511 BO27 – Age and sex differences in the risk and types of gradual onset injuries in runners and cyclists have implications for targeted injury prevention strategies

Background Running and cycling are two of the most popular forms of physical exercise worldwide, with increased participation by older and female athletes. Gradual onset injuries (GOIs) are common in these two sports, requiring individually targeted injury prevention strategies. Objective To determine differences in the period prevalence (12 months) and types of GOIs in runners compared with cyclists, by age and sex. Design Retrospective, cross-sectional study. Setting Community-based mass-participation running (2012–2015) and cycling (2016–2020) events. Participants 139082 consenting entrants completed online pre-race medical questionnaires at time of entry (21.1km & 56km running races: n=76654; 107km single stage cycling race: n=62428). Assessment of Risk Self-reported history of any GOIs (hGOIs) per 12-month period. Main Outcome Measurements Period prevalences (%) of any hGOIs in the past 12 months and prevalence ratios of hGOIs (PR;95% CI) (all, by anatomical areas and injury type) compared in runners vs. cyclists by age and sex. Results Period prevalences of any hGOIs are significantly higher in runners (94.2/1000) compared to cyclists (29.3/1000) (PR=3.2; 95%CI:3.0–3.5;p<0.0001). For older entrants, runners vs cyclists have higher risks of any hGOIs (PR=2.9;95%CI:2.7–3.1;p<0.0001). Female vs male cyclists have higher risks of any hGOIs (RPR=1.3;95%CI:1.2–1.5;p<0.0001). Higher risk of GOIs: any injuries above the lower-back in older cyclists vs older runners (PR=12.0;95%CI:7.8–18.3;p<0.0001); any lower-limb injuries in older runners vs older cyclists (PR=7.1;95%CI:6.5–7.8;p<0.0001) (sex adjusted). Higher risk of muscle-strain GOIs in older runners vs older cyclists (PR=8.9;95%CI:7.7–10.2;p<0.0001) (sex adjusted). Conclusions Period prevalences of any hGOIs, and GOIs by anatomical area/injury type, differ significantly between runners and cyclists, for sex and age category. Targeted injury prevention strategies are needed to reduce the risk of GOIs to promote longevity of sporting careers.