The aim of this study is to identify risk factors for lower extremity injuries in male marathon runners. A random sample of 1500 recreational male marathon runners was drawn. Possible risk factors were obtained from a baseline questionnaire 1 month before the start of the marathon. Information on injuries sustained shortly before or during the marathon was obtained using a post-race questionnaire. Of the 694 male runners who responded to the baseline and post-race questionnaire, 28% suffered a self-reported running injury on the lower extremities in the month before or during the marathon run. More than six times race participation in the previous 12 months [odds ratio (OR) 1.66; confidence interval (CI) 1.08-2.56], a history of running injuries (OR 2.62; CI 1.82-3.78), high education level (OR 0.73; CI 0.51-1.04) and daily smoking (OR 0.23; CI 0.05-1.01) were associated with the occurrence of lower extremity injuries. Among the modifiable risk factor studies, a training distance <40 km a week is a strong protective factor of future calf injuries, and regular interval training is a strong protective factor for knee injuries. Other training characteristics appear to have little or no effect on future injuries.

The aim of this study is to describe the prevalence and incidence of lower extremity injuries occurring before and during the Rotterdam marathon, and to evaluate the impact of the injuries. A cohort study was compiled of recreational male participants in the 2005 Rotterdam marathon. Demographic data and information on previous injuries were obtained from participants using a baseline questionnaire. Information on injuries sustained shortly before or during the marathon was obtained from a post-race questionnaire. Seven hundred and twenty-five (48.3%) participants returned the baseline questionnaire. The 1-year prevalence of running injuries was 54.8%. In the post-race questionnaire, 15.6% of all respondents reported at least one new lower extremity injury in the month preceding the Rotterdam marathon. The incidence of lower extremity injuries occurring during the marathon was 18.2%; most of these injuries occurred in the calf, knee and thigh. Immediately after the marathon the median score of pain intensity at rest was 2 points vs 4.5 points during physical exercise. Hence we can conclude that running injuries are very common among recreational male marathon runners. However, the pain severity and consequences for work and daily activities seem to be relatively low 1 week after the marathon.

One quarter of the runners had persistent complaints of their marathon-related running injury at 3 month follow-up. However, the clinical and social consequences of the injuries seem to be relatively mild. Non-musculoskeletal comorbidities at baseline are related to poor recovery, whereas recovery is also location specific.