We pooled injury data from 36-studies in which 18,195 runners reported 10,688 injuries. The purpose was to find out what the most common running injuries were. This is called a systematic review of literature. Our review has been accepted for publication in the Journal of Sports Science and Medicine. In total, this process has taken 20-months since I first began searching the literature – it is a lot of work and this is a short blog to tell you what we found.
The Knee Down
Runners primarily suffer injuries from the knee downwards (75 – 78% of all injuries). The knee, shin and ankle-foot region are the top 3 sites for men and women. However, when separated women seem to have a higher proportion of knee injuries (40%) compared to ankle-foot (19%) and shin (16%) injuries. Men appear to have a more even distribution between knee (31%), ankle-foot (26%) and shin (21%). The reason for these differences may be linked to the different anatomical make-up of men and women.
Women have wider hips which can lead to more inward pressure at the knee especially if the muscles around the hip and knee are not working sufficiently well to reduce the impact on landing from each stride.
What type of injuries do runners get?
A smaller number of studies (11) reported the specific type of injuries runners suffered. From 3,580 injuries reported by 4,752 runners, we were able to work out the top 10 injuries.
The most common injury was non-specific knee pain (patellofemoral pain syndrome). The top-5 injuries were completed by achilles tendon injury, shin splints (medial tibial stress syndrome), plantar fasciitis (painful at the heel under-foot, especially in the morning) and IT band syndrome (pain on the outside of the knee).
Why do runners get these injuries?
The first reason any athlete in any sport gets injured is because they have loaded their body in a way that exceeds their current physical capacity. The second reason is because once injured once, they are then at a higher risk of future injury.
That being said, the nature of running injury is interesting. The top-5 injuries are all to structures not designed to produce and absorb load but only to assist. The repetitive nature of running is overloading these tissues which suggests at some level the neuromuscular system is failing to absorb the load. This could be due to running when fatigued, not being strong enough, running in such a way that does not allow muscles work effectively or as is often the case – a combination of all 3.
By contrast, football players who have an endurance component to their sport (90-minutes of intermittent running) seem to mainly experience muscle injuries. Muscle are designed to produce and absorb load. This suggests to me that footballers make excellent use of their muscles to the point they over-work them. They do not suffer many of the injuries that runners do which may be due to greater movement variability (running at different speeds, jumping, heading, changing direction), strength or running in a way that allows muscle to produce and absorb the majority of the load.
What is a runner to do?
Make better use of your muscles. This can be done using a mixture of the following:
- Get stronger – move better (gym, circuits, hops and bounds)
- Run at a variety of speeds (including top speed)
- Run up a hill
- Run on varied surfaces
- Barefoot run
As this is the last blog for 2018, happy Christmas and new year to all readers. Peter.
Peter Francis 