Injury risk assessment and the incidence of musculo-skeletal injuries in recreational long-distance runners over a 3-month training period

Master Thesis


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University of Cape Town

Background: Long distance road running is continually growing as competitive and recreational sport, globally. Despite its popularity, a high burden of incidence of injury exists among runners. Previous research has focussed on specific injuries, whereas others have investigated isolated risk factors that may contribute to running related injuries. The purpose of the study is to determine possible internal and external screening variables that may predict the incidence of running-related injuries in general. Methods: Forty one recreational runners participated in an observational study over the course of 12 weeks. Screening assessments consisted of injury history, training history, and anthropometric measurements. Functional and performance assessments included the Foot Posture Index (FPI), the Functional Movement Screen (FMS), vertical jump, single leg hop and sit-and-reach tests. Participants were monitored over a period of 12 weeks by completing a weekly online logbook regarding their training and possible incidence of injury. Monitoring was terminated after 12 weeks of observation. Differences between injured and non-injured runners were determined using Independent -T-tests for mean differences, or Mann-Whitney U Test for distributional differences (non-parametric data). Binomial Logistic regression models were used to determine the influence of internal, external functional and external behavioural factors on the risk for running injury, respectively. Results: The total group revealed a cumulative incidence of injury of 63% over the 12 weeks of observation. There was no gender difference between incidences of injuries over the 12 week observation training period (OTP). Injured runners achieved a higher total FMS score (median = 16, Interquartile Range = 3) compared to uninjured runners (median = 15, Interquartile range = 3; p = 0.006). Binomial logistic regression models of external functional (FMS, Vertical Jump, Sit-and-Reach scores) factors [X² (3) = 9.764, p = 0.021] were statistically significant. Only the FMS score contributed significantly to the incidence of injury (p = 0.013) of the three external functional factors in the Regression Model. Discussion and Conclusion: The study adds to current evidence that the assessment of the Functional Movement Screen is important in predicting injury, however, the present study shows that a higher score obtained during the FMS increase your odds to sustain an injury. The study is in contrast with the body of evidence that the incidence of previous injury is the strongest predictor of the incidence of a current injury. The study concluded that the Functional Movement Screen is a useful screening tool to determine a long distance runner's risk for running-related injuries and should be included in health-injury risk assessments of recreational runners.