Distance running is a popular recreational exercise. It is a beneficial activity for health and well being. However, running may also cause injuries, especially of the lower extremities. In literature there is no agreement what intrinsic and extrinsic factors cause running related injuries (RRIs). In theory, most RRIs are elicited by training errors, this too much, too soon. In a preconditioning program runners can adapt more gradually to the high mechanical loads of running and will be less susceptible to RRIs. In this study the effectiveness of a 4-week preconditioning program on the incidence of RRIs in novice runners prior to a training program will be studied.
The GRONORUN 2 (Groningen Novice Running) study is a two arm randomized controlled trial studying the effect of a 4-week preconditioning (PRECON) program in a group of novice runners. All participants wanted to train for the recreational Groningen 4-Mile running event. The PRECON group started a 4-week preconditioning program with walking and hopping exercises 4 weeks before the start of the training program. The control (CON) and PRECON group started a frequently used 9-week training program in preparation for the Groningen 4-Mile running event.
During the follow up period participants registered their running exposure, other sporting activities and running related injuries in an Internet based running log. The primary outcome measure was the number of RRIs. RRI was defined as a musculoskeletal ailment or complaint of the lower extremities or back causing a restriction on running for at least three training sessions.
The GRONORUN 2 study will add important information to the existing running science. The concept of preconditioning is easy to implement in existing training programs and will hopefully prevent RRIs especially in novice runners.
The Netherlands National Trial Register NTR1906. The NTR is part of the WHO Primary Registries.
Running is associated with desirable lifestyle changes. Therefore several initiatives have been undertaken to promote running. Exact data on the health effects as a result of participating in a short-term running promotion program, however, is scarce. One important reason for dropout from a running program is a running-related injury (RRI). The incidence of RRIs is high, especially in novice runners. Several studies examined potential risk factors for RRIs, however, due to the often underpowered studies it is not possible to reveal the complex mechanism leading to an RRI yet.
The primary objectives are to determine short- and long-term health effects of a nationwide “Start to Run” program and to identify determinants for RRIs in novice runners. Secondary objectives include examining reasons and determinants for dropout, medical consumption and economical consequences of RRIs as a result of a running promotion program.
The NLstart2run study is a multi-center prospective cohort study with a follow-up at 6, 12, 24 and 52 weeks. All participants that sign up for the Start to Run program in 2013, which is offered by the Dutch Athletics Federation, will be asked to participate in the study.
During the running program a digital running log will be completed by the participants every week to administer exposure and running related pain. After the running program the log will be completed every second week. An RRI is defined as any musculoskeletal ailment of the lower extremity or back that the participant attributed to running and hampers running ability for at least one week.
The NLstart2run study will provide insight into the short- and long-term health effects as a result of a short-term running promotion program. Reasons and determinants for dropout from a running promotion program will be examined as well. The study will result in several leads for future RRI prevention and as a result minimize dropout due to injury. This information may increase the effectiveness of future running promotion programs and will thereby contribute positively to public health.
The Netherlands National Trial Register NTR3676. The NTR is part of the WHO Primary Registries.
Throughout the period of one year, approximately 50% of recreational runners will sustain an injury that disrupts their training regimen. Foot orthoses have been shown to be clinically effective in the prevention and treatment of several running-related conditions, yet the physical effect of this intervention during running remains poorly understood. The aim of this literature review was therefore to evaluate the effect of foot orthoses on lower extremity forces and pressure (kinetics) during running.
A systematic search of electronic databases including Medline (1966-present), CINAHL, SportDiscus, and The Cochrane Library occurred on 7 May 2008. Eligible articles were selected according to pre-determined criteria. Methodological quality was evaluated by use of the Quality Index as described by Downs & Black, followed by critical analysis according to outcome variables.
The most widely reported kinetic outcomes were loading rate and impact force, however the effect of foot orthoses on these variables remains unclear. In contrast, current evidence suggests that a reduction in the rearfoot inversion moment is the most consistent kinetic effect of foot orthoses during running.
The findings of this review demonstrate systematic effects that may inform the direction of future research, as further evidence is required to define the mechanism of action of foot orthoses during running. Continuation of research in this field will enable targeting of design parameters towards biomechanical variables that are supported by evidence, and may lead to advancements in clinical efficacy.
Objectives—To identify physical activity that is beneficial for the maintenance of bone strength with increasing age by examining the relation between bone mineral density (BMD) and chronic endurance training in men. BMD at the proximal femur, its subregions, and the lumbar spine, and serum testosterone were compared between two groups of long distance runners with more than 20 years of training experience and non-athletic controls.
Methods—Runners (n = 12) were divided into (a) high volume runners (n = 7), running 64–80 km a week, and (b) very high volume runners (n = 5), running more than 95 km a week, and compared with non-athletic male controls, exercising in non-endurance oriented activities two to four times a week. BMD (g/cm2) at the total proximal femur, femoral neck, trochanteric region, and lumbar spine was measured by dual energy x ray absorptiometry. Total testosterone (nmol/l) and free testosterone (pmol/l) in serum were measured by radioimmunoassay from single fasting blood samples.
Results—Height, weight, and age (range = 40–55 years) were not significantly different between groups. The high volume runners had significantly higher BMD at the total proximal femur (1.09 (0.17) v 0.94 (0.056)), femoral neck (0.91 (0.16) v 0.78 (0.071)), and trochanteric region (0.85 (0.14) v 0.73 (0.053)) than controls (p<0.05). The differences in BMD for the proximal femur between the very high volume runners and the other two groups were not significant. There was no difference in lumbar spine BMD, total testosterone, or free testosterone between groups. However, there was a significant negative correlation between total testosterone (r = -0.73, p<0.01) and free testosterone (r = -0.79, p<0.005) and running volume in the distance runners.
Conclusions—Long term distance running with training volumes less than 80 km a week had a positive effect on BMD of the proximal femur. With running volumes greater than 64 km a week, training was inversely related to testosterone levels, but levels remained within the normal range.
Key Words: exercise; bone mineral density; male athletes; runners; endurance training; testosterone
There is a paucity of knowledge on the association between different foot posture quantified by Foot Posture Index (FPI) and Quadriceps angle (Q-angle) with development of running-related injuries. Earlier studies investigating these associations did not include an objective measure of the amount of running performed.
Therefore, the purpose of this study was to investigate if kilometers to running-related injury (RRI) differ among novice runners with different foot postures and Q-angles when running in a neutral running shoe.
A 10 week study was conducted including healthy, novice runners. At baseline foot posture was evaluated using the foot posture index (FPI) and the Q-angle was measured. Based on the FPI and Q-angle, right and left feet / knees of the runners were categorized into exposure groups. All participants received a Global Positioning System watch to allow them to quantify running volume and were instructed to run a minimum of two times per week in a conventional, neutral running shoe. The outcome was RRI.
Fifty nine novice runners of mixed gender were included. Of these, 13 sustained a running-related injury. No significant difference in cumulative relative risk between persons with pronated feet and neutral feet was found after 125 km of running (Cumulative relative risk = 1.65 [0.65; 4.17], p = 0.29). Similarly, no difference was found between low and neutral Q-angle (Cumulative relative risk = 1.25 [0.49; 3.23], p = 0.63).
Static foot posture as quantified by FPI and knee alignment as quantified by Q-angle do not seem to affect the risk of injury among novice runners taking up a running regimen wearing a conventional neutral running shoe. These results should be interpreted with caution due to a small sample size.
Level of Evidence:
Foot posture; foot Posture Index; novice runners; running-related injuries; Q-angle
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.
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.
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.
Objectives—To assess the available evidence for preventive strategies for lower limb soft tissue injuries caused by running.
Methods—An electronic database search was conducted using The Cochrane Musculoskeletal Injuries Group Specialised Register, The Cochrane Controlled Trials Register, Medline, Embase, Sport Discus, Heracles, Atlantes, Biosis, Cinahl, Scisearch, Current Contents, Index To Theses and Dissertation Abstracts. Any randomised or quasi-randomised trials evaluating interventions to prevent running injuries to lower limb soft tissue were included. The eligibility of trials for inclusion and the quality of the trials were independently assessed by two reviewers.
Results—Exposure to a high training load (duration, frequency, or running distance) increases the risk of injury, and thus modification of the training schedule can reduce the incidence of injury. The effectiveness of stretching exercises and of insoles in the prevention of lower extremity soft tissue injuries caused by running is not known. Wearing a knee brace with a patellar support ring may be effective in the prevention of anterior knee pain caused by running.
Conclusions—This review provides evidence for the effectiveness of the modification of training schedules in reducing lower limb soft tissue running injuries. More studies are required to quantify the optimal training loads and to confirm that knee braces can prevent knee pain. It is important to note that the studies included in this review had few female participants therefore the results may not be generalisable.
Key Words: running; lower limb; soft tissue; knee; ankle
We intended to determine predictor variables of anthropometry and training for marathon race time in recreational female runners in order to predict marathon race time for future novice female runners.
Anthropometric characteristics such as body mass, body height, body mass index, circumferences of limbs, thicknesses of skin-folds and body fat as well as training variables such as volume and speed in running training were related to marathon race time using bi- and multi-variate analysis in 29 female runners.
The marathoners completed the marathon distance within 251 (26) min, running at a speed of 10.2 (1.1) km/h. Body mass (r=0.37), body mass index (r=0.46), the circumferences of thigh (r=0.51) and calf (r=0.41), the skin-fold thicknesses of front thigh (r=0.38) and of medial calf (r=0.40), the sum of eight skin-folds (r=0.44) and body fat percentage (r=0.41) were related to marathon race time. For the variables of training, maximal distance ran per week (r=− 0.38), number of running training sessions per week (r=− 0.46) and the speed of the training sessions (r= − 0.60) were related to marathon race time. In the multi-variate analysis, the circumference of calf (P=0.02) and the speed of the training sessions (P=0.0014) were related to marathon race time. Marathon race time might be partially (r
2=0.50) predicted by the following equation: Race time (min)=184.4 + 5.0 x (circumference calf, cm) –11.9 x (speed in running during training, km/h) for recreational female marathoners.
Variables of both anthropometry and training were related to marathon race time in recreational female marathoners and cannot be reduced to one single predictor variable. For practical applications, a low circumference of calf and a high running speed in training are associated with a fast marathon race time in recreational female runners.
Body Fat; Skin-fold; Training; Limb Circumference; Gender; Marathon
Despite the increasing popularity of marathons, little research has examined the training habits of nonelite marathon runners. Given that nonelite runners, particularly those with a competitive motive, have a higher risk for injury than experienced elite runners, it is important for physicians to understand the training program and features that might distinguish running performance and injury rates in this population.
We hypothesized that nonelite runners who qualify for the Boston Marathon (“qualifers”) would have higher running volumes, more running sessions per week, lower injury rates, and lower body mass index (BMI) than nonqualifying runners.
A cross-sectional Web-based survey of runners (convenience sample) at 1 month (n = 50) and 6 months (n = 41) after participation in the 2008 Twin Cities Marathon (TCM) that acquired data on anthropometric measures, demographic data, finishing time, premarathon/current training program, and self-reported injury.
Thirteen of 50 initial survey respondents were classified as a “qualifier” based on their finishing time. Mean BMI was significantly lower in the qualifiers at 1 month (22.0 versus 23.9 kg/m2, P = 0.0267) but not 6 months postmarathon. There were no significant differences in training volume (running frequency, run length, or cross-training volume) or injury rates between qualifiers and nonqualifiers. Prior to the 2008 TCM, 54% of runners included cross-training in their exercise program, which increased significantly to 74% 1 month postmarathon (P = 0.0039) and 71% 6 months postmarathon (P = 0.0325). There was no association between cross-training and injury rates.
Nonelite marathon runners had a high degree of cross-training in their training program. Qualifiers for the Boston Marathon did not significantly differ in running frequency, run length, or cross-training volume compared with nonqualifiers. Whether changes in the training program at an individual level might facilitate a change in qualifying status remains to be determined.
training; marathon; cross-training; BMI
Forty women took part in a study to determine the effects of high-intensity training and the menstrual cycle on mood states. Half of the sample were competitive distance runners following a training load of between 50 km and 130 km running per week. Seven athletes were amenorrhoeic and 13 either eumenorrhoeic or oligomenorrhoeic. The remaining 20 subjects were inactive women who menstruated regularly. The mean age of all 40 subjects was 29 years. Each subject completed two identical Profile of Mood States (POMS) questionnaires. The 33 menstruating subjects completed both a premenstrual and a midcycle form and the amenorrhoeic athletes completed the questionnaires at a 3-week interval, which acted as a control for the potential effects of premenstrual syndrome (PMS) among the menstruating females. Results showed highly significant differences in mood profiles among amenorrhoeic athletes, non-amenorrhoeic athletes and inactive women. The greatest difference was between premenstrual and midcycle measures for the inactive group. PMS appears to cause marked negative mood swings among menstruating women which the POMS inventory is sensitive in detecting. While the lower-intensity-training runners appeared to benefit psychologically from a training distance of approximately 50 km week-1, high-intensity training had an adverse effect on mood.
OBJECTIVE: To present a practical approach for preventing running injuries. QUALITY OF EVIDENCE: Much of the research on running injuries is in the form of expert opinion and comparison trials. Recent systematic reviews have summarized research in orthotics, stretching before running, and interventions to prevent soft tissue injuries. MAIN MESSAGE: The most common factors implicated in running injuries are errors in training methods, inappropriate training surfaces and running shoes, malalignment of the leg, and muscle weakness and inflexibility. Runners can reduce risk of injury by using established training programs that gradually increase distance or time of running and provide appropriate rest. Orthoses and heel lifts can correct malalignments of the leg. Running shoes appropriate for runners' foot types should be selected. Lower-extremity strength and flexibility programs should be added to training. Select appropriate surfaces for training and introduce changes gradually. CONCLUSION: Prevention addresses factors proven to cause running injuries. Unfortunately, injury is often the first sign of fault in running programs, so patients should be taught to recognize early symptoms of injury.
The purpose of this study was to present a systematic overview of published reports on the incidence and associated potential risk factors of lower extremity running injuries in long distance runners. An electronic database search was conducted using the PubMed–Medline database. Two observers independently assessed the quality of the studies and a best evidence synthesis was used to summarise the results. The incidence of lower extremity running injuries ranged from 19.4% to 79.3%. The predominant site of these injuries was the knee. There was strong evidence that a long training distance per week in male runners and a history of previous injuries were risk factors for injuries, and that an increase in training distance per week was a protective factor for knee injuries.
running injuries; lower extremity
The purpose of this study was to investigate if the risk of injury declines with increasing weekly running volume before a marathon race.
The study was a retrospective cohort study on marathon finishers. Following a marathon, participants completed a web‐based questionnaire. The outcome of interest was a self‐reported running‐related injury. The injury had to be severe enough to cause a reduction in distance, speed, duration or frequency of running for at least 14 days. Primary exposure was self‐reported average weekly volume of running before the marathon categorized into below 30 km/week, 30 to 60 km/week, and above 60 km/week.
A total of 68 of the 662 respondents sustained an injury. When adjusting for previous injury and previous marathons, the relative risk (RR) of suffering an injury rose by 2.02 [95% CI: 1.26; 3.24], p < 0.01, among runners with an average weekly training volume below 30 km/week compared with runners with an average weekly training volume of 30‐60 km/week. No significant differences were found between runners exceeding 60 km/week and runners running 30‐60 km/week (RR=1.13 [0.5;2.8], p=0.80).
Runners may be advised to run a minimum of 30 km/week before a marathon to reduce their risk of running‐related injury.
Level of Evidence:
Running‐related injury; marathon; risk factors; running volume.
Many lower limb disorders are related to calf muscle tightness and reduced dorsiflexion of the ankle. To treat such disorders, stretches of the calf muscles are commonly prescribed to increase available dorsiflexion of the ankle joint.
To determine the effect of static calf muscle stretching on ankle joint dorsiflexion range of motion.
A systematic review with meta‐analyses.
A systematic review of randomised trials examining static calf muscle stretches compared with no stretching. Trials were identified by searching Cinahl, Embase, Medline, SportDiscus, and Central and by recursive checking of bibliographies. Data were extracted from trial publications, and meta‐analyses performed that calculated a weighted mean difference (WMD) for the continuous outcome of ankle dorsiflexion. Sensitivity analyses excluded poorer quality trials. Statistical heterogeneity was assessed using the quantity I2.
Five trials met inclusion criteria and reported sufficient data on ankle dorsiflexion to be included in the meta‐analyses. The meta‐analyses showed that calf muscle stretching increases ankle dorsiflexion after stretching for ⩽15 minutes (WMD 2.07°; 95% confidence interval 0.86 to 3.27), >15–30 minutes (WMD 3.03°; 95% confidence interval 0.31 to 5.75), and >30 minutes (WMD 2.49°; 95% confidence interval 0.16 to 4.82). There was a very low to moderate statistical heterogeneity between trials. The meta‐analysis results for ⩽15 minutes and >15–30 minutes of stretching were considered robust when compared with sensitivity analyses that excluded lower quality trials.
Calf muscle stretching provides a small and statistically significant increase in ankle dorsiflexion. However, it is unclear whether the change is clinically important.
stretching; dorsiflexion; Achilles tendon; gastrocnemius; soleus
Background and Purpose:
Many researchers acknowledge the importance of “training errors” as the main cause of running‐related injuries. The purpose of this clinical commentary is to present a theoretical framework for the assumption that some running‐related injuries among rear‐foot strikers develop due to rapidly changing running volume, while others develop due to rapidly changing running pace.
Description of Topic with Related Evidence:
Evidence from clinical and experimental studies is presented to support the assertion that rapid change in running volume may lead to the development of patellofemoral pain syndrome, iliotibial band syndrome, and patellar tendinopathy, while change in running pace may be associated with the development of achilles tendinopathy, gastrocnemius injuries, and plantar fasciitis.
Discussion/Relation to Clinical Practice:
If this assertion is correct, bias may be prevented in future studies by categorizing injuries into volume or pacing injuries. However, more work is needed to provide further evidence in support of this approach. Future investigations of the link between training patterns and injury development should be designed as large‐scale prospective studies using objective methods to quantify training patterns.
Level of evidence:
Etiology; running pace; running‐related injury; training volume
Objectives: To determine if measurements of static lower limb alignment are related to lower limb injury in recreational runners.
Methods: Static lower limb alignment was prospectively measured in 87 recreational runners. They were observed for the following six months for any running related musculoskeletal injuries of the lower limb. Injuries were defined according to six types: R1, R2, and R3 injuries caused a reduction in running mileage for one day, two to seven days, or more than seven days respectively; S1, S2, and S3 injuries caused stoppage of running for one day, two to seven days, or more than seven days respectively.
Results: At least one lower limb injury was suffered by 79% of the runners during the observation period. When the data for all runners were pooled, 95% confidence intervals calculated for the differences in the measurements of lower limb alignment between the injured and non-injured runners suggested that there were no differences. However, when only runners diagnosed with patellofemoral pain syndrome (n = 6) were compared with non-injured runners, differences were found in right ankle dorsiflexion (0.3 to 6.1), right knee genu varum (–0.9 to –0.3), and left forefoot varus (–0.5 to –0.4).
Conclusions: In recreational runners, there is no evidence that static biomechanical alignment measurements of the lower limbs are related to lower limb injury except patellofemoral pain syndrome. However, the effect of static lower limb alignment may be injury specific.
Objectives: Seventeen running training clinics were investigated to determine the number of injuries that occur in a running programme designed to minimise the injury rate for athletes training for a 10 km race. The relative contributions of factors associated with injury were also reported.
Methods: A total of 844 primarily recreational runners were surveyed in three trials on the 4th, 8th, and 12th week of the 13 week programme of the "In Training" running clinics. Participants were classified as injured if they experienced at least a grade 1 injury—that is, pain only after running. Logistic regression modelling and odds ratio calculation were performed for each sex using the following predictor variables: age, body mass index (BMI), previous aerobic activity, running frequency, predominant running surface, arch height, running shoe age, and concurrent cross training.
Results: Age played an important part in injury in women: being over 50 years old was a risk factor for overall injury, and being less than 31 years was protective against new injury. Running only one day a week showed a non-significant trend for injury risk in men and was a significant risk factor in women and overall injury. A BMI of > 26 kg/m2 was reported as protective for men. Running shoe age also significantly contributed to the injury model. Half of the participants who reported an injury had had a previous injury; 42% of these reported that they were not completely rehabilitated on starting the 13 week training programme. An injury rate of 29.5% was recorded across all training clinics surveyed. The knee was the most commonly injured site.
Conclusions: Although age, BMI, running frequency (days a week), and running shoe age were associated with injury, these results do not take into account an adequate measure of exposure time to injury, running experience, or previous injury and should thus be viewed accordingly. In addition, the reason for the discrepancy in injury rate between these 17 clinics requires further study.
Our purpose was to determine the relationship between energy intake, energy availability, dietary fat and lower extremity injury in adult female runners. We hypothesized that runners who develop overuse running-related injuries have lower energy intakes, lower energy availability and lower fat intake compared to non-injured runners.
Eighty-six female subjects, running a minimum of 20 miles/week, completed a food frequency questionnaire and informed us about injury incidence over the next year.
Injured runners had significantly lower intakes of total fat (63 ± 20 vs. 80 ± 50 g/d) and percentage of kilocalories from fat (27 ± 5 vs. 30 ± 8 %) compared with non-injured runners. A logistic regression analysis found that fat intake was the best dietary predictor, correctly identifying 64% of future injuries. Lower energy intake and lower energy availability approached, but did not reach, a significant association with overuse injury in this study.
Fat intake is likely associated with injury risk in female runners. By documenting these associations, better strategies can be developed to reduce running injuries in women.
This systematic review set out to identify randomised controlled trials and controlled intervention studies that evaluated the effectiveness of preventive strategies in adolescent sport and to draw conclusions on the strength of the evidence. A literature search in seven databases (Medline, SportDiscus, EMBASE, CINAHL, PEDro, Cochrane Review and DARE) was carried out using four keywords: adolescent, sport, injury and prevention (expanded to capture any relevant literature). Assessment of 154 papers found 12 studies eligible for inclusion. It can be concluded that injury prevention strategies that focus on preseason conditioning, functional training, education, balance and sport‐specific skills, which should be continued throughout the sporting season, are effective. The evidence for the effectiveness of protective equipment in injury prevention is inconclusive and requires further assessment.
adolescent; injury; prevention
The present study analyzed the impact of the running style and the morphologic and functional characteristics of the foot on the incidence of non-traumatic foot and lower limb disorders in runners. From January 2004 to December 2008, we prospectively examined 166 runners, both recreational and competitive, involved in various running specialities, from three athletics clubs in Northern Italy. They were 86 males and 80 females, with a mean age of 31.1 ± 12.2 years. We considered non-traumatic foot and lower limb diseases reported during the follow-up period, which resulted in a minimum sport rest of two weeks. The incidence of these diseases was examined with respect to general characteristics, type of activity, foot morphology, running style. 59% of athletes reported one or more diseases. The most common were plantar fasciitis (31% of athletes) and Achilles tendinopathies (24%). Overall, the more prone to injuries were males (60.9% of cases), competitive runners (70.9%), middle-distance runners (51.7%), and those using spike shoes (80.3%). Age, body weight and height were not important predictors of running injuries in general. Considering the morphological characteristics of the foot, the most prone to injury were the varus hindfoot (87.5% of cases) and the cavus arch (71.4%). In conclusion, a deep knowledge of the factors predisposing runners to specific diseases, often chronic and highly debilitating for the athlete, may allow implementing effective therapeutic measures.
Examination of 166 runners during a period of five years of activity.The incidence of these diseases was examined with respect to general characteristics, type of activity, foot morphology, running style.59% of athletes reported one or more diseases. The most common were plantar fascitis (31% of athletes) and Achilles tendinopathies (24%).Overall, the more prone to injuries were males (60.9% of cases), competitive runners (70.9%), middle-distance runners (51.7%), and those using spike shoes (80.3%).Age, body weight and height were not important predictors of running injuries in general.The most prone to injury were the varus hindfoot (87.5% of cases) and the cavus arch (71.4%).
Running; foot; disease.
To examine if there is an increased participation in physical or sporting activities following an Olympic or Paralympic games.
Overview of systematic reviews.
We searched the Medline, Embase, Cochrane, DARE, SportDISCUS and Web of Knowledge databases. In addition, we searched for ‘grey literature’ in Google, Google scholar and on the International Olympic Committee websites. We restricted our search to those reviews published in English. We used the AMSTAR tool to assess the methodological quality of those systematic reviews included.
Primary and secondary outcome measures
The primary outcome was evidence for an increased participation in physical or sporting activities. Secondary outcomes included public perceptions of sport during and after an Olympic games, barriers to increased sports participation and any other non-sporting health benefits.
Our systematic search revealed 844 citations, of which only two matched our inclusion criteria. The quality of these two reviews was assessed by three independent reviewers as ‘good’ using the AMSTAR tool for quality appraisal. Both reviews reported little evidence of an increased uptake of sporting activity following an Olympic Games event. Other effects on health, for example, changes in hospital admissions, suicide rates and drug use, were cited although there was insufficient evidence to see an overall effect.
There is a paucity of evidence to support the notion that hosting an Olympic games leads to an increased participation in physical or sporting activities for host countries. We also found little evidence to suggest other health benefits. We conclude that the true success of these and future games should be evaluated by high-quality, evidence-based studies that have been commissioned before, during and following the completion of the event. Only then can the true success and legacy of the games be established.
Sports Medicine; Preventive Medicine; Public Health; Primary Care
Wearable motion sensors consisting of accelerometers, gyroscopes and magnetic sensors are readily available nowadays. The small size and low production costs of motion sensors make them a very good tool for human motions analysis. However, data processing and accuracy of the collected data are important issues for research purposes. In this paper, we aim to review the literature related to usage of inertial sensors in human lower limb biomechanics studies. A systematic search was done in the following search engines: ISI Web of Knowledge, Medline, SportDiscus and IEEE Xplore. Thirty nine full papers and conference abstracts with related topics were included in this review. The type of sensor involved, data collection methods, study design, validation methods and its applications were reviewed.
inertial sensors; accelerometers; gyroscopes; magnetic sensors; joint kinematics; motion analysis
The aims of this study were to assess levels and patterns of physical activity (PA) in relation to age and regular sport activity, and to examine its relationship to physical fitness in trained and untrained boys. One hundred forty-seven 11-to 15- year-old boys (73 trained and 74 untrained) participated in this study. Trained boys, comprised of 26 soccer, 25 handball and 22 volleyball players, had been training regularly for at least one year. The intensity, duration and frequency of PA were assessed from four complete days of heart rate monitoring with 15-seconds sampling intervals. Aerobic fitness was assessed by determining peakVO2 with a portable breath-by-breath gas analyzer (Cosmed K4b2) and the running speeds at fixed lactate concentrations during an incremental running test. Anaerobic fitness was evalu-ated with the Wingate Anaerobic Test. Skinfold thicknesses from eight sites and Tanner stages of pubic hair were also obtained. Based on 15-s heart rate data, instead of continuous activity, multiple short bouts of moderate and vigorous PA, lasting up to one minute, were characteristic of daily PA patterns of both trained and untrained boys. PA levels of trained boys were higher than untrained boys (p < 0.01) and the levels of PA decreased with age and maturation in both groups (p < 0.05). Daily PA variables were related to body fatness in both groups (p < 0.05), but the relationships were not consistent in the trained group. Daily PA variables were also related to aerobic fitness in the untrained group (p < 0.05) and these relationships were somewhat better with vigorous PA, whereas in the trained group, none of the PA variables were related to any of the aerobic fitness indices (p > 0.05). No relationship was observed between PA variables and anaerobic fitness in either group (p> 0.05). It seems that such relationships may somewhat depend on the fitness level of the subjects.
PA levels of trained boys were higher than untrained boys and the levels of PA decreased with age and maturation in both groups.
Based on the 15-s HR data, instead of continuous activity, multiple short bouts of moderate and vigorous PA, lasting up to one minute, were characteristic of daily PA patterns of both trained and untrained boys.
Daily PA variables were related to aerobic fitness in the untrained group and these relationships were somewhat better with vigorous PA (>70% HRR), whereas in the trained group, none of the PA variables were related to any of the aerobic fitness indices.
Neither peak nor mean power values were related to any of the daily PA variables in both trained and untrained groups.
Physical activity; training; aerobic and anaerobic fitness; body fatness; children
The behaviors and beliefs of recreational runners with regard to hydration maintenance are not well elucidated.
To examine which beverages runners choose to drink and why, negative performance and health experiences related to dehydration, and methods used to assess hydration status.
Marathon registration site.
Patients or Other Participants:
Men (n = 146) and women (n = 130) (age = 38.3 ± 11.3 years) registered for the 2010 Little Rock Half-Marathon or Full Marathon.
A 23-item questionnaire was administered to runners when they picked up their race timing chips.
Main Outcome Measure(s):
Runners were separated into tertiles (Low, Mod, High) based on z scores derived from training volume, expected performance, and running experience. We used a 100-mm visual analog scale with anchors of 0 (never) and 100 (always). Total sample responses and comparisons between tertile groups for questionnaire items are presented.
The High group (58±31) reported greater consumption of sport beverages in exercise environments than the Low (42 ± 35 mm) and Mod (39 ± 32 mm) groups (P < .05) and perceived sport beverages to be superior to water in meeting hydration needs (P < .05) and improving performance during runs greater than 1 hour (P < .05). Seventy percent of runners experienced 1 or more incidents in which they believed dehydration resulted in a major performance decrement, and 45% perceived dehydration to have resulted in adverse health effects. Twenty percent of runners reported monitoring their hydration status. Urine color was the method most often reported (7%), whereas only 2% reported measuring changes in body weight.
Greater attention should be paid to informing runners of valid techniques to monitor hydration status and developing an appropriate individualized hydration strategy.
dehydration; sport beverages; hydration monitoring
Pain in a foot or in the lower leg, not related to specific injury, in a track athlete who does a great deal of running, is the first symptom of fatigue fracture. X-ray films taken at the time pain begins may show no abnormality. Films taken a month or more later may show formation of callus, and perhaps a fracture line, at the point of pain.
Usually no treatment beyond cessation of running for two months or more is needed.
Since the incidence is highest in middle-distance runners who train intensively—quartermilers in particular—and may be related to the hardness of the running track, limiting running to alternate days and doing part of it on grass may help in prevention.