The GRONORUN study: is a graded training program for novice runners effective in preventing running related injuries? Design of a Randomized Controlled Trial

BACKGROUND: Running is a popular form of recreational exercise. Beside the positive effects of running on health and fitness, the risk of a running related injury has to be considered. The incidence of injuries in runners is high and varies from 30–79%. However, few intervention studies on prevention of running related injuries have been performed and none of these studies involved novice runners. METHODS: GRONORUN (Groningen Novice Running) is a two armed randomized controlled trial, comparing the effects of two different training programs for novice runners on the incidence of running related injuries. Participants are novice runners, who want to train for a four mile running event. The control group will train according a standard 8 week training program. The intervention group will use a more gradual, 13 week training program which is based on "the ten percent training rule". During the thirteen week follow up participants register information on running and RRI's in an internet based running log. The primary outcome measure is RRI. An injury is defined as a musculoskeletal ailment of the lower extremity or back, causing a restriction of running for at least one week. DISCUSSION: The GRONORUN trial is the first randomized controlled trial to study a preventive intervention in novice runners. Many different training programs for novice runners are offered, but none are evidence based

Stress fractures of the tibia: can personality traits help us detect the injury-prone athlete?

One of the few serious drawbacks associated with running is overuse injuries such as stress fractures of the tibia, which cause local pain and swelling, often resulting in a temporary cessation of training. Whereas some runners rarely become injured, others experience recurrent injuries even during fairly short periods of time. The aim of the present study was to compare selected personality traits in a group of runners who had sustained a previous tibial stress fracture (n½17), with a matched group of runners (n½17) who had never experienced stress fractures. The results indicated that the injured runners, especially the women, scored higher than the non-injured runners did on inventories measuring both the Type A behavior pattern and exercise dependency. Since motivation, ambitiousness, and competitiveness are integral parts of these inventories, high scoring individuals might be part of a high-risk population for running injuries, the more so if the individual also feels dependent on regular running for managing stress related mood states, which was the case particularly for the injured women in the present study. However, the somewhat limited number of runners who had had a confirmatory scintigram, which was a criterion for inclusion in the study, warrants a cautious interpretation of the results. The findings nevertheless suggest that in order to prevent recurrent injuries, health education professionals and clinicians ought to focus on conveying the importance of detecting precursors of injury, and the subsequent steps which should be taken to avoid developing a serious injury

Are overground or treadmill runners more likely to sustain tibial stress fracture?

Background: Repetitive high bone strain and/or strain rates, such as those that occur during running, contribute to stress fractures as well as promoting maintenance of or increase in bone mass. Kinematic differences are known to exist between overground and treadmill running and these may be reflected in different bone strains and strain rates during the two running techniques. Aim: To measure in vivo strains and strain rates in human tibia during treadmill and overground running and determine if there are significant differences in strain and strain rate levels between the two running techniques. Methods: A strain gauged bone staple was mounted percutaneously along the axial direction in the mid diaphysis of the medial tibia in three subjects, and in vivo tibial strains were measured during treadmill and overground running at 11 km/h. Results: Axial compression strains (p<0.0001), tension strains (p<0.001), compression strain rates (p<0.0001), and tension strain rates (p<0.0001) were 48–285% higher during overground running than during treadmill running. Conclusions: On the basis of lower in vivo strains and strain rates, treadmill runners are at lower risk of developing tibial stress fractures, but less likely to achieve tibial bone strengthening, than overground runners

Evaluation of the performance of a motion capture system for small displacement recording and a discussion for its application potential in bone deformation in vivo

The aim of this study is to evaluate the performance of a motion capture system and discuss the application potential of the proposed system in in vivo bone-segment deformation measurements. In this study, the effects of the calibration procedure, camera distance and marker size on the accuracy and precision of the motion capture system have been investigated by comparing the captured movement of the markers with reference movement. The results indicated that the system resolution is at least 20mm in a capture volume of 40033003300mm3, which mostly covers the range of motion of the tibia during the stance phase of one gait cycle. Within this volume, the system accuracy and precision decreased following the increase of camera distance along the optical axis of the cameras. With the best configuration, the absolute error and precision for the range of 20mm displacement were 1.2–1.8mm and 1.5–2.5mm, respectively. Small markers (Ø3–8 mm) yielded better accuracy and repeatability than the larger marker (Ø10.5mm). We conclude that the proposed system is capable of recording minor displacements in a relative large volume