Running-related musculoskeletal injuries

athletic track with 2012 and Union flag

Welcome to the Musculoskeletal Elf!

This is the first of many regular articles that we plan to publish on this website; highlighting reliable musculoskeletal research and guidance for health and social care professionals.

Our first few blogs will have relevance to the London 2012 summer Olympic Games and Paralympic Games taking place just now. Well done Team GB on success so far in cycling, equestrian, gymnastics and swimming!!.

You can find out more about our aims and the people behind the site by visiting our About page.  We look forward to hearing from you soon so send us your views on this and forthcoming articles (using the comment form at the foot of this page) and become part of the Musculoskeletal Elf community.

xray of runner with joint pain

What types of injuries could Team GB medical team expect to see in our Olympic runners?

What disappointing news last week that Paula Radcliffe, one of the greatest female distance runners, has had to withdraw from the London 2012 summer Olympic games due to osteoarthritis in her foot. With the athletics about to start I wondered what types of injuries the Team GB medical team could expect to see in our Olympic runners? Having been a decent club runner in my youth, but now quite definitely a veteran social jogger on the Elf’s woodland paths, I have suffered from one or two injuries myself! It must also have been an issue for the international team of authors of a systematic review, published in Sports Medicine, of studies on the incidence and prevalence of the main specific running-related musculoskeletal injuries (RRMIs).

Here’s what they did

They searched electronic databases up to October 2011 with no limits on language of publication. Studies that reported only the type of injury, anatomical region or incomplete data that precluded interpretation of the incidence or prevalence rates of RRMIs were excluded. They included eight studies involving approximately 3500 runners. And assessed risk of bias. They performed separate analysis for ultra-marathoners.

Here’s what they found

  • There were 28 types of running related musculoskeletal injuries (RRMIs) reported
  • the main general RRMIs were
    • medial tibial stress syndrome (incidence ranging from 13.6% to 20.0%; prevalence of 9.5%),
    • achilles tendinopathy (incidence ranging from 9.1% to 10.9%; prevalence ranging from 6.2% to 9.5%)
    • plantar fasciitis (incidence ranging from 4.5% to 10.0%; prevalence ranging from 5.2% to 17.5%).
  • The main ultra-marathon RRMIs were
    • achilles tendinopathy (prevalence ranging from 2.0% to 18.5%)
    • patellofemoral syndrome (prevalence ranging from 7.4% to 15.6%).

The Musculoskeletal Elf’s thoughts

The Msk ElfHere is a quick reminder for those confused by the difference between incidence and prevalence. Incidence is a measure of the risk of developing a new injury within a specified period of time, whereas prevalence is a measure of the total number of cases of the injury in a population.  Thus, incidence conveys information about the risk of experiencing the injury, whereas prevalence indicates how widespread the injury is in a population.

This systematic review provides evidence that medial tibia stress syndrome, achilles tendinopathy and plantar fasciitis were the main general running related musculoskeletal injuries (RRMIs), while achilles tendinopathy and patellofemoral syndrome were the most common RRMIs for runners who participated in ultra-marathon races. In general, the articles had moderate risk of bias and only one fulfilled less than half of the quality criteria.

Dr Andrew Murray finishing in the Sahara

The Scottish Government’s Physical Activity Champion, Dr Andrew Murray is a great ultra-marathon runner he completed 2,664 miles from John O’ Groats to the Sahara in just 78 days.

So it appears that Paula Radcliffe is unlucky to have developed osteoarthritis in her foot, however she has had her fair share of injuries in the past. Our Scottish Government’s Physical Activity Champion, Dr Andrew Murray, also GP, is a great ultra-marthon runner. He has run 2,664 miles from John O’ Groats to the Sahara in just 78 days, you can read his book about his journey. He also recently won the North Pole Marathon.  Ultra-marathon running is also a very popular international activity with its own website.

If you are a runner NHS Choices list their view of the 5 most common running injuries and how to spot the symptoms and what to do if you have them, including when to get medical advice. They also provide a video on how to avoid running injuries.

Do you treat these conditions in runners? What is your view on this review, will it impact on your clinical practice? Send us your views on this blog and become part of the Musculoskeletal Elf community.


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