Enter your details:
Name:
E-mail:
 
Thank you for subscribing.
Subscribe to our newsletter!


Žiga Kozinc1, Nejc Sarabon1

1University of Primorska, Faculty of Health Sciences, Izola, Slovenia

Common Running Overuse Injuries and Prevention

Abstract (ENG)

Runners are particularly prone to developing overuse injuries. The most common running-related injuries include medial tibial stress syndrome, Achilles tendinopathy, plantar fasciitis, patellar tendinopathy, iliotibial band syndrome, tibial stress fractures, and patellofemoral pain syndrome. Two of the most significant risk factors appear to be injury history and weekly distance. Several trials have successfully identified biomechanical risk factors for specific injuries, with increased ground reaction forces, excessive foot pronation, hip internal rotation and hip adduction during stance phase being mentioned most often. However, evidence on interventions for lowering injury risk is limited, especially regarding exercise-based interventions. Biofeedback training for lowering ground reaction forces is one of the few methods proven to be effective. It seems that the best way to approach running injury prevention is through individualized treatment. Each athlete should be assessed separately and scanned for risk factors, which should be then addressed with specific exercises. This review provides an overview of most common running-related injuries, with a particular focus on risk factors, and emphasizes the problems encountered in preventing running-related injuries.

Keywords (ENG)

Runners, Exercise, Pain, Risk factors, Injury mechanism, Preventive methods

References

Ackermann, P. W., & Renstrom, P. (2012). Tendinopathy in sport. Sports Health, 4(3), 193-201.

Aderem, J., & Louw, Q. A. (2015). Biomechanical risk factors associated with iliotibial band syndrome in runners: a systematic review. BMC Musculoskeletal Disorders, 16(1), 356.

Anderson, T. (1996). Biomechanics and running economy. Sports Medicine, 22(2), 76-89.

Andres, B. M., & Murrell, G. A. (2008). Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clinical Orthopaedics and Related Research, 466(7), 1539-1554.

Bolgla, L. A., & Boling, M. C. (2011). An update for the conservative management of patellofemoral pain syndrome: a systematic review of the literature from 2000 to 2010. International Journal of Sports Physical Therapy, 6(2), 112-125.

Clansey, A. C., Hanlon, M., Wallace, E. S., Nevill, A., & Lake, M. J. (2014). Influence of tibial shock feedback training on impact loading and running economy. Medicine & Science in Sports & Exercise, 46(5), 973-981.

Craig, D. I. (2008). Medial tibial stress syndrome: evidence-based prevention. Journal of Athletic Training, 43(3), 316-318.

Crowell, H. P., & Davis, I. S. (2011). Gait retraining to reduce lower extremity loading in runners. Clinical Biomechanics, 26(1), 78-83.

Davis, I., Milner, C.E., & Hamill, J. (2004). Does increased loading during running lead to tibial stress fractures? A prospective study Medicine & Science in Sports & Exercise, 36(5), S58.

DiFiori, J. P., Benjamin, H. J., Brenner, J. S., Gregory, A., Jayanthi, N., Landry, G. L., & Luke, A. (2014). Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. British Journal of Sports Medicine, 48(4), 287-288.

Dugan, S. A., & Bhat, K. P. (2005). Biomechanics and analysis of running gait. Physical Medicine and Rehabilitation Clinics of North America, 16(3), 603-621.

Enke, R. C., & Gallas, J. E. (2012). Diagnosis, Treatment, and Prevention of Common Running Injuries. The Journal of Clinical Outcomes Management, 19(2), 86-94.

Fairclough, J., Hayashi, K., Toumi, H., Lyons, K., Bydder, G., Phillips, N., Best, T.M. & Benjamin, M. (2007). Is iliotibial band syndrome really a friction syndrome? Journal of Science and Medicine in Sport, 10(2), 74-76.

Ford, K. R., Nguyen, A. D., Dischiavi, S. L., Hegedus, E. J., Zuk, E. F., & Taylor, J. B. (2015). An evidence-based review of hip-focused neuromuscular exercise interventions to address dynamic lower extremity valgus. Open Access Journal of Sports Medicine, 6, 291-303.

Franklyn, M., & Oakes, B. (2015). Aetiology and mechanisms of injury in medial tibial stress syndrome: Current and future developments. World Journal of Orthopedics, 6(8), 577-589.

Fredericson, M., Cookingham, C. L., Chaudhari, A. M., Dowdell, B. C., Oestreicher, N., & Sahrmann, S. A. (2000). Hip abductor weakness in distance runners with iliotibial band syndrome. Clinical Journal of Sport Medicine, 10(3), 169-175.

Galbraith, R. M., & Lavallee, M. E. (2009). Medial tibial stress syndrome: conservative treatment options. Current Reviews in Musculoskeletal Medicine, 2(3), 127-133.

Goff, J. D., & Crawford, R. (2011). Diagnosis and treatment of plantar fasciitis. American Family Physician, 84(6), 676-682.

Grau, S., Krauss, I., Maiwald, C., Best, R., & Horstmann, T. (2008). Hip abductor weakness is not the cause for iliotibial band syndrome. International Journal of Sports Medicine, 29(7), 579-583.

Hamner, S. R., Seth, A., & Delp, S. L. (2010). Muscle contributions to propulsion and support during running. Journal of Biomechanics, 43(14), 2709-2716.

Heintjes, E., Berger, M. Y., Bierma-Zeinstra, S. M., Bernsen, R. M., Verhaar, J. A., & Koes, B. W. (2004). Pharmacotherapy for patellofemoral pain syndrome. The Cochrane Database of Systematic Reviews (3), CD003470.

Holmes, S. W., Jr., & Clancy, W. G., Jr. (1998). Clinical classification of patellofemoral pain and dysfunction. Journal of Orthopaedic and Sports Physical Therapy, 28(5), 299-306.

Johnston, C. A., Taunton, J. E., Lloyd-Smith, D. R., & McKenzie, D. C. (2003). Preventing running injuries. Practical approach for family doctors. Canadian Family Physician, 49, 1101-1109.

Kurppa, K., Waris, P., & Rokkanen, P. (1979). Peritendinitis and tenosynovitis. A review. Scandinavian Journal of Work, Environment & Health, 5(3), 19-24.

Lavine, R. (2010). Iliotibial band friction syndrome. Current Reviews in Musculoskeletal Medicine, 3(1-4), 18-22.

Lemont, H., Ammirati, K. M., & Usen, N. (2003). Plantar fasciitis: a degenerative process (fasciosis) without inflammation. Journal of the American Podiatric Medical Association, 93(3), 234-237.

Lopes, A. D., Junior, L. C. H., Yeung, S. S., & Costa, L. O. P. (2012). What are the Main Running-Related Musculoskeletal Injuries? Sports Medicine, 42(10), 891-905.

Lucas, C. A. (1992). Iliotibial band friction syndrome as exhibited in athletes. Journal of Athletic Training, 27(3), 250-252.

Malisoux, L., Chambon, N., Delattre, N., Gueguen, N., Urhausen, A., & Theisen, D. (2016). Injury risk in runners using standard or motion control shoes: a randomised controlled trial with participant and assessor blinding. British Journal of Sports Medicine, 50(8), 481-487.

McCarty, E. C., Walsh, W. M., Hald, R. D., Peter, L. E., & Mellion, M. B. (2010). Musculoskeletal Injuries in Sports. In M. C. Madden, M. Putukian, C. C. Young & E. C. McCarty (Eds.), Netter’s Sports Medicine (299-303). Philadelphia, US: Saunders/Elsevier.

Milner, C. E., Ferber, R., Pollard, C. D., Hamill, J., & Davis, I. S. (2006). Biomechanical factors associated with tibial stress fracture in female runners. Medicine & Science in Sports & Exercise, 38(2), 323-328.

Molloy, L. A. (2012). Managing chronic plantar fasciitis: when conservative strategies fail. Journal of the American Academy of Physician Assistants, 25(11), 48, 50, 52-43.

Morley, J. B., Decker, L. M., Dierks, T., Blanke, D., French, J. A., & Stergiou, N. (2010). Effects of varying amounts of pronation on the mediolateral ground reaction forces during barefoot versus shod running. Journal of Applied Biomechanics, 26(2), 205-214.

Nattiv, A., Loucks, A. B., Manore, M. M., Sanborn, C. F., Sundgot-Borgen, J., Warren, M. P., & American College of Sports, Medicine. (2007). American College of Sports Medicine position stand. The female athlete triad. Medicine & Science in Sports & Exercise, 39(10), 1867-1882

Newman, P., Witchalls, J., Waddington, G., & Adams, R. (2013). Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis. Open Access Journal of Sports Medicine, 4, 229-241.

Nicola, T. L., & El Shami, A. (2012). Rehabilitation of running injuries. Clinical Journal of Sport Medicine, 31(2), 351-372.

Nicola, T. L., & Jewison, D. J. (2012). The anatomy and biomechanics of running. Clinical Journal of Sport Medicine, 31(2), 187-201.

Novacheck, T. F. (1998). The biomechanics of running. Gait & Posture, 7(1), 77-95.

Pal, S., Draper, C. E., Fredericson, M., Gold, G. E., Delp, S. L., Beaupre, G. S., & Besier, T. F. (2011). Patellar maltracking correlates with vastus medialis activation delay in patellofemoral pain patients. The American Journal of Sports Medicine, 39(3), 590-598.

Petersen, W., Ellermann, A., Gosele-Koppenburg, A., Best, R., Rembitzki, I. V., Bruggemann, G. P., & Liebau, C. (2014). Patellofemoral pain syndrome. Knee Surgery, Sports Traumatology, Arthroscopy, 22(10), 2264-2274.

Pink, M., Perry, J., Houglum, P. A., & Devine, D. J. (1994). Lower extremity range of motion in the recreational sport runner. The American Journal of Sports Medicine, 22(4), 541-549.

Powers, C. M. (2003). The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. Journal of Orthopaedic and Sports Physical Therapy, 33(11), 639-646.

Putukian, M., McCarty, E. C., & Sebastianelli, W. (2010). Football. In M. C. Madden, M. Putukian, C. C. Young & E. C. McCarty (Eds.), Netter’s Sports Medicine. Philadelphia, US: Saunders/Elsevier.

Rees, J. D., Maffulli, N., & Cook, J. (2009). Management of tendinopathy. The American Journal of Sports Medicine, 37(9), 1855-1867.

Roos, K. G., & Marshall, S. W. (2014). Definition and usage of the term “overuse injury” in the US high school and collegiate sport epidemiology literature: a systematic review. Sports Medicine, 44(3), 405-421.

Rudzki, S. J. (1997). Injuries in Australian Army recruits. Part I: Decreased incidence and severity of injury seen with reduced running distance. Military Medicine, 162(7), 472-476.

Rutland, M., O’Connell, D., Brismee, J. M., Sizer, P., Apte, G., & O’Connell, J. (2010). Evidence-supported rehabilitation of patellar tendinopathy. North American Journal of Sports Physical Therapy, 5(3), 166-178.

Salehi, I., Khazaeli, S., Hatami, P., & Malekpour, M. (2010). Bone density in patients with chondromalacia patella. Rheumatology International, 30(8), 1137-1138.

Saragiotto, B. T., Yamato, T. P., Hespanhol Junior, L. C., Rainbow, M. J., Davis, I. S., & Lopes, A. D. (2014). What are the main risk factors for running-related injuries? Sports Medicine, 44(8), 1153-1163.

Sharma, J., Weston, M., Batterham, A. M., & Spears, I. R. (2014). Gait retraining and incidence of medial tibial stress syndrome in army recruits. Medicine & Science in Sports & Exercise, 46(9), 1684-1692.

Snyder, K. R., Earl, J. E., O’Connor, K. M., & Ebersole, K. T. (2009). Resistance training is accompanied by increases in hip strength and changes in lower extremity biomechanics during running. Clinical Biomechanics, 24(1), 26-34.

Verdini, F., Marcucci, M., Benedetti, M. G., & Leo, T. (2006). Identification and characterisation of heel strike transient. Gait & Posture, 24(1), 77-84.

Videbaek, S., Bueno, A. M., Nielsen, R. O., & Rasmussen, S. (2015). Incidence of Running-Related Injuries Per 1000 h of running in Different Types of Runners: A Systematic Review and Meta-Analysis. Sports Medicine, 45(7), 1017-1026.

Waclawski, E. R., Beach, J., Milne, A., Yacyshyn, E., & Dryden, D. M. (2015). Systematic review: plantar fasciitis and prolonged weight bearing. Occupational Medicine, 65(2), 97-106.

Welck, M. J., Hayes, T., Pastides, P., Khan, W., & Rudge, B. (2015). Stress fractures of the foot and ankle. Injury, 15, 343-345.

Wentz, L., Liu, P. Y., Haymes, E., & Ilich, J. Z. (2011). Females have a greater incidence of stress fractures than males in both military and athletic populations: a systemic review. Military Medicine, 176(4), 420-430.

Williams, P. T., & Thompson, P. D. (2013). Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction. Arteriosclerosis, Thrombosis, and Vascular Biology, 33(5), 1085-1091.

Willy, R. W., & Davis, I. S. (2011). The effect of a hip-strengthening program on mechanics during running and during a single-leg squat. Journal of Orthopaedic and Sports Physical Therapy, 41(9), 625-632.

Yeung, S. S., Yeung, E. W., & Gillespie, L. D. (2011). Interventions for preventing lower limb soft-tissue running injuries. The Cochrane Database of Systematic Reviews (7), CD001256.

Zadpoor, A. A., & Nikooyan, A. A. (2011). The relationship between lower-extremity stress fractures and the ground reaction force: a systematic review. Clinical Biomechanics, 26(1), 23-28.

VIEW FULL ARTICLE (PDF – 732KB)