The effectiveness of compression garments on RRI prevention in half- and full-marathon runners: Emulation of a RCT using data from an observational study

Background Runners use compression garments (CGs) to reduce the risk of lower extremity running-related injuries (RRIs). However, studies investigating if using CGs alters the risk of RRIs in runners are scarce. Purpose To study the effect of CGs on the occurrence of lower extremity RRIs in half and full marathon runners. Study design Observational cohort study Method We emulated a hypothetical target trial, an imaginary RCT, using data from the observational SUMMUM-2017 study. Runners who participated in one of the four cohorts of this study during their preparation for the half or full Utrecht Marathon were followed for 16 weeks. Runners stated whether they used CGs at baseline and reported, every 2 weeks, whether they had sustained an injury, using an online questionnaire. Only runners (n = 329) who had not had a RRI at baseline were included in the analysis. The primary outcome, any lower extremity RRI during any 2-week period, was analyzed with a mixed logistic regression model. Results No significant effects of CGs on the odds of a lower extremity RRI were identified in half or full marathon runners (odds ratio 1.07 95% CI 0.48–2.40). Conclusion Based on our target trial emulation half and full marathon runners, without RRIs at baseline, who used CGs did not have a smaller or greater risk of getting a lower extremity RRI at any point in time during training for a half- or full-marathon event.