between running kinetics, running amount, and knee cartilage may vary between collegiate and recreational runners.
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Affiliation(s)
- Peter K Mitchell
- Department of Kinesiology, California State University, Fullerton, CA, USA
| | - Tyler J Moffit
- Department of Kinesiology, California State University, Bakersfield, CA, USA
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Recreational Runners With a History of Injury Are Twice as Likely to Sustain a Running-Related Injury as Runners With No History of Injury: A 1-Year Prospective Cohort Study. J Orthop Sports Phys Ther 2021; 51:144-150. [PMID: 33356768 DOI: 10.2519/jospt.2021.9673] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate (1) the cumulative incidence proportion and the most common anatomical locations of running-related injuries in recreational runners, and (2) the associations between running-related injuries and previous injury, running experience, weekly running distance, age, sex, and body mass index. DESIGN A 1-year prospective cohort study. METHODS Two hundred twenty-four recreational runners (average weekly running distance for the past 12 months, 15 km) were included (89 women, 135 men). Pain information was reported weekly for 1 year, and all running-related injuries that resulted in time loss or medical consultation were recorded. We accounted for censoring when calculating cumulative incidence proportion, and used crude Cox proportional hazards regression to evaluate whether the variables of interest were associated with running-related injuries. RESULTS The 1-year cumulative incidence proportion of running-related injuries was 45.9% (95% confidence interval [CI]: 38.4%, 54.2%). The most common anatomical locations were the knee (20/75, 27%) and Achilles tendon/calf (19/75, 25%). Previous injury was associated with a higher injury rate (hazard rate ratio = 1.9; 95% CI: 1.2, 3.2), while the other variables had no statistically significant association with injury. CONCLUSION There were 75 running-related injuries during the 1-year surveillance period, for a cumulative incidence proportion of 46%. The most common injuries were to the knee and Achilles tendon/calf. Recreational runners with a previous injury were twice as likely to sustain a running-related injury as runners with no previous injury. J Orthop Sports Phys Ther 2021;51(3):144-150. Epub 25 Dec 2020. doi:10.2519/jospt.2021.9673.
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Hollander K, Johnson CD, Outerleys J, Davis IS. Multifactorial Determinants of Running Injury Locations in 550 Injured Recreational Runners. Med Sci Sports Exerc 2021; 53:102-107. [PMID: 32769811 DOI: 10.1249/mss.0000000000002455] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE Despite the health benefits of running, the prevalence of running-related injuries (RRI) remains high. The underlying risk factors between these injuries are still not well understood. Therefore, the aim of this study was to compare biomechanical, anthropometric, and demographic injury risk factors between different locations in injured recreational runners. METHODS In this retrospective case-control analysis, 550 injured runners (49.6% female) with a medically diagnosed RRI were included. All runners had undergone an instrumented treadmill analysis to determine habitual footstrike pattern, vertical instantaneous load rate, peak vertical ground reaction force (vGRF) and cadence. Injuries were classified by location according to a recent consensus statement. A logistic regression model was used to determine the association between the biomechanical parameters and RRI locations. Because injuries can be associated with age, sex, and body mass index, these variables were also entered into the logistic regression. RESULTS Strike pattern and peak vGRF were the only biomechanical variable distinguishing an injury from the group of injuries. A midfoot strike differentiated Achilles tendon injuries (odds ratio [OR], 2.27; 90% confidence interval [CI], 1.17-4.41) and a forefoot strike distinguished posterior lower leg injuries (OR, 2.59; 90% CI, 1.50-4.47) from the rest of the injured group. Peak vGRF was weakly associated with hip injuries (OR, 1.14; 90% CI, 1.05-1.24). Female sex was associated with injuries to the lower leg (OR, 2.65; 90% CI, 1.45-4.87) and hip/groin (OR, 2.22; 90% CI, 1.43-3.45). Male sex was associated with Achilles tendon injuries (OR, 1.923; 90% CI, 1.094-3.378). CONCLUSIONS Sex, foot strike pattern, and vGRF were the only factors that distinguished specific injury locations from the remaining injury locations.
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Affiliation(s)
| | - Caleb D Johnson
- Department of Physical Medicine and Rehabilitation, Spaulding National Running Center, Harvard Medical School, Cambridge, MA
| | - Jereme Outerleys
- Department of Physical Medicine and Rehabilitation, Spaulding National Running Center, Harvard Medical School, Cambridge, MA
| | - Irene S Davis
- Department of Physical Medicine and Rehabilitation, Spaulding National Running Center, Harvard Medical School, Cambridge, MA
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Menéndez C, Batalla L, Prieto A, Rodríguez MÁ, Crespo I, Olmedillas H. Medial Tibial Stress Syndrome in Novice and Recreational Runners: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207457. [PMID: 33066291 PMCID: PMC7602098 DOI: 10.3390/ijerph17207457] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/28/2020] [Accepted: 10/10/2020] [Indexed: 01/10/2023]
Abstract
This systematic review evaluates the existing literature about medial tibial stress syndrome (MTSS) in novice and recreational runners. PubMed/MEDLINE, EMBASE, Web of Science, Scopus, SPORTDiscus and CINAHL databases were searched until July 2020. Studies covering risk factors, diagnostic procedures, treatment methods and time to recovery of MTSS in novice and recreational runners were selected. Eleven studies met the inclusion criteria and were included. The risk factors of MTSS are mainly intrinsic and include higher pelvic tilt in the frontal plane, peak internal rotation of the hip, navicular drop and foot pronation, among others. Computed tomography (CT) and pressure algometry may be valid instruments to corroborate the presence of this injury and confirm the diagnosis. Regarding treatment procedures, arch-support foot orthoses are able to increase contact time, normalize foot pressure distribution and similarly to shockwave therapy, reduce pain. However, it is important to take into account the biases and poor methodological quality of the included studies, more research is needed to confirm these results.
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Affiliation(s)
- Claudia Menéndez
- Department of Functional Biology, Universidad de Oviedo, 33003 Oviedo, Spain; (C.M.); (L.B.); (A.P.); (M.Á.R.); (I.C.)
| | - Lucía Batalla
- Department of Functional Biology, Universidad de Oviedo, 33003 Oviedo, Spain; (C.M.); (L.B.); (A.P.); (M.Á.R.); (I.C.)
| | - Alba Prieto
- Department of Functional Biology, Universidad de Oviedo, 33003 Oviedo, Spain; (C.M.); (L.B.); (A.P.); (M.Á.R.); (I.C.)
| | - Miguel Ángel Rodríguez
- Department of Functional Biology, Universidad de Oviedo, 33003 Oviedo, Spain; (C.M.); (L.B.); (A.P.); (M.Á.R.); (I.C.)
| | - Irene Crespo
- Department of Functional Biology, Universidad de Oviedo, 33003 Oviedo, Spain; (C.M.); (L.B.); (A.P.); (M.Á.R.); (I.C.)
- Institute of Biomedicine, Universidad de León, 24071 León, Spain
| | - Hugo Olmedillas
- Department of Functional Biology, Universidad de Oviedo, 33003 Oviedo, Spain; (C.M.); (L.B.); (A.P.); (M.Á.R.); (I.C.)
- Health Research Institute of the Principality of Asturias (ISPA), 33011 Oviedo, Spain
- Correspondence:
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Knee Injuries in Normal-Weight, Overweight, and Obese Runners: Does Body Mass Index Matter? J Orthop Sports Phys Ther 2020; 50:397-401. [PMID: 32605464 DOI: 10.2519/jospt.2020.9233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate whether the proportion of running-related knee injuries differed in normal-weight, overweight, and obese runners. DESIGN Comparative study. METHODS Data from 4 independent prospective studies were merged (2612 participants). The proportion of running-related knee injuries out of the total number of running-related injuries was calculated for normal-weight, overweight, and obese runners, respectively. The measure of association was absolute difference in proportion of running-related knee injuries with normal-weight runners as the reference group. RESULTS A total of 571 runners sustained a running-related injury (181 running-related knee injuries and 390 running-related injuries in other anatomical locations). The proportion of running-related knee injuries was 13% lower (95% confidence interval: -22%, -5%; P = .001) among overweight runners compared with normal-weight runners. Similarly, the proportion of running-related knee injuries was 12% lower (95% confidence interval: -23%, -1%; P = .042) among obese runners compared with normal-weight runners. CONCLUSION Overweight and obese runners had a lower proportion of running-related knee injuries than normal-weight runners. J Orthop Sports Phys Ther 2020;50(7):397-401. doi:10.2519/jospt.2020.9233.
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Winters M. [The diagnosis and management of medial tibial stress syndrome : An evidence update-German version]. Unfallchirurg 2019; 122:848-853. [PMID: 31628497 DOI: 10.1007/s00113-019-0666-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Medial tibial stress syndrome is a common overuse injury in jumping and running athletes. It is defined as exercise-induced pain along the distal posteromedial border of the tibia and the presence of recognisable pain on palpation over a length of 5 or more centimetres. This overview article provides an evidence update on the diagnosis and management of athletes with medial tibial stress syndrome.
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Affiliation(s)
- Marinus Winters
- Abteilung für Rehabilitation, Physiotherapiewissenschaft und Sport, Universitätsklinikum Utrecht, Utrecht, Niederlande. .,Forschungsstelle für Allgemeinmedizin in Aalborg, Abteilung Klinische Medizin, Universität Aalborg, Fyrkildevej 7, 9220, Aalborg Øst, Dänemark.
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Dingenen B, Malliaras P, Janssen T, Ceyssens L, Vanelderen R, Barton CJ. Two-dimensional video analysis can discriminate differences in running kinematics between recreational runners with and without running-related knee injury. Phys Ther Sport 2019; 38:184-191. [DOI: 10.1016/j.ptsp.2019.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/25/2019] [Accepted: 05/25/2019] [Indexed: 02/04/2023]
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