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The most recent version of this article was published on 1 August 2007

Br J Sports Med. Published Online First: 1 May 2007. doi:10.1136/bjsm.2006.033548
Copyright © 2007 BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine.

Review Article

Incidence and determinants of lower extremity running injuries in long distance runners: A systematic review

Bobbie R.N. van Gent 1, Danny D. Siem 2, Marienke van Middelkoop 2*, Ton A.G. van Os 2, Sita S.M.A. Bierma-Zeinstra 2 and Bart B.W. Koes 2

1 Erasmus MC Rotterdam, Netherlands Antilles
2 Erasmus MC Rotterdam, Netherlands

* To whom correspondence should be addressed. E-mail: m.vanmiddelkoop{at}erasmusmc.nl.

Accepted 13 March 2007


Abstract

Background: Various studies have reported on the prevalence and incidence of running injuries occurring in long distance runners during training and/or races. Risk factors contributing to the occurrence of these injuries are reported in the medical literature. The purpose of this study was to present a systematic overview of literature on the incidence and associated potential risk factors of lower extremity running injuries in long distance runners.

Study design: Systematic review

Methods: An electronic database search was conducted using the PubMed-Medline database. Two observers independently assessed the quality of the studies and a best evidence synthesis was used to summarize the results.

Results: Of the selected studies, the incidence of lower extremity running injuries ranged from 19.4% to 79.3%. The most predominant site of these injuries was the knee. For many determinants only conflicting or limited evidence for associations with lower extremity running injuries was found. There is strong evidence that a long training distance per week in male runners and a history of previous injuries are risk factors for these injuries. There is also strong evidence that an increase in training distance per week is a protective factor for knee injuries.

Conclusions: The reported overall incidence numbers of lower extremity running injuries showed a large range. Strong evidence was found for a higher training distance per week in male runners and a history of previous injuries as a risk factor for male and female runners.

Key Words: incidence, injuries, lower extremity, running


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