Trail running injury risk factors: a living systematic review.

Carel Viljoen, Dina C Christa Janse van Rensburg, Willem van Mechelen, Evert Verhagen, Bruno Silva, Volker Scheer, Manuela Besomi, Rubén Gajardo-Burgos, Sérgio Matos, Marlene Schoeman, Audrey Jansen van Rensburg, Nicol van Dyk, Susan Scheepers, Tanita Botha

Journal: British journal of sports medicine 2022;56(10):577-587

PMID: 35022162

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Abstract

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.

Address: Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa [email protected].; Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, location VU University Medical Center, Amsterdam, The Netherlands.; Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa.; Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.; Medical Board Member, World Netball, Manchester, UK.; School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia.; Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.; School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland.; School of Sports and Leisure, Department of Sports Science, Tourism and Leisure, Polytechnic Institute of Viana do Castelo, Melgaço, Portugal.; Research Center in Sports Science, Health Science and Human Development (CIDESD), University of Tras-os-Montes e Alto Douro, Vila Real, Portugal.; Ultra Sports Science Foundation (USSF), Pierre-Benite, France.; Carrera de Kinesiología, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.; Escuela de Kinesiología, Instituto de Aparato Locomotor y Rehabilitación, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile.; Department of Sports, Higher Institute of Educational Sciences of the Douro, Penafiel, Portugal.; High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.; Department of Library Services, University of Pretoria, Pretoria, South Africa.; Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa.

DOI: 10.1136/bjsports-2021-104858

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MeSH Terms: Athletic Injuries, Foot, Humans, Incidence, Lower Extremity, Risk Factors, Running, Sunburn