Behavioural Risk Factors for Running Injury

This is getting somewhat out of my area of expertise, but I still going to write about it! This study looked at a selected group of parameters to prospectively determine which one of them was a risk factor for a running related injury. Here is the abstract:

Predictors of Running-Related Injuries Among 930 Novice Runners; A 1-Year Prospective Follow-up Study
Rasmus Oestergaard Nielsen, et al
Orthopaedic Journal of Sports Medicine January-June 2013
Background: To identify persons at high risk of sustaining running-related injuries, an evidence-based understanding of the risk factors associated with injury is needed.
Purpose: To identify demographic and behavioral risk factors associated with running-related injuries.
Study Design: Observational prospective cohort study with a 1-year follow-up.
Methods: Exposures including sex, age, body mass index (BMI), behavior (Type A Self-Rating Inventory [TASRI]), running experience, other sports activity, previous running-related injuries, and other injuries not related to running were assessed prior to or at baseline. The outcome of interest was a running-related injury, defined as any musculoskeletal complaint of the lower extremity or back caused by running that restricted the amount of running (volume, duration, pace, or frequency) for at least 1 week. All participants quantified their running volume by global positioning system (GPS) and used a neutral running shoe. Time to first injury for each exposure variable was analyzed using a generalized linear model, with cumulative kilometers of the training sessions as the time scale.
Results: A total of 930 individuals were included in the study, of which 254 sustained a running-related injury during a total of 155.318 km of running. By calculating the cumulative injury risk differences (cIRDs) [95% confidence intervals] after 500 km of running, the TASRI Type B behavior (cIRD, 11.9% [−0.5%; 23.3%]; P = .04) was found to be a significant predictor of injury, while age between 45 and 65 years (cIRD, 14.7% [−2.1%; 31.5%]; P = .08) and previous injuries not related to running (cIRD, 11.1% [−0.2%; 22.4%]; P = .05) were considered clinically interesting, although not statistically significant. In addition, χ2 test results across 4 BMI groups also revealed a borderline significant relationship (P = .06). No significant or clinically relevant relationships were found for sex (P = .42), previous running-related injury (P = .47), running experience (P = .30), and other sports activities (P = .30).
Conclusion: The findings of the present study suggest BMI >30 kg/m2, age between 45 and 65 years, noncompetitive behavior, and previous injuries not related to running are associated with increased risk of injury among novice runners, while BMI <20 kg/m2 was protective. Still, the role of the risk factors in the causal mechanism leading to injury needs to be investigated.

This was a one year follow-up of 930 runners. The main risk factors identified in this study were:

  • a BMI >30 kg/m2 (not surprising as the higher the body weight, the greater the accumulated load in the tissues to cause an injury).
  • being between ages 45-65 yrs (not surprising as you approach those ages the tissues are less able to resist the loads that they can do at a younger age…tell me about it!).
  • previous injury (two things at play here: a previous injury means you have a number of risk factors for injury, and invariably a number of them will still be present. Secondly, after the tissues heal from a previous injury, they may be at greater risk for re-injury; or there is an alteration in gait increasing the load on different tissues).
  • Type B behavior

It was the last one the caught my eye, as in my limited understanding of the Type A & B personalty types is that the Type B personality is the easy going laid back type of personality. I would have thought that Type A would be at greater risk as they are more competitive. Maybe they are at greater risk in contact sports where they take more risks, but not in running? Anyone care to leave a comment below?

As always, I go where the evidence takes me.

Nielsen, R., Buist, I., Parner, E., Nohr, E., Sorensen, H., Lind, M., & Rasmussen, S. (2013). Predictors of Running-Related Injuries Among 930 Novice Runners: A 1-Year Prospective Follow-up Study Orthopaedic Journal of Sports Medicine, 1 (1) DOI: 10.1177/2325967113487316

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3 Responses to Behavioural Risk Factors for Running Injury

  1. chris paget-marsh May 8, 2013 at 8:14 am #

    Type B personality less inclined to warm-up, cool down, stretch, train strength/stability etc?

  2. Scott Douglas May 8, 2013 at 1:12 pm #

    Type B more likely to dissociate on runs, while Type A more likely to associate? That could mean Type A more attuned to warning signals.

  3. René Korsgaard May 9, 2013 at 9:37 pm #

    I am thinking that type b personality could be more associated with some kind of kinesiophobia?

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