The 5- or 10-km Marikenloop Run: A Prospective Study of the Etiology of Running-Related Injuries in Women

CORE™ wearable sensor: Comparison against gastrointestinal temperature during cold water ingestion and a 5 km running time-trial

Five km running time-trials (TT) are associated with rapid and significant increases in core body temperature (T_C). For such races, real-time feedback from pre-exercise and exercise T_C may be helpful in the design of an optimal pacing strategy aimed at limiting the possibility of developing heat-related illnesses. This study compared measurements of T_C obtained with a wearable device, the CORE™, to those of a gastrointestinal pill (GI pill), during cold water ingestion and a 5 km running TT. Twelve participants (25 ± 4 yrs) ingested 7.5 mL/kg fat-free mass of 4 °C water over the first 5 min of a 120 min sitting period, after which they completed a 5 km running TT at 30 °C, 50% relative humidity. A T_C difference > ± 0.25 °C between sensors was deemed clinically unacceptable. Prior to water ingestion, the CORE-derived T_C was 0.49 ± 0.25 °C lower than the GI pill. The CORE was irresponsive to the 0.26 ± 0.22 °C peak decline in T_C captured with the GI pill 40 min following water ingestion. Prior to the TT, T_C was 0.30 ± 0.25 °C lower with the CORE than the GI pill. During the TT, the CORE underestimated the rate of increase in T_C by 0.0125 ± 0.019 °C/min compared with the GI pill, and mean absolute difference in T_C between sensors was of 0.47 ± 0.34 °C. In conclusion, the CORE does not capture the cooling effect of cold water ingestion and provides a clinically relevant underestimation of T_C during a 5 km running TT in the heat.

A qualitative examination of the factors affecting the adoption of injury focused wearable technologies in recreational runners

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.

Biomechanical and Musculoskeletal Measurements as Risk Factors for Running-Related Injury in Non-elite Runners: A Systematic Review and Meta-analysis of Prospective Studies

BACKGROUND

Running-related injury (RRI) is highly prevalent among recreational runners and is a key barrier to participation. Atypical lower limb alignment and mechanical function have been proposed to play a role in development of lower extremity injury. The purpose of this study was to investigate relationships between incidence of running-related injury (RRI) in non-elite runners with biomechanical and musculoskeletal variables.

METHODS

A systematic review and meta-analysis of prospective studies. Published research indexed in MEDLINE, EMBASE, CINAHL, SPORTDiscus, AMED, and The Cochrane library until 13th January 2021, grey literature, and reference lists of included studies were screened to identify prospective studies of non-elite adult runners that measured a relationship between biomechanical or musculoskeletal measures and incidence of RRI.

RESULTS

Thirty studies (3404 runners), testing over 100 discrete biomechanical and musculoskeletal risk factors for RRI, were included. Nineteen studies were pooled in twenty-five separate meta-analyses. Meta-analysis of four studies detected significantly less knee extension strength among runners who developed a RRI (SMD - 0.19, 95% CI - 0.36 to - 0.02, p = 0.03), though this may not be clinically important. A meta-analysis of two studies detected significantly lower hip adduction velocity among runners who developed a RRI (MD - 12.80, 95% CI - 25.22 to - 0.38, p = 0.04). Remaining meta-analyses found no significant relationship between biomechanical or musculoskeletal variables and RRI.

CONCLUSION

This systematic review and meta-analysis found the currently available literature does not generally support biomechanical or musculoskeletal measures as risk factors for RRI in non-elite runners. While meta-analysis findings for knee extension strength and hip adduction velocity as risk factors for RRI were statistically significant, the associated trivial to small effects sizes suggest these findings should be treated with caution. Until further evidence emerges, recommendations for injury prevention in non-elite runners cannot be made based on biomechanical and musculoskeletal measurements alone.

The association between running injuries and training parameters: A systematic review

OBJECTIVE

To synthesise the current evidence on the incidence of running-related injuries (RRI) and their association with training parameters (distance, duration, frequency, intensity), as well as recent changes in training parameters.

DATA SOURCES

Searches were conducted in Medline/Ovid, CINAHL, Embase and SportDiscus up to July 7, 2020.

STUDY SELECTION

Included articles had to report prospective data on RRIs and training parameters, or any changes in parameters, and be published in English or French. Two reviewers independently screened titles, abstracts and full-texts.

DATA EXTRACTION

Data extraction and quality assessment (QualSyst) were performed by two independent raters.

DATA SYNTHESIS

Thirty-six articles totaling 23,047 runners were included. Overall, 6,043 runners (26.2%) sustained an RRI (incidence range: 8.8% to 91.3%). The incidence of RRI was 14.9% in novice runners (range: 9.4 to 94.9%), 26.1% in recreational runners (range: 17.9 to 79.3%) and 62.6% in competitive runners (range: 52.6 to 91.3%). The three most frequently injured body parts were the knee (25.8%), foot/ankle (24.4%) and lower leg (24.4%). Overall, there was conflicting evidence about the association between weekly running distance, duration, frequency, intensity or specific changes in training parameters and the onset of RRIs.

CONCLUSIONS

Despite high rates of RRIs, current evidence does not consistently link RRIs with specific training parameters or recent changes in training parameters. Therefore, caution should be taken when recommending optimal parameters or progressions. Given the multifactorial nature of RRIs, future studies also need to consider the interaction between training parameters, as well as psychosocial, hormonal, lifestyle and recovery outcomes to better understand the onset of RRIs.

A systematic review of running-related musculoskeletal injuries in runners

OBJECTIVE

Running-related musculoskeletal injuries (RRMIs), especially stemming from overuse, frequently occur in runners. This study aimed to systematically review the literature and determine the incidence and prevalence proportion of RRMIs by anatomic location and specific pathology.

METHODS

An electronic database search with no date beginning restrictions was performed in SPORTDiscus, PubMed, and MEDLINE up to June 2020. Prospective studies were used to find the anatomic location and the incidence proportion of each RRMI, whereas retrospective or cross-sectional studies were used to find the prevalence proportion of each RRMI. A separate analysis for ultramarathon runners was performed.

RESULTS

The overall injury incidence and prevalence were 40.2% ± 18.8% and 44.6% ± 18.4% (mean ± SD), respectively. The knee, ankle, and lower leg accounted for the highest proportion of injury incidence, whereas the knee, lower leg, and foot/toes had the highest proportion of injury prevalence. Achilles tendinopathy (10.3%), medial tibial stress syndrome (9.4%), patellofemoral pain syndrome (6.3%), plantar fasciitis (6.1%), and ankle sprains (5.8%) accounted for the highest proportion of injury incidence, whereas patellofemoral pain syndrome (16.7%), medial tibial stress syndrome (9.1%), plantar fasciitis (7.9%), iliotibial band syndrome (7.9%), and Achilles tendinopathy (6.6%) had the highest proportion of injury prevalence. The ankle (34.5%), knee (28.1%), and lower leg (12.9%) were the 3 most frequently injured sites among ultramarathoners.

CONCLUSION

The injury incidence proportions by anatomic location between ultramarathoners and non-ultramarathoners were not significantly different (p = 0.798). The pathologies with the highest incidence proportion of injuries were anterior compartment tendinopathy (19.4%), patellofemoral pain syndrome (15.8%), and Achilles tendinopathy (13.7%). The interpretation of epidemiological data in RRMIs is limited due to several methodological issues encountered.

Knowledge and management of low back pain as running-related injuries among Italian physical therapists: findings from a national survey

OBJECTIVES

To investigate the beliefs, knowledge, attitudes, behavior, and the clinical management procedures of the Italian physical therapists specialized in orthopedic manipulative physical therapy (OMPT) toward running and its correlation with low back pain (LBP).Design: A cross-sectional online survey was conducted in 2019, according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.Setting: Italy.Participants: One thousand two hundred and eighteen Italian OMPTs.

METHODS

Survey Monkey software was used to administer the survey. The questionnaire was self-reported and included 26 questions. Descriptive statistics were used and related to the effective respondents for each question.

RESULTS

One thousand two hundred and eighteen questionnaires (60.9%) were included in the analysis. A considerable cohort of OMPTs working in private practice clinical settings (n = 845; 69.4%; 95% CI 66.7-71.9) has indicated running not to be a relevant risk factor for the onset of LBP (n = 806; 66.2%; 95% CI 63.4-68.8). Moreover, most of the participants (n = 679; 55.7%; 95% CI 52.9-58.5) adopted a combination of manual therapy techniques and therapeutic exercise for the management of runners with LBP.

CONCLUSIONS

Widespread knowledge of clinical and theoretical management of LBP in runners-patients has emerged among Italian OMPTs. The OMPTs' academic background agrees with the recent literature and therefore highlights the paucity of studies related to LBP as running-related injuries.

Independent Risk Factors Predicting Gradual Onset Injury in 2824 Trail Running Race Entrants: SAFER XVIII Study

INTRODUCTION

Trail running is characterized by elevation changes, with uneven and varying running surfaces. Risk factors that may predict gradual-onset running-related injuries (GORRIs) in short-distance trail running have not been explored. The objective was to determine risk factors that predict GORRIs in trail running race entrants who entered mass community-based trail running events.

METHODS

In this descriptive cross-sectional study, data were collected prospectively from a prerace medical screening questionnaire over 4 trail run events held annually. Using a Poisson regression model, runner demographics, race distance, running training/racing variables, history of chronic diseases (number of chronic diseases reported as a cumulative "chronic disease composite score"), and allergies were investigated to determine factors predicting self-reported GORRI history in the previous 12 mo.

RESULTS

This study included 2824 race entrants (80% of entrants). The retrospective annual incidence for GORRIs was 13%. Independent risk factors predicting GORRIs were longer race distance (P<0.0001), increasing chronic disease composite score (P=0.0012), and a history of allergies (P=0.0056). The lower limb (94%) was the main anatomic region of GORRIs, and soft tissue injuries accounted for most (83%) GORRIs. Common specific GORRIs were iliotibial band syndrome (22%), Achilles tendon injury (10%), and hamstring injury (9%).

CONCLUSIONS

Independent risk factors predicting GORRIs among trail running entrants included longer race distance, a higher chronic disease composite score, and a history of allergies. This study has highlighted trail running race entrants at risk for sustaining GORRIs who could be targeted for future injury prevention interventions.

The socio-economic impact of running-related injuries: A large prospective cohort study

Objectives

To evaluate the impact of running‐related injuries (RRIs) on activities of daily living (ADL), work, healthcare utilization, and estimated costs.

Design

Prospective cohort study with data from a randomized controlled trial.

Methods

Adult recreational runners who registered for a running event (distances 5 to 42 km) were included in this study. Minimum follow‐up duration was 3 months (preparation, event participation, and post‐race period). Injuries were registered using a standardized definition. Primary outcome measure was a standardized 5‐item survey on limitations in ADL. The survey data were categorized to the number of injured runners with complete/moderate/no limitations. This outcome was expressed as the percentage of injured runners with any limitation (complete or moderate limitations amalgamated). Secondary outcomes were work absenteeism, the number of healthcare visits per injured runner, and estimated direct medical and indirect costs per participant and per RRI.

Results

1929 runners (mean [SD] age 41 [12] years, 53% men) were included in this study and 883 runners (46%) sustained a RRI during the course of the study. Injured runners reported the highest limitations (% with any limitation) of RRIs during the first week of injury on sports and leisure activities (70%) and transportation activities (23%). 39% of the injured runners visited a healthcare professional. Work absenteeism due to the RRI was reported in 5% of the injured runners. The total mean estimated costs were €74 per RRI and €35 per participant.

Conclusions

Injured runners are mainly limited in their transportation activities and during sports and leisure. While the estimated costs of RRIs are not high when expressed per participant, the absolute costs may be substantial due to the popularity of running.

Barbell Hip-Thrust Exercise: Test-Retest Reliability and Correlation With Isokinetic Performance

ABSTRACT

Dello Iacono, A, Padulo, J, Bešlija, T, and Halperin, I. Barbell hip-thrust exercise: Test-retest reliability and correlation with isokinetic performance. J Strength Cond Res 35(3): 659-667, 2021-The barbell hip-thrust (BHT) exercise is growing in popularity as evident by the large increase in research outputs investigating its utility as a training intervention and a testing tool. The aim of this study was to examine the test-retest reliability of the BHT and its correlation with isokinetic performance. Test-retest reliability was established by correlating the peak force and power outcomes measured with the BHT force-velocity profile test of 20 handball athletes on 2 separate days. The peak force and power measured with the BHT force-velocity profile test of 49 handball athletes were correlated with peak concentric force of the knee flexors and hip extensors measured with an isokinetic device at 2 different velocities (60-180°·s-1). The correlation between the isokinetic testing scores and the BHT force-velocity profile tests were moderate to large (Pearson r ranges: 0.45-0.86, all p values <0.001). Test-retest reliability of the BHT force-velocity profile was very high as shown with intraclass correlations of 0.94 and 0.99 for peak force and 0.97 and 0.99 for peak power measures. The BHT force-velocity profile can serve as a tentative substitute in cases that athletes do not have access to an isokinetic device, given the moderate to large correlations between them. Moreover, the BHT force-velocity profile was shown to be very reliable, thus providing coaches and scientists a range of day-to-day performance variability in this exercise.

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

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.

Low back pain among Italian runners: A cross-sectional survey

BACKGROUND

Low Back Pain (LBP) is commonly reported as a very frequent disorder in sports, but its prevalence in runners remains unclear.

OBJECTIVES

To determine the prevalence of LBP in a wide sample of Italian runners.

DESIGN

A cross-sectional online survey.

SETTING

A national survey, according to the CHERRIES and STROBE guidelines, was performed in 2019.

PARTICIPANTS

2539 Italian runners.

METHODS

A sample of Italian runners registered with national running associations was recruited. The survey was conducted using an online survey development platform. The questionnaire was self-reported and included 38 questions.

MAIN OUTCOME MEASURES

Descriptive statistics and frequencies were used to analyze results. Relationships between demographics, daily habits and running characteristics and the responses given was calculated with Cramer's V. Only correlation values higher >0.60 were deemed of interest.

RESULTS

2539 questionnaires (63.5%) were valid for analysis. In total, 22.6% of runners reported having experienced LBP in the past year. Most participants (77.0%) reporting episodes of LBP believed it was not caused by running. No significant correlations (Cramer's V < 0.60) were found between LBP and demographics, training characteristics or lifestyle habits.

CONCLUSION

The prevalence of LBP among Italian runners was 22,57%. LBP was not associated with training, equipment or lifestyle.

Risk factors for overuse injuries in short- and long-distance running: A systematic review

PURPOSE

The aim of this study was to review information about risk factors for lower extremity running injuries in both short-distance (mean running distance ≤20 km/week and ≤10 km/session) and long-distance runners (mean running distance >20 km/week and >10 km/session).

METHODS

Electronic databases were searched for articles published up to February 2019. Prospective cohort studies using multivariable analysis for the assessment of individual risk factors or risk models for the occurrence of lower extremity running injuries were included. Two reviewers independently selected studies for eligibility and assessed risk of bias with the Quality in Prognostic Studies Tool. The GRADE approach was used to assess the quality of the evidence.

RESULTS

A total of 29 studies were included: 17 studies focused on short-distance runners, 11 studies focused on long-distance runners, and 1 study focused on both types of runners. A previous running-related injury was the strongest risk factor for an injury for long-distance runners, with moderate-quality evidence. Previous injuries not attributed to running was the strongest risk factor for an injury for short-distance runners, with high-quality evidence. Higher body mass index, higher age, sex (male), having no previous running experience, and lower running volume were strong risk factors, with moderate quality evidence, for short-distance runners. Low-quality evidence was found for all risk models as predictors of running-related injuries among short- and long-distance runners.

CONCLUSION

Several risk factors for lower extremity injuries have been identified among short- and long-distance runners, but the quality of evidence for these risk factors for running-related injuries is limited. Running injuries seem to have a multifactorial origin both in short- and long-distance runners.

Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis

OBJECTIVES

We aimed to determine the prevalence of low back pain (LBP) in sport, and what risk factors were associated with LBP in athletes.

DESIGN

Systematic review with meta-analysis.

DATA SOURCES

Literature searches from database inception to June 2019 in Medline, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus, supplemented by grey literature searching.

ELIGIBILITY CRITERIA

Studies evaluating prevalence of LBP in adult athletes across all sports.

RESULTS

Eighty-six studies were included (30 732, range 20-5958, participants), of which 45 were of 'high' quality. Definitions of LBP varied widely, and in 17 studies, no definition was provided. High-quality studies were pooled and the mean point prevalence across six studies was 42%; range 18%-80% (95% CI 27% to 58%, I2=97%). Lifetime prevalence across 13 studies was 63%; range 36%-88% (95% CI 51% to 74%, I2=99%). Twelve-month LBP prevalence from 22 studies was 51%; range 12%-94% (95% CI 41% to 61%, I2=98%). Comparison across sports was limited by participant numbers, study quality and methodologies, and varying LBP definitions. Risk factors for LBP included history of a previous episode with a pooled OR of 3.5; range 1.6-4.0 (95% CI 1.9 to 6.4). Statistically significant associations were reported for high training volume, periods of load increase and years of exposure to the sport.

CONCLUSION

LBP in sport is common but estimates vary. Current evidence is insufficient to identify which sports are at highest risk. A previous episode of LBP, high training volume, periods of load increase and years of exposure are common risk factors.

Enhanced injury prevention programme for recreational runners (the SPRINT study): design of a randomised controlled trial

Introduction

Running-related injuries (RRIs) are frequent, but no effective injury prevention measures have been identified yet. Therefore, we have set up the INSPIRE trial in 2017, in which the effectiveness of an online injury prevention programme was tested. Although this programme was not effective in reducing the number of RRIs, we gained new insights from this study, which we used to design an enhanced, online multidisciplinary injury prevention programme. The aim of this study is to test the effectiveness of this enhanced injury prevention programme in a group of recreational runners.

Methods and analysis

For this randomised controlled trial, we aim to include 3394 recreational runners aged 18 years or older who register for a running event (distances 10 to 42.2 km). During the preparation for the running event, runners in the intervention group get access to the enhanced online injury prevention programme. This online programme consists of 10 steps, all covering separate items of RRI prevention. Runners in the control group will follow their regular preparation. With three follow-up questionnaires (1 month before, 1 week before and 1 month after the running event), the proportions of self-reported RRIs in the intervention group and the control group are compared.

Ethics and dissemination

An exemption for a comprehensive application has been obtained by the Medical Ethical Committee of the Erasmus MC University Medical Center, Rotterdam, the Netherlands. The results of the study will be disseminated among the running population, published in peer-reviewed international journals and presented on international conferences.

Trial registration number

NL7694

Prevalence and incidence of low back pain among runners: a systematic review

Background

Running is one of the most popular sports worldwide. Despite low back pain (LBP) represents the most common musculoskeletal disorder in population and in sports, there is currently sparse evidence about prevalence, incidence and risk factors for LBP among runners. The aims of this systematic review were to investigate among runners: prevalence and incidence of LBP and specific risk factors for the onset of LBP.

Methods

A systematic review has been conducted according to the guidelines of the PRISMA statement. The research was conducted in the following databases from their inception to 31st of July 2019: PubMed; CINAHL; Google Scholar; Ovid; PsycINFO; PSYNDEX; Embase; SPORTDiscus; Scientific Electronic Library Online; Cochrane Library and Web of Science. The checklists of The Joanna Briggs Institute Critical Appraisal tools were used to investigate the risk of bias of the included studies.

Results

Nineteen studies were included and the interrater agreement for full-text selection was good (K = 0.78; 0.61–0.80 IC 95%). Overall, low values of prevalence (0.7–20.2%) and incidence (0.3–22%) of LBP among runners were reported. Most reported risk factors were: running for more than 6 years; body mass index > 24; higher physical height; not performing traditional aerobics activity weekly; restricted range of motion of hip flexion; difference between leg-length; poor hamstrings and back flexibility.

Conclusions: Prevalence and incidence of LBP among runners are low compared to the others running related injuries and to general, or specific population of athletes. View the low level of incidence and prevalence of LBP, running could be interpreted as a protective factor against the onset of LBP.

Systematic review registration

PROSPERO CRD42018102001.

Effects of sports bra and footwear on vertebral posture during walking and running

Little attention has been given to factors which affects women running, such as proper footwear and breast support and their effects on spine. The objective of study was to analyse the influence of different breast support and footwear on vertebral posture during walking and running. Seventeen women (x¯ = 23.51; SD = 3.70 years) performed a treadmill walking (5 km/h) and running (7 and 10 km/h) with different footwear (barefoot, minimalist and traditional) and breast support (bare breast, everyday bra and sports bra) conditions. Spine movements were analyzed using three cameras in grayscale video mode, positioned behind the participant to register reflective markers fixed in the vertebrae. From the 3D coordinates of the trunk markers we computed, for the whole gait cycle (C) and for the average gait posture (neutral curve-NC) the maximal (M) thoracic (T) kyphosis and lateral flexion, and the maximal lumbar (L) lordosis and lateral flexion. Frontal plane: bare breast presented higher lumbar NC than the everyday bra and sports bra, higher MLC than the sports bra and lower MTC than the everyday bra and sports bra. Barefoot presented higher MTC than minimalist. Sagittal plane: bare breast presented lower MTC than the sports bra. Barefoot presented higher lumbar NC than the minimalist and traditional footwear and higher MLC than the minimalist and traditional ones. The sports bra increased curvatures in the thoracic spine that were rectified during bare breast conditions. In addition, both footwears were able to maintain the natural curvatures of the spine in the lumbar.

Low back pain and calf pain in a recreational runner masking peripheral artery disease: A case report

Background: Running is one of the most popular sports worldwide due to its low costs and its beneficial impact on health. Recent evidence suggests 11% to 85% of recreational runners experience at least one running-related injury each year and most of these are related to musculoskeletal conditions. The aim of this case report is to describe the clinical decision-making process that guided a physiotherapist to suspect a non-musculoskeletal cause in a recreational runner presenting with low back pain and calf pain secondary to Peripheral Artery Disease.Case Presentation: This case report describes the clinical history, clinical exam, laboratory and imaging tests, and surgical procedure of a 65 y.o. amateur runner suffering low back pain and left calf pain for 3 months. The patient's clinical findings suggested that referral to another health-care provider was required to explore potential non-musculoskeletal sources of pain. An angioplasty was necessary to solve the patient's clinical situation.Discussion and Conclusion: In this patient case, clinical findings along with a comprehensive family and personal history, ruled out a musculoskeletal condition and implicated a vascular condition.

Importance of screening in physical therapy: vertebral fracture of thoracolumbar junction in a recreational runner

Running is one of the most popular sports worldwide. Studies suggest that 11%-85% of recreational runners have at least one running-related injury (RRI) each year, resulting in a reduction or interruption in training. A high risk for running-related injuries (RRIs) represents an important inconvenience counterbalancing the beneficial effects of running. RRIs primarily affect the joints of the lower limb and lumbar spine. Noteworthy, in some cases, the clinical presentation of signs and symptoms is confusing and may hide serious conditions; thus, clinicians have to pay special attention when potential factors arise, such as the presence of red flags. As reported in this case report, patients can present with low back pain (LBP) as a primary problem, mimicking a red flag such as a fracture of the spine. The aim of this case report was to describe a case of a recreational runner presenting with LBP as the sole symptom of an underlying thoracolumbar fracture.

Influence of speed and heel-to-toe drop in running shoes for female recreational runners: A cross-sectional study

In recent years, the popularity of running has boomed and the number of women runners has risen sharply. However, little research has been conducted into the running cycle as concerns female runners. The aim of this study is to analyse, in women runners, the relationships between spatiotemporal parameters in the running cycle, the heel drop in running shoes and a progressive increase in training speed, when running on a treadmill.Thirty-eight female runners were recruited from the Malaga University Athletics Club and Nerja Athletics Club. All were at least 18 years old, recreationally active (3-4 running sessions per week) and able to run 5 km in less than 25 min. Their running performance on a treadmill was recorded and spatiotemporal parameters assessed using the OptoGait system.As the running speed increased (8-12-15 km/h) the spatiotemporal parameters of the running cycle altered: the flight time increased (P < .001) and the contact time decreased (P = .05). Heel drop (4-12 mm) was not significantly associated with any of the parameters (phase 1: P = .198; phase 2: P = .191; phase 3: P = .242).A progressive increase in training speed on a treadmill directly influences the spatiotemporal parameters of the running cycle in women runners.

Online multifactorial prevention programme has no effect on the number of running-related injuries: a randomised controlled trial

Objective

To examine the effect of a multifactorial, online injury prevention programme on the number of running-related injuries (RRIs) in recreational runners.

Methods

Adult recreational runners who registered for a running event (distances 5 km up to 42.195 km) were randomised into the intervention group or control group. Participants in the intervention group were given access to the online injury prevention programme, which consisted of information on evidence-based risk factors and advices to reduce the injury risk. Participants in the control group followed their regular preparation for the running event. The primary outcome measure was the number of self-reported RRIs in the time frame between registration for a running event and 1 month after the running event.

Results

This trial included 2378 recreational runners (1252 men; mean [SD] age 41.2 [11.9] years), of which 1196 were allocated to the intervention group and 1182 to the control group. Of the participants in the intervention group 37.5% (95% CI 34.8 to 40.4) sustained a new RRI during follow-up, compared with 36.7% (95% CI 34.0 to 39.6) in the control group. Univariate logistic regression analysis showed no significant difference between the intervention and control group (OR 1.08; 95% CI 0.90 to 1.30). Furthermore, the prevention programme seemed to have a negative impact on the occurrence of new RRIs in the subgroup of runners with no injuries in the 12 months preceding the trial (OR 1.30; 95% CI 0.99 to 1.70).

Conclusion

A multifactorial, online injury prevention programme did not decrease the total number of RRIs in recreational runners.

Trial registration number

NTR5998.

Recent Versus Old Previous Injury and Its Association with Running-Related Injuries During Competition by SeRUN® Running Profiles: a Cross-sectional Study

BACKGROUND

Previous injury in the last 12 months is the main risk factor for future running-related injuries (RRI) during training and competition environments. However, the relationship between a recent versus old previous injury and a new RRI has not been established yet, nor a separate analysis by different types of runners.

METHODS

An online questionnaire was sent to 6000 participants of a running event (10 km, 21 km and 42 km), 10 days following the event. The questionnaire included the following information: the presence and topography of new RRIs during the race, old previous injury (from 12-4 months before the race), recent previous injury (from 3-0 months before the race), running experience, training factors and socio-demographic characteristics. Univariate binomial regression analysis was applied to assess different associated factors, and multivariable binomial backward regression (p < 0.05) was used to analyse the relationship between the new and previous injury.

RESULTS

A total of 868 surveys were analysed (10 km, 32.6%; 21 km, 52%; 42 km, 15.4%). The median age was 38 years (IQR 31-46), and 63.5% were males. Previous injury was reported by 30.3% and 27.6% for old and recent, respectively. The majority of runners were categorised into the advanced group (42.9%), having more than 5 years of running experience. During the race, 7.0% reported a RRI, with 36.1% located at the knee. The multivariable analysis showed an association only between new injury and recent injury.

CONCLUSION

The delineation of recent and old previous injuries should be considered in running epidemiological research.

How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury

Athletes participating in elite sports are exposed to high training loads and increasingly saturated competition calendars. Emerging evidence indicates that poor load management is a major risk factor for injury. The International Olympic Committee convened an expert group to review the scientific evidence for the relationship of load (defined broadly to include rapid changes in training and competition load, competition calendar congestion, psychological load and travel) and health outcomes in sport. We summarise the results linking load to risk of injury in athletes, and provide athletes, coaches and support staff with practical guidelines to manage load in sport. This consensus statement includes guidelines for (1) prescription of training and competition load, as well as for (2) monitoring of training, competition and psychological load, athlete well-being and injury. In the process, we identified research priorities.