Background Although running is one of the most popular sports in the world, there are few studies that describe the relationships between anatomic characteristics of lower limb in this population.

Objective To systematically review studies aimed at testing the association between lower limb alignment and running-related injuries.

Design A systematic review.

Setting The articles are related with long-distance runners without restriction of competitive level.

Interventions We performed a search on MEDLINE, LILACS and SciELO. The keywords and operands used were: anatomical factors OR alignment OR Q angle OR foot structure OR lower limb injuries AND running. There was no restriction with regards to the year of publication.

Main outcome measurements The lower limb alignment related with the musculoskeletal injuries in runners.

Results Of the 1919 studies found, 973 were excluded by the title, 686 were excluded after reading the abstract and 287 were excluded after reading the original text. Eight articles were considered eligible and therefore were included. The main lower limb alignment characteristics related with the musculoskeletal injuries in runners found were: the Q angle greater than 20°, the navicular drop exceeding 5 mm, excessive pronation of the subtalar joint, the length discrepancy between the lower limbs (more than 10 mm), and the height of the medial longitudinal arch (dorsum foot height/truncated foot length ratio, high arch >0.356 and low arch <0.275). These variables as those most associated with the Patellar Tendinitis, Iliotibial Band Syndrome and the Plantar Fasciitis.

Conclusion The main lower limb alignment characteristics related with running-related injuries found were: the Q angle greater than 20°, the navicular drop exceeding 5 mm, excessive pronation of the subtalar, the length discrepancy between the lower limbs, and the height of the medial longitudinal arch.