Associations between biomechanical and clinical/anthropometrical factors and running-related injuries among recreational runners: a 52-week prospective cohort study

Jungmalm, Jonatan; Nielsen, Rasmus Oestergaard; Desai, Pia; Karlsson, Jón; Hein, Tobias; Grau, Stefan

doi:10.1186/s40621-020-00237-2

Cited by 12 publications

(26 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Five study authors provided additional data for inclusion in this review [ 15 , 19 , 25 , 51 , 60 ]. Two studies included some ineligible participants, i.e., below 18 years of age [ 51 ] or non-recreational runners [ 15 ].…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2022

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

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

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Another methodological concern is that the relationship between impact force characteristics and injury risk might not be linear, but U-shaped (Bahr and Holme, 2003 ; Jungmalm et al, 2020 ). In such a case, impact force characteristics cannot be used as continuous variables in a regression model but they should be categorized using cut-off points.…”

Section: Discussionmentioning

confidence: 99%

“…Each force characteristic was categorized. Since no cut-off values have been proposed so far to define populations at higher or lower injury risk with regard to force characteristics, the cut-off values were defined as ±1 SD from the mean, where values outside of that range were considered below or above the reference group, respectively (Jungmalm et al, 2020 ). The assumption of proportional hazards was evaluated using log-minus-log plots and Schoenfeld's global test.…”

Section: Methodsmentioning

confidence: 99%

“…This is a second piece of evidence that the protective effect of greater cushioning observed in our previous trial may be related to the attenuation of impact force of the high frequency signal. Another methodological concern is that the relationship between impact force characteristics and injury risk might not be linear, but U-shaped (Bahr and Holme, 2003;Jungmalm et al, 2020). In such a case, impact force characteristics cannot be used as continuous variables in a regression model but they should be categorized using cut-off points.…”

Section: Impact Forces and Injury Riskmentioning

confidence: 99%

See 1 more Smart Citation

Relevance of Frequency-Domain Analyses to Relate Shoe Cushioning, Ground Impact Forces and Running Injury Risk: A Secondary Analysis of a Randomized Trial With 800+ Recreational Runners

Malisoux

Gette

Backes

et al. 2021

Front. Sports Act. Living

View full text Add to dashboard Cite

Cushioning systems in running shoes are used assuming that ground impact forces relate to injury risk and that cushioning materials reduce these impact forces. In our recent trial, the more cushioned shoe version was associated with lower injury risk. However, vertical impact peak force was higher in participants with the Soft shoe version. The primary objective of this study was to investigate the effect of shoe cushioning on the time, magnitude and frequency characteristics of peak forces using frequency-domain analysis by comparing the two study groups from our recent trial (Hard and Soft shoe group, respectively). The secondary objective was to investigate if force characteristics are prospectively associated with the risk of running-related injury. This is a secondary analysis of a double-blinded randomized trial on shoe cushioning with a biomechanical running analysis at baseline and a 6-month follow-up on running exposure and injury. Participants (n = 848) were tested on an instrumented treadmill at their preferred running speed in their randomly allocated shoe condition. The vertical ground reaction force signal for each stance phase was decomposed into the frequency domain using the discrete Fourier transform. Both components were recomposed into the time domain using the inverse Fourier transform. An analysis of variance was used to compare force characteristics between the two study groups. Cox regression analysis was used to investigate the association between force characteristics and injury risk. Participants using the Soft shoes displayed lower impact peak force (p < 0.001, d = 0.23), longer time to peak force (p < 0.001, d = 0.25), and lower average loading rate (p < 0.001, d = 0.18) of the high frequency signal compared to those using the Hard shoes. Participants with low average and instantaneous loading rate of the high frequency signal had lower injury risk [Sub hazard rate ratio (SHR) = 0.49 and 0.55; 95% Confidence Interval (CI) = 0.25–0.97 and 0.30–0.99, respectively], and those with early occurrence of impact peak force (high frequency signal) had greater injury risk (SHR = 1.60; 95% CI = 1.05–2.53). Our findings may explain the protective effect of the Soft shoe version previously observed. The present study also demonstrates that frequency-domain analyses may provide clinically relevant impact force characteristics.Clinical Trial Registration:https://clinicaltrials.gov/, identifier: 9NCT03115437.

show abstract

“…Some MRI studies show that even running 4487 km in a multistage UM does not cause permanent negative changes in the knee joint [13,14]. Potential overload injuries during long runs are influenced by a number of individual factors: biochemical, clinical, and anthropometric [15]. There are a few well-documented studies that testify knee joint adaptability, even on extreme mountain UMs [16].…”

Section: Knee Overload Injuries In Um Runnersmentioning

confidence: 99%

Right Knee—The Weakest Point of the Best Ultramarathon Runners of the World? A Case Study

Gajda¹,

Walasek

Jarmuszewski³

2020

IJERPH

View full text Add to dashboard Cite

The impact of ultramarathons (UM) on the organs, especially in professional athletes, is poorly understood. We tested a 36-year-old UM male runner before and after winning a 24-h marathon. The primary goal of the study was cardiovascular assessment. The athlete experienced right knee pain for the first time after 12 h of running (approximately 130 km), which intensified, affecting his performance. The competitors ran on a 1984 m rectangle-loop (950 × 42 m) in an atypical clockwise fashion. The winner completed 516 rectangular corners. Right knee Magnetic Resonance Imaging (MRI) one day after the run showed general overload in addition to degenerative as well as specific features associated with “turning to the right”. Re-examination after three years revealed none of these findings. Different kinds of overloading of the right lower limb, including right knee pain, were indicated in 6 of 10 competitors from the top 20, including a woman who set the world record. The affected competitors suggested as cause for discomfort the shape of the loop and running direction. They believed that changing the direction of the run during the competition and an athletics stadium loop shape on a 2000–2500 m length is better for 24-h UM runners. In the absence of technical alternatives, the “necessary evil” is a counterclockwise run (also Association of Athletics Federations IAAF recommendation). Results suggest that a one-way, clockwise, 24-h UM run had an adverse effect on the athlete’s right knee, as a result of unsymmetrical load. Organizers of 24-h UM runs should consider the shape of the competition loop and apply the principle of uniform load on the musculoskeletal system (alternate directions run). In case of technical impossibility, it would be better to run counterclockwise, which is more common, preferred by runners, and recommended by the IAAF.

show abstract

Associations between biomechanical and clinical/anthropometrical factors and running-related injuries among recreational runners: a 52-week prospective cohort study

Cited by 12 publications

References 27 publications

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

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

Relevance of Frequency-Domain Analyses to Relate Shoe Cushioning, Ground Impact Forces and Running Injury Risk: A Secondary Analysis of a Randomized Trial With 800+ Recreational Runners

Right Knee—The Weakest Point of the Best Ultramarathon Runners of the World? A Case Study

Contact Info

Product

Resources

About