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Boshielo PMM, Jansen van Rensburg A, Viljoen C, Botha T, de Villiers CEE, Ramagole D, Seyani L, Janse van Rensburg DCC. Illness is more prevalent than injury in trail runners participating in a mountainous ultra trail race. PHYSICIAN SPORTSMED 2024:1-9. [PMID: 38872606 DOI: 10.1080/00913847.2024.2367401] [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] [Received: 01/30/2024] [Accepted: 06/10/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVES Trail running is a popular off-road sport involving running in natural environments over various terrains, often in remote locations. This study aims to investigate the epidemiology and risk factors of injuries and illnesses, i.e. medical encounters, on race day among trail runners in a high-altitude ultra trail race. METHODS This descriptive cross-sectional study on an ultra trail race (38 km, 65 km and 100 km) in South Africa, included participants 18 years or older. Of the 331 race participants, 285(86.1%) consented to participate in the study. Data collection included demographic details, injuries (body region, specific body area, tissue type, pathology) and illnesses (organ system, symptom cluster, etiology). Risk factor analysis includes sex, age, weight, height, race distance, illness and injury history, training and running experience. Frequency (n, %), prevalence (%) and odds ratios (OR; 95%CI) are reported. RESULTS Eighty-nine (31.2%) individuals reported 131 medical encounters [49 injuries (37.4%); 82 illnesses (62.6%)]. Injuries were sustained by 14.7% of athletes, and 22.5% reported illnesses. For injuries, the lower limb was mainly involved (n = 41; 83.7%). Most injuries affected the foot (n = 18; 36.7%), ankle (n = 10; 20.4%) and knee (n = 7; 14.3%). Tissue types mainly involved skin (n = 21; 42.8%), ligament (n = 7; 14.3%) and muscle (n = 7; 14.3%). Multiple (n = 45; 54.9%) and gastrointestinal (n = 17; 20.7%) organ systems were mainly involved in illnesses. Only 100 km runners reported dehydration (n = 28; 31.5%), and one in every six of these runners (n = 5; 17.9%) did not finish. Runners reporting fatigue (n = 21; 23.6%) had a high (n = 8; 38.1%) did not finish rate. Two in every five participants (n = 36; 40.4%) with a medical encounter, did not finish. No medical encounter-associated risk factors were identified. CONCLUSIONS Illnesses were more common than injuries during the mountainous ultra trail race. Sustaining a medical encounter increased the chance of not completing the race. Further research on the epidemiology of race day medical encounters in trail running is required.
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Affiliation(s)
| | | | - Carel Viljoen
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Science, Amsterdam UMC, Amsterdam, The Netherlands
| | - Tanita Botha
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Dimakatso Ramagole
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Limbikani Seyani
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Dina C Christa Janse van Rensburg
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Chair, Medical Advisory Panel, World Netball, Manchester, UK
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Ravier G, Dury J, Grevillot J, Girard B, Bouzigon R, Michel F. Acute Neuromuscular Alterations of Ankle Evertors Induced by Short Trail Running: Sex-Related Considerations. J Strength Cond Res 2023; 37:2008-2015. [PMID: 37015004 DOI: 10.1519/jsc.0000000000004486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Abstract
Ravier, G, Dury, J, Grevillot, J, Girard, B, Bouzigon, R, and Michel, F. Acute neuromuscular alterations of ankle evertors induced by short trail running: sex-related considerations. J Strength Cond Res 37(10): 2008–2015, 2023—This study investigated the exercise-induced effects on the neuromuscular function of ankle evertors, balance control associated with trail running, and sex-related interactions. Fourteen male and 14 female medium-level runners completed a 16-km (400 D+) course. At rest and immediately after running, maximal voluntary isometric contraction (MVC) and rate of force development (RFD) for knee extension and ankle eversion, electromyographic (EMG) activity of peroneus muscles during MVC plateau (EMG) and the first 200 ms (EMG200), ankle angular velocity (
INV) during 20 weight-bearing inversion movements, and balance control during destabilizing single-leg task were evaluated. Repeated measures ANOVA-revealed changes in knee and ankle MVC (ankle: P = 0.0004, −12%) and RFD (ankle: P < 0.0001, −19%), EMG (P < 0.0001, −17%), EMG200 (P < 0.0001, −19%), and ankle
INV (P < 0.0001, +35%) in response to trail running. Single-leg balance was not impaired. Sex-related differences were observed in EMG and EMG200 with higher values in men than in women. MVC and RFD were greater in men when expressed in absolute values, but not different relative to body mass. Single-leg balance and ankle
INV did not differ between men and women. Finally, none of these variables showed any sex-related difference when considering pre-exercise to postexercise changes. This study demonstrated impairment in neuromuscular function of evertor muscles and ability in braking inversion in response to trail running. Sex-related differences were observed in neuromuscular activity but not in fatigability. These data suggest that coaches might implement strength exercises specifically designed for ankle lateral stability into their training program.
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Affiliation(s)
- Gilles Ravier
- University of Franche Comte, Laboratory of Culture Sport Health Society (EA 4660), Sport and Performance Department, 31 Chemin de l'Epitaphe
| | - Jeanne Dury
- University of Franche Comte, Laboratory of Culture Sport Health Society (EA 4660), Sport and Performance Department, 31 Chemin de l'Epitaphe
| | - Joris Grevillot
- University of Franche Comte, Laboratory of Culture Sport Health Society (EA 4660), Sport and Performance Department, 31 Chemin de l'Epitaphe
| | - Bruno Girard
- University of Franche Comte, Laboratory of Culture Sport Health Society (EA 4660), Sport and Performance Department, 31 Chemin de l'Epitaphe
| | - Romain Bouzigon
- Inside the Athletes 3.0 Association, 56 Chemin des Montarmots; and
| | - Fabrice Michel
- University of Franche Comte, Laboratory of Nanomedicine (EA 4662), Department of Physical Medicine and Rehabilitation, Jean Minjoz Hospital, 25000 Besançon, France
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Cloosterman KLA, Fokkema T, de Vos RJ, van Oeveren B, Bierma-Zeinstra SMA, van Middelkoop M. Feasibility and usability of GPS data in exploring associations between training load and running-related knee injuries in recreational runners. BMC Sports Sci Med Rehabil 2022; 14:78. [PMID: 35484612 PMCID: PMC9052652 DOI: 10.1186/s13102-022-00472-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 04/04/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The purpose of the present study was to explore the feasibility of collecting GPS data and the usability of GPS data to evaluate associations between the training load and onset of running-related knee injuries (RRKIs). METHODS Participants of the INSPIRE-trial, a randomized-controlled trial on running injury prevention, were asked to participate in this study. At baseline, demographic variables were collected. Follow-up questionnaires assessed information on RRKIs. Participants with a new reported RRKI and uninjured participants were sent a GPS export request. Weekly GPS-based training distances were used to calculate Acute:Chronic Workload Ratios (ACWRs). RESULTS A total of 240 participants (62.7%) tracked their running training sessions with the use of a GPS-enabled device or platform and were willing to share their GPS data. From the participants (N = 144) who received a GPS export request, 50.0% successfully shared their data. The majority (69.4%) of the shared GPS data were usable for analyses (N = 50). GPS data were used to present weekly ACWRs of participants with and without an RRKI eight weeks prior to RRKI onset or running event. CONCLUSIONS It seems feasible to collect GPS data from GPS-enabled devices and platforms used by recreational runners. The results indicate that GPS data is usable to calculate weekly ACWRs to evaluate associations between training load and onset of RRKIs in recreational runners. Therefore, GPS-based ACWR measures can be used for future studies to evaluate associations between training load and onset of RRIs.
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Affiliation(s)
- Kyra L A Cloosterman
- Department of General Practice, Erasmus MC University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Tryntsje Fokkema
- Department of General Practice, Erasmus MC University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Robert-Jan de Vos
- Department of Orthopaedics and Sports Medicine, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | | | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Orthopaedics and Sports Medicine, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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Viljoen C, Janse van Rensburg DCC, van Mechelen W, Verhagen E, Silva B, Scheer V, Besomi M, Gajardo-Burgos R, Matos S, Schoeman M, Jansen van Rensburg A, van Dyk N, Scheepers S, Botha T. Trail running injury risk factors: a living systematic review. Br J Sports Med 2022; 56:577-587. [PMID: 35022162 DOI: 10.1136/bjsports-2021-104858] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To review and frequently update the available evidence on injury risk factors and epidemiology of injury in trail running. DESIGN Living systematic review. Updated searches will be done every 6 months for a minimum period of 5 years. DATA SOURCES Eight electronic databases were searched from inception to 18 March 2021. ELIGIBILITY CRITERIA Studies that investigated injury risk factors and/or reported the epidemiology of injury in trail running. RESULTS Nineteen eligible studies were included, of which 10 studies investigated injury risk factors among 2 785 participants. Significant intrinsic factors associated with injury are: more running experience, level A runner and higher total propensity to sports accident questionnaire (PAD-22) score. Previous history of cramping and postrace biomarkers of muscle damage is associated with cramping. Younger age and low skin phototypes are associated with sunburn. Significant extrinsic factors associated with injury are neglecting warm-up, no specialised running plan, training on asphalt, double training sessions per day and physical labour occupations. A slower race finishing time is associated with cramping, while more than 3 hours of training per day, shade as the primary mode of sun protection and being single are associated with sunburn. An injury incidence range 0.7-61.2 injuries/1000 hours of running and prevalence range 1.3% to 90% were reported. The lower limb was the most reported region of injury, specifically involving blisters of the foot/toe. CONCLUSION Limited studies investigated injury risk factors in trail running. Our review found eight intrinsic and nine extrinsic injury risk factors. This review highlighted areas for future research that may aid in designing injury risk management strategies for safer trail running participation.PROSPERO registration numberCRD42021240832.
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Affiliation(s)
- Carel Viljoen
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa .,Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, location VU University Medical Center, Amsterdam, The Netherlands.,Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa
| | - Dina C Christa Janse van Rensburg
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Medical Board Member, World Netball, Manchester, UK
| | - Willem van Mechelen
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, location VU University Medical Center, Amsterdam, The Netherlands.,School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia.,Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
| | - Evert Verhagen
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, location VU University Medical Center, Amsterdam, The Netherlands
| | - Bruno Silva
- School of Sports and Leisure, Department of Sports Science, Tourism and Leisure, Polytechnic Institute of Viana do Castelo, Melgaço, Portugal.,Research Center in Sports Science, Health Science and Human Development (CIDESD), University of Tras-os-Montes e Alto Douro, Vila Real, Portugal
| | - Volker Scheer
- Ultra Sports Science Foundation (USSF), Pierre-Benite, France
| | - Manuela Besomi
- Carrera de Kinesiología, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Rubén Gajardo-Burgos
- Escuela de Kinesiología, Instituto de Aparato Locomotor y Rehabilitación, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Sérgio Matos
- School of Sports and Leisure, Department of Sports Science, Tourism and Leisure, Polytechnic Institute of Viana do Castelo, Melgaço, Portugal.,Department of Sports, Higher Institute of Educational Sciences of the Douro, Penafiel, Portugal
| | - Marlene Schoeman
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland
| | - Susan Scheepers
- Department of Library Services, University of Pretoria, Pretoria, South Africa
| | - Tanita Botha
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa
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Vincent HK, Brownstein M, Vincent KR. Injury Prevention, Safe Training Techniques, Rehabilitation, and Return to Sport in Trail Runners. Arthrosc Sports Med Rehabil 2022; 4:e151-e162. [PMID: 35141547 PMCID: PMC8811510 DOI: 10.1016/j.asmr.2021.09.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/22/2021] [Indexed: 12/31/2022] Open
Abstract
This current concept, narrative review provides the latest integrated evidence of the musculoskeletal injuries involved with trail running and therapeutic strategies to prevent injury and promote safe participation. Running activities that comprise any form of off-road running (trail running, orienteering, short-long distance, different terrain, and climate) are relevant to this review. Literature searches were conducted to 1) identify types and mechanisms of acute and chronic/overuse musculoskeletal injuries in trail runners, 2) injury prevention techniques most relevant to running trails, 3) safe methods of participation and rehabilitation timelines in the sport. The majority of acute and chronic trail running-related musculoskeletal injuries in trail running occur in the lower leg, primarily in the knee and ankle. More than 70% are due to overuse, and ankle sprains are the most common acute injury. Key mechanisms underlying injury and injury progression include inadequate neuromotor control-balance-coordination, running through fatigue, and abnormal kinematics on variable terrain. Complete kinetic chain prehabilitation programs consisting of dynamic flexibility, neuromotor strength and balance, and plyometrics exercise can foster stable, controlled movement on trails. Patient education about early musculoskeletal pain symptoms and training adjustment can help prevent injury from progressing to serious overuse injuries. Real-time adjustments to cadence, step length, and knee flexion on the trail may also mitigate impact-related risk for injury. After injury occurs, rehabilitation will involve similar exercise components, but it will also incorporate rest and active rest based on the type of injury. Multicomponent prehabilitation can help prevent musculoskeletal injuries in trail runners through movement control and fatigue resistance.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida, U.S.A
| | - Michael Brownstein
- Department of Physical Medicine and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida, U.S.A
| | - Kevin R Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida, U.S.A
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Viljoen CT, Janse van Rensburg DC, Verhagen E, van Mechelen W, Tomás R, Schoeman M, Scheepers S, Korkie E. Epidemiology of Injury and Illness Among Trail Runners: A Systematic Review. Sports Med 2021; 51:917-943. [PMID: 33538997 DOI: 10.1007/s40279-020-01418-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Trail running is characterised by large elevation gains/losses and uneven varying running surfaces. Limited information is available on injury and illness among trail runners to help guide injury and illness prevention strategies. OBJECTIVE The primary aim of this review was to describe the epidemiology of injury and illness among trail runners. METHODS Eight electronic databases were systematically searched (MEDLINE Ovid, PubMed, Scopus, SportsDiscus, CINAHL, Health Source: Nursing/Academic, Health Source: Consumer Ed., and Cochrane) from inception to November 2020. The search was conducted according to the PRISMA statement and the study was registered on PROSPERO international prospective register of systematic reviews (CRD42019135933). Full-text English and French studies that investigated injury and/or illness among trail runners participating in training/racing were included. The main outcome measurements included: trail running injury (incidence, prevalence, anatomical site, tissue type, pathology-type/specific diagnosis, severity), and illness (incidence, prevalence, symptoms, specific diagnosis, organ system, severity). The methodological quality of the included studies was assessed using an adapted Downs and Black assessment tool. RESULTS Sixteen studies with 8644 participants were included. Thirteen studies investigated race-related injury and/or illness and three studies included training-related injuries. The overall incidence range was 1.6-4285.0 injuries per 1000 h of running and 65.0-6676.6 illnesses per 1000 h of running. The foot was the most common anatomical site of trail running injury followed by the knee, lower leg, thigh, and ankle. Skin lacerations/abrasions were the most common injury diagnoses followed by skin blisters, muscle strains, muscle cramping, and ligament sprains. The most common trail running illnesses reported related to the gastro-intestinal tract (GIT), followed by the metabolic, and cardiovascular systems. Symptoms of nausea and vomiting related to GIT distress and dehydration were commonly reported. CONCLUSION Current trail running literature consists mainly of injury and illness outcomes specifically in relation to single-day race participation events. Limited evidence is available on training-related injury and illness in trail running. Our review showed that injury and illness are common among trail runners, but certain studies included in this review only focused on dermatological injuries (e.g. large number of feet blisters) and GIT symptoms. Specific areas for future research were identified that could improve the management of trail running injury and illness.
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Affiliation(s)
- Carel T Viljoen
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Hillcrest Campus, University of Pretoria, Burnett Street, Hatfield, Pretoria, 0002, South Africa.
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands.
| | - Dina C Janse van Rensburg
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Hillcrest Campus, University of Pretoria, Burnett Street, Hatfield, Pretoria, 0002, South Africa
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Evert Verhagen
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
- Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
| | - Rita Tomás
- Portugal Football School, Portuguese Football Federation, Lisbon, Portugal
| | - Marlene Schoeman
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Susan Scheepers
- Department of Library Services, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Elzette Korkie
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Hillcrest Campus, University of Pretoria, Burnett Street, Hatfield, Pretoria, 0002, South Africa
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