Age, Running Biomechanics, And The Incidence Of Running-related Injuries: A 1-year Prospective Cohort Study

Running is associated with countless health benefits. However, running is also related to running-related injuries (RRI) at an incidence of up to 79% per year in runners. However, there is a significant gap in the research evidence describing the association between basic biomechanical parameters and the incidence of RRI. In addition, previous studies have usually only described which age groups had the highest incidence of RRI. PURPOSE: To determine the association between age, running biomechanics, and incidence of RRI. METHODS: Our 1-year prospective study involved 737 recreational runners (41% females; 59% males) ranging in age from 18-65. At baseline testing, runners completed activity questionnaires and underwent a 3-D biomechanical analysis at their self-selected speed in neutral running shoes. Subsequently, runners self-reported RRI for a 1-year follow-up using a standardized online questionnaire. Associations between age, stride length, step frequency, and RRI (also injury region) were analyzed using a multivariable logistic regression controlling for sex, height, and training volume. RESULTS: The incidence of RRI during the 1-year follow-up was 28.9%. The highest incidence of RRI was in the calf (16.5%), foot (15.4%), lower back (12.2%), and hip (11%) regions. A logistic regression model for total RRI (OR = 1.040, p < 0.001) and sub-anatomic regions (OR = 1.034-1.072, p ≤ 0.003) showed that age was the most significant predictor of RRI (Fig 1). With each increase in one year of life, the risk of RRI in recreational runners increased by an average of 5% (3.4-7.2%). Stride length and step frequency were not associated with the incidence of RRI except for the hip region (step frequency: OR = 0.972, p = 0.035). CONCLUSIONS: Older age runners had the highest risk of RRI. Lower step frequency was associated with a lower risk of hip RRI. FIG 1 - Predictions derived from logistic regression, controlling for sex, height, training volume, step frequency, and stride length. European Union and Ministry of Education, Youth and Sports of the Czech Republic, grant number CZ.02.1.01/0.0/0.0/16_019/0000798 Program 4 Healthy Aging in Industrial Environment, European Union under the LERCO project number CZ.10.03.01/00/22_003/0000003 via the Operational Program Just Transition