Running on a track could be associated with a greater risk for heel pain

There is not a lot known about risk of injury from running on different surfaces. Despite claims that softer surfaces are better as there is less impact, the available evidence shows that the injury rates between hard and soft surfaces are the same (I discussed that here). Now we have this new study:

The Association between plantar heel pain and running surfaces in competitive long-distance male runners
Hotta T. , Nishiguchi S., Fukutani N., Tashiro Y., Adachi D., Morino S. 1, Aoyama T.
The Journal of Sports Medicine and Physical Fitness 2015 May 05
AIM: Plantar heel pain (PHP) is a common complaint, and is most often caused by plantar fasciitis. Plantar fasciitis is reported to be associated with running surfaces, however the association between PHP and running surfaces has not previously been revealed in an epidemiological investigation. Therefore, the purpose of the current study was to examine the association between PHP and running surfaces.
METHODS: This is a cross-sectional study. A total of 347 competitive long-distance male runners participated in this study. The participants completed an original questionnaire, which included items assessing demographic characteristics, training characteristics focusing on running surfaces (soft surface, hard surface and tartan), and the prevalence of PHP during the previous 12 months. A logistic regression analysis was used to identify the effect of running surfaces on PHP.
RESULTS: We found that 21.9% of participants had experienced PHP during the previous 12 months. The multivariate logistic regression analysis, after adjusting for demographic and training characteristics, revealed that running on tartan was associated with PHP (odds ratio = 2.82, 95% confidence interval = 1.42 to 5.61; p <0.01).
CONCLUSION: Our findings suggest that running more than 25% on tartan is associated with PHP in competitive long-distance male runners.

Firstly, I have no more information than what is available in the above abstract as I can not access the full paper, so will only make some notes to think about rather than a detailed analysis:

  • this was a cross-sectional study design that relied on recalling information from the previous 12 months. That is associated with a whole range of issues that can weaken the results of such study designs.
  • the rate of injury between running on soft vs hard surfaces appears to be the same; so that confirms the previous study that found the same thing.
  • there was an association between plantar heel pain and running on a tartan track, but I really do not know how that fits into the differences between hard and soft surfaces. I could only speculate on a number a different reasons as to the mechanism or reason for this, but it is not clear what the mechanical differences would be between those that run on a tartan track vs other surfaces.
  • 76 runners in the study reported heel pain, which seems extraordinarily high. Maybe there is more information in the full paper to clarify that. The abstract does not state how many of that 76 were in the tartan track group (I assume that this is in the full paper and it would be helpful to know that).
  • I mentioned in the title of this post: “could” as its not possible to determine risk from this type of study design as it is set up to look for associated (ie while I do not think it is the case, but it is entirely possible that when people get heel pain, they do more running on a track; so the track running was ’caused’ by the heel pain)

As always, I go where the evidence takes me until convinced otherwise ….and this study through up an interesting speculation.

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