Predictors of Running-Related Injuries Among 930 Novice Runners: A 1-Year Prospective Follow-up Study

Rasmus Oestergaard Nielsen, Ida Buist, Erik Thorlund Parner, Ellen Aagaard Nohr, Henrik Sørensen, Martin Lind, Sten Rasmussen, Rasmus Oestergaard Nielsen, Ida Buist, Erik Thorlund Parner, Ellen Aagaard Nohr, Henrik Sørensen, Martin Lind, Sten Rasmussen

Abstract

Background: To identify persons at high risk of sustaining running-related injuries, an evidence-based understanding of the risk factors associated with injury is needed.

Purpose: To identify demographic and behavioral risk factors associated with running-related injuries.

Study design: Observational prospective cohort study with a 1-year follow-up.

Methods: Exposures including sex, age, body mass index (BMI), behavior (Type A Self-Rating Inventory [TASRI]), running experience, other sports activity, previous running-related injuries, and other injuries not related to running were assessed prior to or at baseline. The outcome of interest was a running-related injury, defined as any musculoskeletal complaint of the lower extremity or back caused by running that restricted the amount of running (volume, duration, pace, or frequency) for at least 1 week. All participants quantified their running volume by global positioning system (GPS) and used a neutral running shoe. Time to first injury for each exposure variable was analyzed using a generalized linear model, with cumulative kilometers of the training sessions as the time scale.

Results: A total of 930 individuals were included in the study, of which 254 sustained a running-related injury during a total of 155.318 km of running. By calculating the cumulative injury risk differences (cIRDs) [95% confidence intervals] after 500 km of running, the TASRI Type B behavior (cIRD, 11.9% [-0.5%; 23.3%]; P = .04) was found to be a significant predictor of injury, while age between 45 and 65 years (cIRD, 14.7% [-2.1%; 31.5%]; P = .08) and previous injuries not related to running (cIRD, 11.1% [-0.2%; 22.4%]; P = .05) were considered clinically interesting, although not statistically significant. In addition, χ(2) test results across 4 BMI groups also revealed a borderline significant relationship (P = .06). No significant or clinically relevant relationships were found for sex (P = .42), previous running-related injury (P = .47), running experience (P = .30), and other sports activities (P = .30).

Conclusion: The findings of the present study suggest BMI >30 kg/m(2), age between 45 and 65 years, noncompetitive behavior, and previous injuries not related to running are associated with increased risk of injury among novice runners, while BMI <20 kg/m(2) was protective. Still, the role of the risk factors in the causal mechanism leading to injury needs to be investigated.

Keywords: BMI; age; behavior; novice; running-related injury.

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: Adidas, Herzogenaurach (Germany), and Garmin International Inc (Olathe, Kansas, USA) provided the research group with discounts on running shoes and GPS watches. The Danish Rheumatism Organization provided financial support.

Figures

Figure 1.
Figure 1.
Kaplan-Meier survival graphs for (A) previous running-related injury dichotomized into yes/no; (B) previous injuries not related to running dichotomized into yes/no; (C) sex dichotomized into female/male; (D) behavior measured by Type A Self-Rating Inventory (TASRI) dichotomized into 120 (type A: competitive, impatient, hyperactive personality); (E) age categorized into 18-30, 30-45, and 45-65 years; (F) sports activity categorized into no, yes—sports activity with axial load, and yes—sports activity without axial load; (G) body mass index (BMI) in kg/m2 categorized into <20, 20-25, 25-30, and >30; and (H) previous running experience dichotomized into yes/no. All exposures were assessed prior to or at baseline of 0 kilometers at risk. RRI, running-related injury.

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