Table 6

 Running/training related factors for lower extremity injury

DeterminantAuthorInjurySpecification of determinantOutcome (95% CI)
*Not-running injuries and running, but not lower extremity, injuries were included to establish the outcome.
†Represents adjusted OR or RR.
‡RRs were obtained from special subgroups in which information on distances run (miles) and time spent running (hours) was measured.
§RRs were calculated dividing the number of injured runners by the total number of runner-weeks accumulated (relative incidence ratios).
CI, confidence interval; F, female; m, months; M, male; OR, odds ratio; ref, reference; RR, relative risk; wk, week.
Training frequencyTaunton et al, 200319Overall injuries*F, running frequency 1 d/wkRR = 3.68 (1.08 to 12.30)†
Macera et al, 198914Lower extremity injuriesM, run 6 or 7 d/wkOR = 1.4 (0.8 to 2.5)†
Walter et al, 198920New injuries*F, run 6 or 7 d/wkOR = 0.5 (0.1 to 2.1)†
M, 3 d running/wk (ref 0–2)OR = 2.93 (1.27 to 6.20)†
M, 4 d running/wk (ref 0–2)OR = 2.49 (1.08 to 5.26)†
M, 5 d running/wk (ref 0–2)OR = 3.13 (1.38 to 6.46)†
M, 6 d running/wk (ref 0–2)OR = 3.66 (1.62 to 7.50)†
M, 7 d running/wk (ref 0–2)OR = 5.92 (2.49 to 12.75)†
F, 3 d running/wk (ref 0–2)OR = 0.59 (0.15 to 2.22)†
F, 4 d running/wk (ref 0–2)OR = 1.91 (0.56 to 5.65)†
F, 5 d running/wk (ref 0–2)OR = 1.25 (0.36 to 3.82)†
F, 6 d running/wk (ref 0–2)OR = 2.11 (0.62 to 6.12)†
F, 7 d running/wk (ref 0–2)OR = 5.50 (1.44 to 17.39)†
M, running year roundOR = 1.64 (1.12 to 2.35)†
F, running year roundOR = 2.00 (1.01 to 3.75)†
Jakobsen et al, 198922Overall injuriesFewer months trainingp>0.05
Fewer h/wkp<0.05
Training alterationSatterthwaite et al, 199917Stiffness and/or pain in front thighIncrease in training of 1 d/wkOR = 1.19 (1.05 to 1.34)†
Stiffness and/or pain in hamstringIncrease in training of 10 km/wkOR = 1.07 (1.02 to 1.13)†
Stiffness and/or pain in kneeDecrease in training of 10 km/wkOR = 1.13 (1.04 to 1.23)†
Wen et al, 199821Overall injuries*Increased h/wk (miles)‡RR = 0.57 (0.42 to 0.78)†
Increased h/wk (h)‡RR = 0.58 (0.45 to 0.73)†
Knee injuriesIncreased miles/wk (miles)‡RR = 0.90 (0.82 to 0.99)†
Increased h/wk (h)‡RR = 0.49 (0.30 to 0.80)†
Foot injuriesIncreased h/wk (miles)‡RR = 0.31 (0.15 to 0.63)†
Increased h/wk (h)‡RR = 0.21 (0.10 to 0.44)†
Macera et al, 199123Lower extremity musculoskeletal problemsM, increased mileage in month before the raceOR = 1.1 (0.7 to 1.8)†
F, increased mileage in month before the raceOR = 1.6 (0.6 to 4.6)†
Training distanceMacera et al, 198914Lower extremity injuriesM, 16.0–31.8 km/wk for preceding 3 mOR = 1.6 (0.8 to 3.0)†
M, 32.0–47.8 km/wk for preceding 3 mOR = 1.6 (0.8 to 3.2)†
M, 48.0–63.8 km/wk for preceding 3 mOR = 1.7 (0.8 to 3.6)†
M, 64.0+ km/wk for preceding 3 mOR = 2.9 (1.1 to 7.5)†
F, 16.0–31.8 km/wk for preceding 3 mOR = 2.1 (0.5 to 9.7)†
F, 32.0–47.8 km/wk for preceding 3 mOR = 4.2 (0.8 to 21.7)†
F, 48.0–63.4 km/wk for preceding 3 mOR = 7.4 (0.9 to 60.3)†
F, 64.0+ km/wk for preceding 3 mOR = 3.0 (0.3 to 27.5)†
Walter et al, 198920New injuries*M, longest run each wk >8 kmOR = 2.49 (1.64 to 3.71)†
F, longest run each wk >8 kmOR = 1.78 (0.99 to 3.13)†
M, 16–30.4 km/wk (ref <16)OR = 0.88 (0.40 to 1.58)†
M, 32–46.4 km/wk (ref <16)OR = 1.36 (0.77 to 2.35)†
M, 48–62.4 km/wk (ref <16)OR = 1.27 (0.70 to 2.27)†
M, ⩾64 km/wk (ref <16)OR = 2.22 (1.30 to 3.68)†
F, 16–30.4 km/wk (ref <16)OR = 0.98 (0.43 to 2.21)†
F, 32–46.4 km/wk (ref <16)OR = 1.37 (0.58 to 3.23)†
F, 48–62.4 km/wk (ref <16)OR = 1.97 (0.97 to 4.80)†
F, ⩾64 km/wk (ref <16)OR = 3.42 (1.42 to 7.85)†
Kretsch et al, 198411Overall injuries*<60 km/wk in 3 m before marathonp<0.025
Jakobsen et al, 198922Overall injuriesMore km/wkp<0.01
Race distanceMacera et al, 199123Lower extremity musculoskeletal problemsM, marathonOR = 1.7 (1.0 to 2.8)†
F, marathonOR = 4.7 (1.2 to 17.4)†
ExperienceSatterthwaite et al, 199917Stiffness and/or pain in hamstringParticipation in marathon for first timeOR = 1.55 (1.08 to 2.22)†
Stiffness and/or pain in kneeParticipation in marathon for first timeOR = 1.66 (1.16 to 2.38)†
Wen et al, 199821Overall injuries*Higher experience§RR = 1.88 (1.16 to 3.05)†
Foot injuriesHigher experience§RR = 1.09 (1.03 to 1.15)†
Macera et al, 198914Lower extremity injuriesM, 0–2 years running experienceOR = 2.2 (1.5 to 3.3)†
M, 10+ years running experienceOR = 1.2 (0.8 to 1.9)†
F, 0–2 years running experienceOR = 1.4 (0.3 to 6.4)†
F, 10+ years running experienceOR = 1.7 (0.5 to 6.1)†
M, run a marathon during preceding 12 mOR = 1.3 (0.7 to 2.2)†
F, run a marathon during preceding 12 mOR = 4.3 (0.7 to 27.0)†
Nicholl & Williams, 198215Overall injuries*Any previous experience of running a half and/or a full marathonp<0.05
Jakobsen et al, 198922Overall injuries<5 Years experiencep>0.05
Nicholl & Williams, 198225Overall injuries*No previous experience of running a half and/or a full marathon (half marathon)OR = 1.66 (0.99 to 2.80)
No previous experience of running a half and/or a full marathon (marathon)OR = 1.75 (1.10 to 2.81)
Warm upMacera et al, 198914Lower extremity injuriesM, stretch before runningOR = 1.1 (0.8 to 5.9)
F, stretch before runningOR = 1.6 (0.7 to 3.5)
Walter et al, 198920New injuries*M, usually using stretching (ref always)OR = 0.80 (0.55 to 1.17)†
M, sometimes using stretching (ref always)OR = 1.56 (1.10 to 2.21)†
M, never using stretching (ref always)OR = 0.87 (0.50 to 1.57)†
M, usually using warm up (ref always)OR = 1.03 (0.73 to 1.44)†
M, sometimes using warm up (ref always)OR = 1.30 (0.87 to 1.93)†
M, never using warm up (ref always)OR = 0.37 (0.19 to 0.81)†
F, usually using stretching (ref always)OR = 0.95 (0.48 to 1.96)†
F Sometimes using stretching (ref always)OR = 1.78 (0.91 to 3.53)†
F, never using stretching (ref always)OR = 0.85 (0.27 to 3.22)†
F, usually using warm up (ref always)OR = 0.82 (0.42 to 1.60)†
F, sometimes using warm up (ref always)OR = 0.95 (0.47 to 1.96)†
F, never using warm up (ref always)OR = 0.55 (0.22 to 1.51)†
Circumstances of trainingMacera et al, 198914Lower extremity injuriesM, hilly terrainOR = 1.1 (0.7 to 1.6)
M, asphalt surfaceOR = 1.2 (0.8 to 1.7)
M, run in darkOR = 0.9 (0.6 to 1.3)
M, run in morningOR = 1.1 (0.7 to 1.7)
F, hilly terrainOR = 1.0 (0.4 to 2.5)
F, asphalt surfaceOR = 1.8 (0.8 to 4.2)
F, run in darkOR = 1.0 (0.4 to 2.7)
F, run in morningOR = 1.4 (0.6 to 3.2)
M, concrete surfaceOR = 1.4 (0.8 to 2.5)†
M, concrete surfaceOR = 5.6 (1.1 to 29.3)†
Type of runnerWalter et al, 198920New injuries*M, recreational runner (ref fitness runner)OR = 1.18 (0.84 to 1.66)†
M, competitive runner (ref fitness runner)OR = 1.73 (1.21 to 2.49)†
F, recreational runner (ref fitness runner)OR = 0.71 (0.37 to 1.40)†
F, competitive runner (ref fitness runner)OR = 1.93 (0.97 to 3.89)†
Shoe useTaunton et al, 200319Overall injuries*M, running shoe age 4–6 mRR = 0.36 (0.15 to 0.83)†
New injuriesF, running shoe age 4–6 mRR = 1.74 (1.10 to 2.98)†
F, running shoe age 1–3 mRR = 0.61 (0.38 to 0.99)†
Wen et al, 199821Shin injuriesHigher number of shoes (h)‡RR = 6.91 (1.36 to 35.15)†
PaceWen et al, 199821Shin injuriesMore intervals§RR = 14.89 (0.50 to 147.33)†
Jakobsen et al, 198922Overall injuriesLower pacep = 0.06