Sex-Specific Differences in Running Injuries: A Systematic Review with Meta-Analysis and Meta-Regression

Hollander, Karsten; Rahlf, Anna Lina; Wilke, Jan; Edler, Christopher; Steib, Simon; Junge, Astrid; Zech, Astrid

doi:10.1007/s40279-020-01412-7

Cited by 53 publications

(31 citation statements)

References 103 publications

(116 reference statements)

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“…Another key message that should be noted was the variances explained in the PC2 in females (33.76%) and males (12.74%) in the LR region, which suggested that female runners had higher variations of LR as speeding up. This was consistent with findings reported from a recent review that female runners had a higher risk of bone stress injuries than male runners, which related to LRs from landing impact (Hollander et al, 2021).…”

Section: Discussionsupporting

confidence: 92%

Principal Component Analysis of the Running Ground Reaction Forces With Different Speeds

Mei

Xiang

et al. 2021

Front. Bioeng. Biotechnol.

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Ground reaction force (GRF) is a key metric in biomechanical research, including parameters of loading rate (LR), first impact peak, second impact peak, and transient between first and second impact peaks in heel strike runners. The GRFs vary over time during stance. This study was aimed to investigate the variances of GRFs in rearfoot striking runners across incremental speeds. Thirty female and male runners joined the running tests on the instrumented treadmill with speeds of 2.7, 3.0, 3.3, and 3.7 m/s. The discrete parameters of vertical average loading rate in the current study are consistent with the literature findings. The principal component analysis was modeled to investigate the main variances (95%) in the GRFs over stance. The females varied in the magnitude of braking and propulsive forces (PC1, 84.93%), whereas the male runners varied in the timing of propulsion (PC1, 53.38%). The female runners dominantly varied in the transient between the first and second peaks of vertical GRF (PC1, 36.52%) and LR (PC2, 33.76%), whereas the males variated in the LR and second peak of vertical GRF (PC1, 78.69%). Knowledge reported in the current study suggested the difference of the magnitude and patterns of GRF between male and female runners across different speeds. These findings may have implications for the prevention of sex-specific running-related injuries and could be integrated with wearable signals for the in-field prediction and estimation of impact loadings and GRFs.

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Section: Discussionsupporting

confidence: 92%

Principal Component Analysis of the Running Ground Reaction Forces With Different Speeds

Mei

Xiang

et al. 2021

Front. Bioeng. Biotechnol.

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“…There were no differences in sex, age, BMI or competition distance between athletes that reported an injury/illness and those who did not. Regarding the comparison by sex, a recent systematic review found no differences between the overall injury rate between females and males [20.8 per 100 (95% CI 19.9-21.7) vs. (20.4 (95% CI 19.7-21.1) respectively] [27]. Observing competition distance, a higher incidence of injury in females competing in 10 kilometres or less (RR of 1.08; 95% CI: 1.04-1.39) was the only finding, but the analysis did not incorporate trail running studies [27].…”

Section: Discussionmentioning

confidence: 99%

Frequency of Injury and Illness in the Final 4 Weeks before a Trail Running Competition

Gajardo-Burgos

Monrroy-Uarac

Barría

et al. 2021

IJERPH

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We aimed to (i) determine self-reported injury and illness frequency in trail runners 4 weeks preceding competition; (ii) compare athletes with and without injury/illness by sex, age, body mass index (BMI) and competition distance; (iii) describe mechanism of injury, anatomical region (injury)/organ system (illness) involved, consequences of injury on preparation and self-perception of injury severity; (iv) compare anatomical region (injury) and organ system (illness) by sex. A total of 654 trail runners (age 36.2, IQR 30.6–43.0; 36.9% females) participated in this retrospective cross-sectional study by completing a self-reported questionnaire. Injury and illness frequency rates were 31.3% (n = 205, CI:27.7–35.0%) and 22.3% (n = 146, CI:19.1–25.7%), respectively. No significant difference was found between injured vs. non-injured or ill vs. non-ill study participants by sex, age, BMI and competition distance. Regarding injuries, gradual onset (41.6%) and knee (33.2%) were the most indicated mechanism and anatomical region of injury. At least 85.4% of trail runners changed their training following injury and 79% indicated that their injury would affect their competition performance. Regarding illness, the respiratory tract was the most frequent organ system involved (82.9%). Male and female participants reported similar proportions of anatomical regions (injury) and organ systems (illness) affected. These results could help to generate education strategies and appropriate medical support before and during these competitions.

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“…This may help to evaluate the impact of MSKI on race performance and withdrawal, as MSKI can lead to performance decrement (Fallon, 1996) and race withdrawal in 0.7%-4.8% of runners (Hutson, 1984;McGowan and Hoffman, 2015). Further, most studies include both sexes and sex difference have not been examined separately, however, it may be of interest as in non-UER females have more bone stress injuries while male runners more Achilles tendon injuries, although overall injury rates in non-UER athletes are similar (20.8 injuries/1000 females and 20.4 injuries/1000 males) (Hollander et al, 2021). Generally, there is less research in female UER, and it would be important to examine sex differences, as key aspects of female athlete physiology warrant careful consideration, e.g., RED-S that may lead to physiological impairments resulting in an increased risk of bone stress injuries (Tiller et al, 2021).…”

Section: Future Research Directionsmentioning

confidence: 99%

Musculoskeletal Injuries in Ultra-Endurance Running: A Scoping Review

Scheer¹,

Krabak

2021

Front. Physiol.

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Ultra-endurance running (UER) has seen an important increase in participation over the last few decades. Long hours of UER can lead to excessive stress on the body, resulting in musculoskeletal injuries (MSKI). UER is not a uniform sport and events can differ considerably in distance (over 42.195 km), time (e.g., events over 6 h) and multi-day or multi-stage events on various surfaces (e.g., track, on-road, off-road). The aims of this scoping review were therefore: (1) to examine the current evidence of MSKI, providing a synthesis of the most common MSKI by anatomical region and specific diagnosis; (2) categorize MSKI by type of UER activity (competition: time-limited; multi-stage; continuous UER events and training); (3) describe knowledge gaps in the literature and provide advice on potential further research. Our electronic literature search (PubMed, SPORTDiscus, Web of Science) identified a total of 13 studies (9 in competition, and 4 in training). Anatomical site, diagnosis and rate of injuries differ between competition and training as well as between different UER types. MSKI are observed in 18% of multi-stage events (0.7–1.8 injuries/runner and 7.2 injuries/1000 h). Most MSKI involve the lower leg (35.0%), ankle (16.8%), knee (13.1%) and foot (12.6%), with main diagnosis of medial tibial stress syndrome (30.1%) and patella femoral pain syndrome (PFPS; 7.2%). Single, continuous UER events differ between a 1005 km road race with almost all of the injuries due to overuse, with the main anatomical site of the knee (31%), ankle (28%) and lower leg (14%) and main diagnosis of PFPS (15.6%), compared to a 65 km trail race, with 32.8% of MSKI, mainly on the foot [plantar fasciitis (28.6%)], ankle [sprain (28.6%)] and knee. Timed-UER events (injury rate of 2.1 injuries/athlete) observed most injuries on the ankle (36%) and knee (19%), with the main diagnosis of tendinitis of the foot dorsiflexors (30%). Injuries during training most commonly affect, the back (42%), and knee (40%) and bone stress injuries (22%). Main diagnoses include ankle sprain (18%), iliotibial band injury (16%) and Achilles tendinopathy (11%). Future considerations include examining MSKI in different UER events, environments and surfaces, and on larger study populations. Establishing risk factors, examining sex differences and using a standard reporting system of MSKI in UER are also important.

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Sex-Specific Differences in Running Injuries: A Systematic Review with Meta-Analysis and Meta-Regression

Cited by 53 publications

References 103 publications

Principal Component Analysis of the Running Ground Reaction Forces With Different Speeds

Principal Component Analysis of the Running Ground Reaction Forces With Different Speeds

Frequency of Injury and Illness in the Final 4 Weeks before a Trail Running Competition

Musculoskeletal Injuries in Ultra-Endurance Running: A Scoping Review

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