458 FO16 – The running injury continuum: an examination of recreational runners’ description and management of the injury development process

Introduction Running-related injuries (RRIs) are frequent and predominately overuse in nature (1); however, current definitions may not encapsulate their full development process. Understanding runners' lived experience of the injury development process may enhance its examination, improving risk factor identification, furthering injury prevention. This study aimed to examine recreational runners' description and management of the injury development process. Methods A qualitative study of seven semi-structured focus groups with 31 recreational runners (13 male, 18 female) took place. Focus groups were 90 minutes, audio and video recorded, and transcribed verbatim. Transcripts were reflexively thematically analysed (2). A critical friend approach was taken to data coding, with multiple methods of trustworthiness executed (3). Results & Conclusion Runners describe a nine-level continuum of the injury development process: Running smooth, Discomfort, Niggle, Twinge, Persisting niggle, Non-responding niggle, Injury: short-term effect, Injury: long-term effect, and Career-ending injury. Each level is distinctively described across four categories of descriptors: physical description, outcome (effect on running and daily life), psychological description, and management (Fig. 1). Uniquely, we identified two clear categories of injury: lower- and higher-level injuries. Higher-level injuries reflect the vast majority of research to date (4), while lower-level injuries expand significantly on limited research (5). Our novel findings highlight a failure by previous research to consider lower-level injuries, potentially explaining the high variation in reported injury rates for injury surveillance (5) and the lack of consistent findings in identifying risk factors for RRIs (6), either missing the identification of significant risk factors, or identifying false risk factors. Clinicians and researchers should strive to monitor the development of all levels of RRIs, across all categories of descriptors, in order to better understand, manage and prevent RRIs.