Biomechanical Risk Factors Associated with Running-Related Injuries: A Systematic Review

Abstract

Background Running is a popular form of physical activity with many health benefits. However, the incidence and prevalence of running-related injuries (RRIs) is high. Biomechanical factors may be related to the development of RRIs. Objective This systematic review synthesizes biomechanical risk factors related to the development of RRIs in non-injured runners. Methods PubMed, Web of Science, CINAHL, Embase, and SPORTDiscus were searched in July 2018 for original peerreviewed prospective studies evaluating potential biomechanical factors associated with the development of RRIs. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Two reviewers independently assessed articles for inclusion and methodological quality. Due to methodological heterogeneity across studies, a narrative synthesis of findings was conducted, rather than a meta-analysis. Results Sixteen studies, including 13 of high quality and three of moderate quality, were included. A large number of biomechanical variables were evaluated, producing inconsistent evidence overall. Limited evidence indicated greater peak hip adduction in female runners developing patellofemoral pain and iliotibial band syndrome, but not for a mixed-sex population of crosscountry runners sustaining an RRI. The relationship between vertical loading rate and RRIs was inconsistent. Other kinematic, kinetic and spatiotemporal factors were only studied to a limited extent. Conclusions Current prospective evidence relating biomechanical variables to RRI risk is sparse and inconsistent, with findings largely dependent on the population and injuries being studied. Future research is needed to confirm these biomechanical risk factors and determine whether modification of these variables may assist in running injury prevention and management. Key Points Despite the common belief that biomechanical factors greatly influence running-related injury (RRI) risk, only a limited body of high-quality research, with significant heterogeneity in study populations, methodologies and outcome variables, was identified. Current prospective evidence relating biomechanical variables with the risk to sustain an RRI is inconsistent and largely dependent on the population and injuries being studied. A number of single-study findings related to kinematics, kinetics and spatiotemporal variables require confirmation via further high-quality prospective studies before clinical recommendations can be made.

Patellofemoral Joint Loads during Running Immediately Changed by Shoes with Different Minimalist Indices: A Cross-sectional Study

“…Hundreds of millions of citizens participate in sports, among which running is widely known. Injury remains high with the popularity of running, with 19.4% to 79.3% sustaining a running-related injury annually [1]; patellofemoral pain syndrome (PFPS) is one of the most common running injuries, exhibiting the highest incidence of 17% in the specific pathologies of running-related injuries [2]. Increased patellofemoral joint stress (PFJS) was determined as an important pathogenic factor [3].…”

Peer Review #2 of "Manifestations of muscle fatigue in baseball pitchers: a systematic review (v0.2)"

“…Manuscript to be reviewed bias (Ceyssens, et al, 2019). The remaining 23 articles received a low risk of bias score.…”

“…An assessment of risk bias was determined based on the work of Lopes, et al (2012) and adapted by Ceyssens, et al (2019). The criteria used by Lopes, et al (2012) was adapted for our work, with the scoring system based on the same 10 items: (1) definition of injury clearly described, (2) prospective design that presents incidence or prevalence data, (3) description of level of pitchers (e.g., recreational or professional level), (4) the process of inclusion of athletes in the study was random (i.e., not by convenience) or the data collection was performed with the entire target population; (5) data analysis performed with at least 80% of the athletes included in the study; (6) injury data reported by pitchers; (7) same mode of injury data collection used; (8) injury diagnosis conducted by a medical professional; (9) follow-up period of at least 6 months;…”

Associations between biomechanical and clinical/anthropometrical factors and running-related injuries among recreational runners: a 52-week prospective cohort study

“…Risk factors for running-related injury (RRI) have been explored in several original studies and synthesized in various systematic reviews (Ceyssens et al 2019;Saragiotto et al 2014;Hulme et al 2017). Although the attempts to identify risk factors for RRI in the original articles included in these systematic reviews have been extraordinary, 86 out of 89 studies used a relative measure of association (e.g.…”

“…Absolute differences have been reported in biomechanical studies, although these differences are normally between injury groups and not between exposure groups (Ceyssens et al 2019;Powers 2010). In prospective cohort studies, the most common analytical approach has been to compare differences in biomechanical measures, such as external knee adduction moments (Dudley et al 2017), ankle eversion range of motion and eversion velocity (Kuhman et al 2016), and hip strength (Finnoff et al 2011), between injured and non-injured runners.…”