Health and Economic Burden of Running-Related Injuries in Dutch Trailrunners: A Prospective Cohort Study

Abstract

BackgroundTrailrunning is becoming very popular. However, the risk and burden of running-related injuries (RRI) in trailrunning is not well established.ObjectiveTo investigate the prevalence, injury rate, severity, nature, and economic burden of RRIs in Dutch trailrunners.MethodsThis prospective cohort study included 228 trailrunners aged 18 years or over (range 23–67), and was conducted between October 2013 and December 2014. After completing the baseline questionnaire, the Oslo Sports Trauma Research Center Questionnaire on Health Problems was administered every 2 weeks to collect data on RRIs. Participants who reported RRIs were asked about healthcare utilization (direct costs) and absenteeism from paid work (indirect costs). RRI was defined as disorders of the musculoskeletal system or concussions experienced or sustained during participation in running.ResultsThe mean prevalence of RRIs measured over time was 22.4 % [95 % confidence interval (CI) 20.9–24.0], and the injury rate was 10.7 RRIs per 1000 h of running (95 % CI 9.4–12.1). The prevalence was higher for overuse (17.7 %; 95 % CI 15.9–19.5) than for acute (4.1 %; 95 % CI 3.3–5.0) RRIs. Also, the injury rate was higher for overuse (8.1; 95 % CI 6.9–9.3) than for acute (2.7; 95 % CI 2.0–3.4) RRIs. The median of the severity score was 35.0 [25–75 %, interquartile range (IQR) 22.0–55.7], and the median of the duration of RRIs was 2.0 weeks (IQR 2.0–6.0) during the study. The total economic burden of RRIs was estimated at €172.22 (95 % CI 117.10–271.74) per RRI, and €1849.49 (95 % CI 1180.62–3058.91) per 1000 h of running. An RRI was estimated to have a direct cost of €60.92 (95 % CI 45.11–94.90) and an indirect cost of €111.30 (95 % CI 61.02–192.75).ConclusionsThe health and economic burden of RRIs presented in this study are significant for trailrunners and for society. Therefore, efforts should be made in order to prevent RRIs in trailrunners.Electronic supplementary materialThe online version of this article (doi:10.1007/s40279-016-0551-8) contains supplementary material, which is available to authorized users.

Effectiveness of online tailored advice to prevent running-related injuries and promote preventive behaviour in Dutch trail runners: a pragmatic randomised controlled trial

“…The difference in change from baseline for warming up found in a previous study (13% in the intervention and 4% in the control group) investigating the effects of an online tailored intervention in runners was used as a reference effect size for preventive behaviours 18. The reference value for the mean proportion of trail runners sustaining RRIs (22.4%) was based on a previous prospective cohort study conducted with the same source population 11. The hypothesised reduction in the proportion of trail runners sustaining RRIs was 20% in the intervention and 10% in the control group, on average.…”

“…The hypothesised reduction in the proportion of trail runners sustaining RRIs was 20% in the intervention and 10% in the control group, on average. Considering an α of 0.05, power of 0.8, three repeated measurements for preventive behaviours (at baseline and at 2 and 6 months after baseline), 13 repeated measurements for RRI (every 2 weeks during 6 months), a within-person correlation of 0.311 and a response rate of 70%,11 12 the sample size was estimated at 105 participants for each group for preventive behaviours (total of 210 participants) and 92 participants for each group for RRI (total of 184 participants).…”

“…According to VeiligheidNL (the Dutch Consumer Safety Institute), running was the third most practised sport in the Netherlands in 2013, with around 2.1 million people 5. A mode of running known as trail running is quickly gaining in popularity 11. Trail running consists of running in the outdoors, mainly on unpaved, rugged, muddy and/or hilly/mountain terrains 11.…”

“…A mode of running known as trail running is quickly gaining in popularity 11. Trail running consists of running in the outdoors, mainly on unpaved, rugged, muddy and/or hilly/mountain terrains 11. To illustrate the spike in popularity, according to MudSweatTrails (the largest trail running community in the Netherlands), there was no trail running event in the Netherlands and Belgium in 2010, and there were over 150 in 2015.…”

“…This counteracts efforts to increase physical activity levels 3. The prevalence proportion of RRIs in Dutch trail runners is estimated at 22.4% (95% frequentist confidence interval (CI) 20.9 to 24.0), and the injury rate is 10.7 RRIs per 1000 hours of running (95% CI 9.4 to 12.1) 11. Despite the burden of RRIs to the runners and for society,11–13 there is no substantial evidence on interventions to prevent RRIs 14–17.…”