Should Adolescents Run Marathons?: Youth Marathon Training Injury Epidemiology and Risk Factors

Abstract

Objective:Youth participation in distance running has increased, yet little data exist about the injury patterns and safety of such activity. This study seeks to determine the types and rates of injuries seen in an adolescent marathon training program.Design:Observational prospective cohort study.Setting:Community-based adolescent marathon training program.Participants:The study enrolled 1927 students from 50 high schools (HS) and 34 middle schools (MS) participating in the 2017 to 2018 Students Run Los Angeles marathon training program.Assessment of Risk Factors:Weekly injury reports completed by running coaches. Data elements included participant demographics, weekly training distance, injury type, injury acuity, and missed training time.Main Outcome Measures:Epidemiology of self-reported injury in adolescent runners.Results:A total of 583 injuries occurred in 18% of runners during the training program. High schools runners were more likely to be injured than MS runners (20.8% vs 14.2%, P < 0.001). Seventy-two percent of injuries were acute with a mean missed training time of 4.8 days (SD 4.8). The most frequent site of injury was the knee (33%). Overall, runners with injuries ran a significantly greater distance per week than uninjured runners (14.6 mi vs 12.0 mi, P < 0.001). Ninety-nine percent of marathon participants completed the race.Conclusions:During a 28-week marathon training program, 18% of adolescent participants reported an injury. More injuries occurred in HS students, were acute, and involved the knee. This study represents one of the largest descriptions of injury prevalence in adolescent distance running and highlights a lower injury rate than adults during marathon training.

Youth Distance Running and Lower Extremity Injury: A Systematic Review

“…After full-text screening, eight articles were retained for data extraction. One additional article [ 20 ] was later identified through a hand search resulting in a total of nine articles that met eligibility criteria and were included in the qualitative analysis ( Figure 1 ).…”

“…The prospective study by Goldman et al had a sample of 1927 students from 50 high schools and 34 middle schools that participated in the 2017–2018 Students Run Los Angeles (SRLA) Marathon Training Program [ 20 ]. There were a total of 720 seventh and eighth grade middle school participants and 102 of the 720 reported an injury [ 20 ]. Middle school runners were less likely to report an injury than high school runners (14.2% vs. 20.8%, p < 0.001) [ 20 ].…”

“…There were a total of 720 seventh and eighth grade middle school participants and 102 of the 720 reported an injury [ 20 ]. Middle school runners were less likely to report an injury than high school runners (14.2% vs. 20.8%, p < 0.001) [ 20 ]. Middle school runners who sustained an injury over the training program ran significantly greater distance on average per week than non-injured runners (14.1 miles vs. 12.0 miles, p < 0.001) [ 20 ].…”

“…Middle school runners were less likely to report an injury than high school runners (14.2% vs. 20.8%, p < 0.001) [ 20 ]. Middle school runners who sustained an injury over the training program ran significantly greater distance on average per week than non-injured runners (14.1 miles vs. 12.0 miles, p < 0.001) [ 20 ]. The most commonly reported injury site was the knee, followed by the lower leg, foot, ankle, thigh, and hip [ 20 ].…”

“…Total scores ranged from 15 to 17. The following total scores ranges on the Downs and Black Checklist have been suggested as categories of study quality: excellent (26-28), good (20)(21)(22)(23)(24)(25), fair (15)(16)(17)(18)(19), and poor (≤14) [29].…”