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AbstractBackground Trail running presents with a high incidence of injury. Insight into the various race distance injury profiles could aid in developing more specific injury prevention strategies.Objectives Determine and compare the epidemiology, clinical characteristics, and injury severity among race entrants training towards different ultra-trail race distances.Design Retrospective, cross-sectional study.Setting 2022 Mac Mac Ultra races (46km, 80km, 161km and 322km).Participants Of the 245 race entrants, 162 (66%) consented to analyse their data in this study.Assessment Three weeks before the races, race entrants completed a pre-race medical screening questionnaire that collected data on their injury history in the 6 months leading up to the races.Main Outcome Measures Retrospective injury rate (injuries/1000h of running), the point prevalence (% of currently injured participants), the injury severity (time lost in days from running) and the frequency (n,%) of injury.Results We reported 1) a statistically significantly higher injury rate among the 46km study participants (3.09 injuries/1000h) compared to the 80 km (0.68 injuries/1000h; p=0.001) and 161km (1.09 injuries/1000h; p=0.028) study participants, 2) the lower limb (89%) was the most injured anatomical region, with only 46km study participants reporting upper limb, trunk, and head injuries (11%), 3) muscle/tendon accounted for the most injured tissue type (56%), with muscle injuries (31%) and tendinopathies (25%) the most reported pathology types, and 4) participants training towards the shorter ultra-trail race distances had the highest injury severity 46km=13.2±18.4 days lost; 80km=16.4±9.2 days lost.Conclusion Training towards shorter ultra-trail distance races caused trail runners to present with a higher injury rate, a more diverse injury profile, and a higher injury severity. This emphasises the need to report injuries separately within distinct race distance categories, enabling more tailored risk factor analyses and improving the design of targeted injury prevention strategies.
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