Anterior knee pain and its intrinsic risk factors among runners in under-resourced communities in Ekurhuleni, Gauteng

Abstract

BackgroundAnterior knee pain (AKP) is the most common injury among runners, especially in females and young runners. Because of a deficit of rehabilitation services in under-resourced communities, runners train and compete with injuries, resulting in further complications.ObjectivesThis study aimed to determine the prevalence and modifiable intrinsic risk factors for AKP among runners in under-resourced communities in Ekurhuleni, Gauteng Province.MethodThis cross-sectional study included a population of 347 runners from six running clubs. Convenience sampling was used to recruit 183 participants aged between 13 and 55. A standardised questionnaire determined AKP prevalence, and 12 physical tests screened for modifiable intrinsic risk factors. Descriptive and inferential statistical tests were used to analyse the data.ResultsAKP was present in 40% of participants, particularly in males (57.9%) and young runners (57.9%) with 3–5 years of running experience (31.1%). Anterior knee pain was significantly associated with age (chi-square [χ2] = 6.484, p = 0.039) and running experience (χ2 = 8.389, p = 0.036). The modifiable intrinsic risk factors found to have contributed significantly to AKP were: tight hamstrings (odds ratio [OR] = 1.021; p = 0.051); tight iliotibial band (OR = 1.1; p = 0.046); weak quadriceps (OR = 0.15; p = 0.040); weak hip muscles (OR = 1.13; p = 0.004) and patellar tilt abnormalities (OR = 1.33; p = 0.015).ConclusionAnterior knee pain and various modifiable intrinsic risk factors were found among these runners. These findings suggest that management of AKP should take into consideration the effect of these identified modifiable risk factors to improve management outcomes. A community-based rehabilitation approach should be considered, given the lack of resources in low socio-economic communities.Clinical implicationsThe results from this study make explicit the risk factors associated with AKP, particularly in runners from under-resourced communities. These are important considerations in the development of rehabilitation programmes to manage AKP.

Anterior knee pain and its extrinsic risk factors among runners in under-resourced communities in Ekurhuleni, Gauteng, South Africa

“…Anterior knee pain was found to be strongly associated with age ( 2 = 6.48, p = 0.04) followed by the group of young people [7] Kunene et al [7] (n = 33, 18%) and, lastly, running experience ( 2 = 8.39, p = 0.04). Participants with 1-3-years of running experience was the most affected group (n = 22, 12%) ( Table 2).…”

“…[6] In particular, tight hamstrings and weakness of the iliotibial band and quadriceps, weak hip control muscles and patellar tilt abnormalities were found to be significant when associated with AKP in an under-resourced community in South Africa. [7] It is therefore critical that the intrinsic risk factors be considered in the management of AKP in order to improve management outcomes. [7] Establishing extrinsic risk factors is another important component to be considered when dealing with the management of AKP.…”

“…[7] It is therefore critical that the intrinsic risk factors be considered in the management of AKP in order to improve management outcomes. [7] Establishing extrinsic risk factors is another important component to be considered when dealing with the management of AKP. Extrinsic factors which are external to the body may include: the action of running, the level of participation (including training and competition), other types of physical activities and the way they are performed, running surfaces, environmental conditions, and the effect of the equipment encountered during physical activities, e.g.…”

Experiences and rehabilitation needs of runners with anterior knee pain in under-resourced communities in Ekurhuleni, Gauteng, South Africa

“…Other factors may include tight iliopsoas muscles, tightness of the gastrocnemius complex, foot pronation, general joint laxity, leg length discrepancy, patellar glide abnormalities, and patellar hypermobility. [4,5] Kunene et al [5] also found that a heavy training load, lack of warm-up exercises during training, poor condition of running shoes, and downhill running significantly contribute to AKP among runners. [6] The incidence of sports injuries and their associated problems continues to increase among athletes, more especially among those in the poorer communities who live under unfavourable socioeconomic conditions.…”

“…[3] Various factors were found to contribute to this condition. According to Kunene et al [4] tight hamstring and iliotibial band muscles, weak quadriceps muscles, weak gluteal muscles (resulting in poor hip control) and patellar tilt problems, were found to contribute significantly to AKP. Other factors may include tight iliopsoas muscles, tightness of the gastrocnemius complex, foot pronation, general joint laxity, leg length discrepancy, patellar glide abnormalities, and patellar hypermobility.…”