Predictors of Running-Related Injuries Among 930 Novice Runners: A 1-Year Prospective Follow-up Study. 2013

Rasmus Oestergaard Nielsen, and Ida Buist, and Erik Thorlund Parner, and Ellen Aagaard Nohr, and Henrik Sørensen, and Martin Lind, and Sten Rasmussen
Department of Public Health, Section of Sport Science, Aarhus University, Aarhus, Denmark. ; Orthopaedic Surgery Research Unit, Science and Innovation Center, Aalborg University Hospital, Aalborg, Denmark.

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. OBJECTIVE To identify demographic and behavioral risk factors associated with running-related injuries. METHODS 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). CONCLUSIONS 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.

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