Epidemiology, clinical characteristics, and risk factors for running-related injuries among South African trail runners

Trail running involves running on varying natural terrains, often including large elevation gains/losses. Trail running has a high risk of injury, and runners often participate in remote regions where medical support is challenging. The aim of this study was to determine the epidemiology, clinical characteristic, and associated injury risk factors among trail runners. A modified Oslo Sports Trauma Research Center Questionnaire for Health Problems (OSTRC-H) was used biweekly to collect running-related injury (RRI) and training history data prospectively, among 152 participants (males n = 120, females n = 32) over 30 weeks. We report an overall injury rate of 19.6 RRIs per 1000 h and an RRI mean prevalence of 12.3%. The leading anatomical site of RRIs was the lower limb (82.9%), affecting the knee (29.8%), shin/lower leg (18.0%), and the foot/toes (13.7%). A history of previous RRI in the past 12 months (p = 0.0032) and having a chronic disease (p = 0.0188) are independent risk factors for RRIs among trail runners. Two in three trail runners sustain an RRI mainly affecting the knee, shin/lower leg, and foot/toes. A history of previous RRI in the past 12 months and a having chronic disease is independently associated with RRI among trail runners. These results could be used to develop future RRI prevention strategies, combined with clinical knowledge and experience.File S1: Online consent form and baseline questionnaire, File S2: Online follow-up questionnaire on the Qualtrics platform, File S3: The frequency of tissue and pathology types of RRIs among trail runners.https://www.mdpi.com/journal/ijerpham2022PhysiotherapySports MedicineStatistic

The use of skeletal muscle relaxants in musculoskeletal injuries : what is the evidence?

Skeletal muscle relaxants (SMRs) consist of a heterogeneous group of medications with a side effect profile of concern. The aim of this paper was to review the evidence of use of SMRs in the treatment of sports injuries. A literature search between 2005 – 2018 (Ovid MEDLINE, SPORTDiscus and SCOPUS) were conducted. In addition, citations within articles were searched, and the most commonly prescribed SMRs in South Africa were also used to explore the literature for additional publications. Relevant studies that met the inclusion criteria were selected. Clinical recommendations for general practitioners are given based on the Strength of Recommendation Taxonomy (SORT) level of evidence. Combination drugs rather than single agents are mostly used, however the effectiveness of SMR agents, single and in combination, as well as its significance as opposed to analgesics and non-steroidal anti-inflammatory drugs, still has to be evaluated. Evidence suggest SMRs to be probably effective for use in non-specific lower back pain (acute and chronic lower back muscle strains, ligament sprains, soft tissue contusions), as well as for whiplash associated disorder, mechanical neck disorders, piriformis syndrome, lateral epicondylosis, and plantar fasciitis. It does not appear if there is a role for SMRs as part of combination management for acute cervical strains, post-exercise muscle soreness or myofacial pain syndrome. However, substantial evidence to confirm the use of SMRs in the treatment of sports injuries have not been adequately investigated and is currently largely based on case reports and general reviews.http://www.safpj.co.za/index.php/safpjam2019PhysiotherapySports Medicin

One in five trail running race entrants sustained an injury in the 12 months training period before the 2021 Mac Mac ultra race

DATA AVAILABILITY: Data are available upon reasonable request.BACKGROUND : Trail running is characterised by large elevation gains/losses and varying uneven running surfaces. Limited literature is available to help guide injury prevention strategies among trail runners. The purpose of this study was to determine the epidemiology, clinical characteristics, and related risk factors for running-related injuries (RRIs) amid trail runners who entered the 2021 Mac Mac Ultra races. METHODS : DESIGN : Descriptive cross-sectional study. SETTING : 2021 Mac Mac Ultra Race. PARTICIPANTS : Consent for data analysis was given by 251 of 330 (76%) race entrants. MAIN OUTCOME MEASURES : Point prevalence (%), frequency (n, %), retrospective annual incidence (RRIs/100 athlete-years), characteristics (pathology type, tissue type, body area, anatomical region), and associated injury risk factors (training and demographic variables) of RRIs. RESULTS : In the sample, the retrospective annual incidence was 19.92/100 athlete-years. The point prevalence was 4%. Injuries mostly appeared in the lower limb (95%), with the lower leg (26%), thigh (22%), ankle and foot (13%) described as the highest injured body areas. Of tissue type injuries, muscle/tendon comprised 60%. Muscle injury (36%), tendinopathy (24%), and joint sprain (9%) were the most reported pathology types. No related injury risk factors were discovered in this study. CONCLUSIONS : One in five trail runners reported one or more RRI during the 12 months before a competitive event. RRIs commonly involved the low.https://www.mdpi.com/journal/applsciPhysiotherapySports MedicineStatistic

Epidemiology of injury and illness among trail runners : a systematic review

BACKGROUND : Trail running is characterised by large elevation gains/losses and uneven varying running surfaces. Limited information is available on injury and illness among trail runners to help guide injury and illness prevention strategies. OBJECTIVE : The primary aim of this review was to describe the epidemiology of injury and illness among trail runners. METHODS : Eight electronic databases were systematically searched (MEDLINE Ovid, PubMed, Scopus, SportsDiscus, CINAHL, Health Source: Nursing/Academic, Health Source: Consumer Ed., and Cochrane) from inception to November 2020. The search was conducted according to the PRISMA statement and the study was registered on PROSPERO international prospective register of systematic reviews (CRD42019135933). Full-text English and French studies that investigated injury and/or illness among trail runners participating in training/racing were included. The main outcome measurements included: trail running injury (incidence, prevalence, anatomical site, tissue type, pathology-type/specific diagnosis, severity), and illness (incidence, prevalence, symptoms, specific diagnosis, organ system, severity). The methodological quality of the included studies was assessed using an adapted Downs and Black assessment tool. RESULTS : Sixteen studies with 8644 participants were included. Thirteen studies investigated race-related injury and/or illness and three studies included training-related injuries. The overall incidence range was 1.6–4285.0 injuries per 1000 h of running and 65.0–6676.6 illnesses per 1000 h of running. The foot was the most common anatomical site of trail running injury followed by the knee, lower leg, thigh, and ankle. Skin lacerations/abrasions were the most common injury diagnoses followed by skin blisters, muscle strains, muscle cramping, and ligament sprains. The most common trail running illnesses reported related to the gastro-intestinal tract (GIT), followed by the metabolic, and cardiovascular systems. Symptoms of nausea and vomiting related to GIT distress and dehydration were commonly reported. CONCLUSION : Current trail running literature consists mainly of injury and illness outcomes specifically in relation to single-day race participation events. Limited evidence is available on training-related injury and illness in trail running. Our review showed that injury and illness are common among trail runners, but certain studies included in this review only focused on dermatological injuries (e.g. large number of feet blisters) and GIT symptoms. Specific areas for future research were identified that could improve the management of trail running injury and illness.https://www.springer.com/journal/402792022-02-04hj2021PhysiotherapySports MedicineDepartment of Library Service

Epidemiology, clinical characteristics, and risk factors for running-related injuries among south african trail runners

Trail running involves running on varying natural terrains, often including large elevation gains/losses. Trail running has a high risk of injury, and runners often participate in remote regions where medical support is challenging. The aim of this study was to determine the epidemiology, clinical characteristic, and associated injury risk factors among trail runners. A modified Oslo Sports Trauma Research Center Questionnaire for Health Problems (OSTRC-H) was used biweekly to collect running-related injury (RRI) and training history data prospectively, among 152 participants (males n = 120, females n = 32) over 30 weeks. We report an overall injury rate of 19.6 RRIs per 1000 h and an RRI mean prevalence of 12.3%. The leading anatomical site of RRIs was the lower limb (82.9%), affecting the knee (29.8%), shin/lower leg (18.0%), and the foot/toes (13.7%). A history of previous RRI in the past 12 months (p = 0.0032) and having a chronic disease (p = 0.0188) are independent risk factors for RRIs among trail runners. Two in three trail runners sustain an RRI mainly affecting the knee, shin/lower leg, and foot/toes. A history of previous RRI in the past 12 months and a having chronic disease is independently associated with RRI among trail runners. These results could be used to develop future RRI prevention strategies, combined with clinical knowledge and experience

Development of a trail running injury screening instrument : a multiple methods approach

OBJECTIVE : To develop a trail running injury screening instrument (TRISI) for utilisation as clinical decision aid in determining if a trail runner is at an increased risk for injury. DESIGN : Multiple methods approach. METHODS : The study utilised five phases 1) identification of injury risk factors 2) determining the relevance of each identified risk factor in a trail running context, 3) creating the content of the Likert scale points from 0 to 4, 4) rescaling the Likert scale points to determine numerical values for the content of each Likert scale point, and 5) determining a weighted score for each injury risk factor that contributes to the overall combined composite score. RESULTS : Of the 77 identified injury risk factors, 26 were deemed relevant in trail running. The weighted score for each injury risk factor ranged from 2.21 to 5.53 with the highest calculated score being 5.53. The final TRISI includes risk categories of training, running equipment, demographics, previous injury, behavioural, psychological, nutrition, chronic disease, physiological, and biomechanical factors. CONCLUSION : The developed TRISI aims to assist the clinician during pre-race injury screening or during a training season to identify meaningful areas to target in designing injury risk management strategies and/or continuous health education.http://www.elsevier.com/ptsp2023-07-12hj2023PhysiotherapySports MedicineStatistic

The use of skeletal muscle relaxants in musculoskeletal injuries: what is the evidence?

Skeletal muscle relaxants (SMRs) consist of a heterogeneous group of medications with a side effect profile of concern. The aim of this paper was to review the evidence of use of SMRs in the treatment of sports injuries. A literature search between 2005 – 2018 (Ovid MEDLINE, SPORTDiscus and SCOPUS) were conducted. In addition, citations within articles were searched, and the most commonly prescribed SMRs in South Africa were also used to explore the literature for additional publications. Relevant studies that met the inclusion criteria were selected. Clinical recommendations for general practitioners are given based on the Strength of Recommendation Taxonomy (SORT) level of evidence. Combination drugs rather than single agents are mostly used, however the effectiveness of SMR agents, single and in combination, as well as its significance as opposed to analgesics and non-steroidal anti-inflammatory drugs, still has to be evaluated. Evidence suggest SMRs to be probably effective for use in non-specific lower back pain (acute and chronic lower back muscle strains, ligament sprains, soft tissue contusions), as well as for whiplash associated disorder, mechanical neck disorders, piriformis syndrome, lateral epicondylosis, and plantar fasciitis. It does not appear if there is a role for SMRs as part of combination management for acute cervical strains, post-exercise muscle soreness or myofacial pain syndrome. However, substantial evidence to confirm the use of SMRs in the treatment of sports injuries have not been adequately investigated and is currently largely based on case reports and general reviews

Epidemiology of Injury and Illness Among Trail Runners: A Systematic Review

Background: Trail running is characterised by large elevation gains/losses and uneven varying running surfaces. Limited information is available on injury and illness among trail runners to help guide injury and illness prevention strategies. Objective: The primary aim of this review was to describe the epidemiology of injury and illness among trail runners. Methods: Eight electronic databases were systematically searched (MEDLINE Ovid, PubMed, Scopus, SportsDiscus, CINAHL, Health Source: Nursing/Academic, Health Source: Consumer Ed., and Cochrane) from inception to November 2020. The search was conducted according to the PRISMA statement and the study was registered on PROSPERO international prospective register of systematic reviews (CRD42019135933). Full-text English and French studies that investigated injury and/or illness among trail runners participating in training/racing were included. The main outcome measurements included: trail running injury (incidence, prevalence, anatomical site, tissue type, pathology-type/specific diagnosis, severity), and illness (incidence, prevalence, symptoms, specific diagnosis, organ system, severity). The methodological quality of the included studies was assessed using an adapted Downs and Black assessment tool. Results: Sixteen studies with 8644 participants were included. Thirteen studies investigated race-related injury and/or illness and three studies included training-related injuries. The overall incidence range was 1.6–4285.0 injuries per 1000 h of running and 65.0–6676.6 illnesses per 1000 h of running. The foot was the most common anatomical site of trail running injury followed by the knee, lower leg, thigh, and ankle. Skin lacerations/abrasions were the most common injury diagnoses followed by skin blisters, muscle strains, muscle cramping, and ligament sprains. The most common trail running illnesses reported related to the gastro-intestinal tract (GIT), followed by the metabolic, and cardiovascular systems. Symptoms of nausea and vomiting related to GIT distress and dehydration were commonly reported. Conclusion: Current trail running literature consists mainly of injury and illness outcomes specifically in relation to single-day race participation events. Limited evidence is available on training-related injury and illness in trail running. Our review showed that injury and illness are common among trail runners, but certain studies included in this review only focused on dermatological injuries (e.g. large number of feet blisters) and GIT symptoms. Specific areas for future research were identified that could improve the management of trail running injury and illness

Training for shorter ultra-trail races results in a higher injury rate, a more diverse injury profile, and more severe injuries : 2022 Mac ultra races

DATA STATEMENT : The research data related to this study will be made available upon reasonable request.OBJECTIVES : Determine and compare the epidemiology, clinical characteristics, and injury severity among race entrants training towards different ultra-trail race distances. DESIGN : Retrospective cross-sectional study. SETTING : The six months training period before the 2022 Mac Ultra races (46 km, 80 km, 161 km and 322 km). PARTICIPANTS : Of the 245 race entrants, 162 (66% of Mac ultra-trail runners) consented to analyse their data. OUTCOME MEASURES : Injury rate (injuries per 1000 h of running), point prevalence (% of currently injured participants), injury severity (time loss), and the frequency (n, %) of injuries reported during pre-race medical screening in the six months before the race. Using inferential statistics, we compared the injury rates between the different race distance categories (46 km, 80 km, 161 km, 322 km). All tests were performed at a 5% level of significance. RESULTS : We reported a statistically significantly higher injury rate among 46 km study participants (3.09 injuries per 1000 h) compared to the injury rates reported among 80 km (0.68 injuries per 1000 h; p = 0.001) and 161 km (1.09 injuries per 1000 h; p = 0.028) participants. The lower limb (89%) was the most injured anatomical region, with only 46 km study participants reporting upper limb, trunk, and head injuries (11%). Muscle/tendon was the most reported injured tissue type (56%), with muscle injuries (31%) the most reported pathology type. Shorter distance ultra-trail runners reported the highest injury severity. CONCLUSION : Ultra-trail runners training towards shorter ultra-trail distance races presented with a higher injury rate, more diverse injury profile, and a higher injury severity.https://www.elsevier.com/ptsp2024-11-16hj2023PhysiotherapySports MedicineStatisticsSDG-03:Good heatlh and well-bein

Trail running injury risk factors : a living systematic review

OBJECTIVE : To review and frequently update the available evidence on injury risk factors and epidemiology of injury in trail running. DESIGN : Living systematic review. Updated searches will be done every 6 months for a minimum period of 5 years. DATA SOURCES : Eight electronic databases were searched from inception to 18 March 2021. ELIGIBILITY CRITERIA : Studies that investigated injury risk factors and/or reported the epidemiology of injury in trail running. RESULTS : Nineteen eligible studies were included, of which 10 studies investigated injury risk factors among 2 785 participants. Significant intrinsic factors associated with injury are: more running experience, level A runner and higher total propensity to sports accident questionnaire (PAD-22) score. Previous history of cramping and postrace biomarkers of muscle damage is associated with cramping. Younger age and low skin phototypes are associated with sunburn. Significant extrinsic factors associated with injury are neglecting warm-up, no specialised running plan, training on asphalt, double training sessions per day and physical labour occupations. A slower race finishing time is associated with cramping, while more than 3 hours of training per day, shade as the primary mode of sun protection and being single are associated with sunburn. An injury incidence range 0.7-61.2 injuries/1000 hours of running and prevalence range 1.3% to 90% were reported. The lower limb was the most reported region of injury, specifically involving blisters of the foot/toe. CONCLUSION : Limited studies investigated injury risk factors in trail running. Our review found eight intrinsic and nine extrinsic injury risk factors. This review highlighted areas for future research that may aid in designing injury risk management strategies for safer trail running participation. PROSPERO registration numberCRD42021240832.http://bjsm.bmj.comhj2023PhysiotherapySports MedicineStatisticsDepartment of Library Service