Closing Pandora's Box: adapting a systems ergonomics methodology for better understanding the ecological complexity underpinning the development and prevention of running-related injury

The popularity of running as a form of exercise continues to increase dramatically worldwide. Alongside this participation growth is the burden of running-related injury (RRI). Over the past four decades, traditional scientific research applications have primarily attempted to isolate discrete risk factors for RRI using observational study designs as commonly used in public health epidemiology. Unfortunately, only very few randomised controlled trials have evaluated the efficacy associated with a well-specified RRI prevention intervention. Even though the knowledge about risk factors as generated in observational studies is valuable for better understanding why RRI develops, it nonetheless means that there remains a major knowledge gap about how best to prevent it, especially in a way that fully addresses all causal factors. Alongside the continuing use of traditional scientific approaches, a particular systems ergonomics methodology should also be considered in light of its potential to visualise the complete distance running system. This article adapts the Systems Theoretic Accident Mapping and Processes (STAMP) model to the RRI research prevention context. The direct application of STAMP might offer new knowledge about how to prevent RRI, such as exposing questions around the feasibility of adopting novel injury prevention interventions that do not directly target runners themselves.