Evidence for preventive strategies to lessen running injuries is needed as these occur in 40%-50% of runners on an annual basis. Many factors influence running injuries, but strong evidence for prevention only exists for training modification primarily by reducing weekly mileage. Two anatomical factors - cavus feet and leg length inequality - demonstrate a link to injury. Weak evidence suggests that orthotics may lessen risk of stress fracture, but no clear evidence proves they will reduce the risk of those athletes with leg length inequality or cavus feet. This article reviews other potential injury variables, including strength, biomechanics, stretching, warm-up, nutrition, psychological factors, and shoes. Additional research is needed to determine whether interventions to address any of these will help prevent running injury.

Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the centre of the controversy is the addition of a resting ECG to the standard preparticipation evaluation using history and physical examination. The American Medical Society for Sports Medicine (AMSSM) formed a task force to address the current evidence and knowledge gaps regarding preparticipation cardiovascular screening in athletes from the perspective of a primary care sports medicine physician. The absence of definitive outcome-based evidence at this time precludes AMSSM from endorsing any single or universal cardiovascular screening strategy for all athletes, including legislative mandates. This statement presents a new paradigm to assist the individual physician in assessing the most appropriate cardiovascular screening strategy unique to their athlete population, community needs and resources. The decision to implement a cardiovascular screening programme, with or without the addition of ECG, necessitates careful consideration of the risk of SCA/D in the targeted population and the availability of cardiology resources and infrastructure. Importantly, it is the individual physician's assessment in the context of an emerging evidence base that the chosen model for early detection of cardiac disorders in the specific population provides greater benefit than harm. AMSSM is committed to advancing evidenced-based research and educational initiatives that will validate and promote the most efficacious strategies to foster safe sport participation and reduce SCA/D in athletes. BACKGROUND

The purpose of this study was to examine the association between nine measures of limb and trunk flexibility and running economy. Within a week prior to running economy assessment, and after 10 min of jogging at 3.13 m.s-1, 19 well-trained male sub-elite distance runners underwent two complete sets of lower limb and trunk flexibility assessments. Runners then completed two 10-min running economy assessment sessions on consecutive days at 4.13 m.s-1 following two 30-min sessions of treadmill accommodation at 4.13 m.s-1. Intraclass correlation coefficients indicated that the repeated flexibility measurements were highly reliable (X R = 0.92 +/- 0.09), as were the two running economy appraisals (R = 0.99). Correlational analyses revealed that dorsiflexion (r = 0.65) and standing hip rotation (r = 0.53) were significantly (P< or = 0.05) associated with the mean aerobic demand of running, such that runners who were less flexible on these measures were more economical. Although speculative, these results suggest that inflexibility in certain areas of the musculoskeletal system may enhance running economy in sub-elite male runners by increasing storage and return of elastic energy and minimizing the need for muscle-stabilizing activity.

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