Common injuries and risk factors in South African long-distance runners over a 12-month period

Background: The 12-month incidence of injuries in long-distance running is high, and injury rates vary between 17% and 90%. Objectives: The aim of this study was to describe injury incidence, type, location and risk factors in long-distance runners over the last 12 months. Methods: A retrospective, descriptive, quantitative research design was used. Participants (n=215) were drawn from South African long-distance runners. A previously used online one-year injury recall questionnaire was used to investigate injury incidence, type, location and risk factors. Descriptive and inferential statistics were used to develop a model explaining the risk of injury in runners based on significant risk factors. Statistical significance was set at p<0.05. Results: In total, 157 injuries were reported by 110 runners (51%). When comparing by sex, 54% of males and 48% of females reported an injury. The sex comparison also showed that males ran significantly faster than females (p=0.04). Most injuries were due to overuse (79%). Common injury locations included the knee (26%), the ankle/foot complex (19%), and the lower leg (18%). There was no significant difference in injury location between male and female runners (p=0.13). Significant injury risk factors identified included: low BMI (p=0.002), greater height (p=0.05), lack of running experience (p=0.05), not warming up (p<0.001), not cooling down (p=0.01), not stretching before running (p=0.004), not stretching after running (p=0.01), and previous injury (p<0.001). Logistic regression analysis, using only the significant injury risk factors, yielded an injury prediction accuracy of 78% (p<0.001). Conclusion: The 12-month incidence of injury in long-distance runners was 51%, and several significant risk factors were identified. These risk factors explained or predicted 78% of the injuries sustained. Most injuries were due to overuse and occurred in the lower limbs. In the current sample of runners, not stretching and not warming up prior to running were statistically significant risk factors for overuse injuries.