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Hip and core exercise programme prevents running-related overuse injuries in adult novice recreational runners: a three-arm randomised controlled trial (Run RCT)
  1. Mari Leppänen1,2,
  2. Janne Viiala1,
  3. Piia Kaikkonen1,
  4. Kari Tokola3,
  5. Tommi Vasankari3,4,
  6. Benno M Nigg5,
  7. Tron Krosshaug6,
  8. Penny Werthner7,
  9. Jari Parkkari1,8,
  10. Kati Pasanen1,5,7,9,10
  1. 1Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
  2. 2Tampere University Hospital, Tampere, Finland
  3. 3UKK Institute, Tampere, Finland
  4. 4Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
  5. 5Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  6. 6Oslo Sports Trauma Reseach Center, Norwegian School of Sports Sciences, Oslo, Norway
  7. 7Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  8. 8Faculty of Sports and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
  9. 9Integrative Neuromuscular Sport Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  10. 10Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  1. Correspondence to Dr Mari Leppänen, Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Pirkanmaa, Finland; mari.leppanen{at}ukkinstituutti.fi

Abstract

Objective This study aims to investigate the efficacy of two exercise interventions in reducing lower extremity (LE) injuries in novice recreational runners.

Methods Novice runners (245 female, 80 male) were randomised into hip and core (n=108), ankle and foot (n=111) or control (n=106) groups. Interventions were completed before running and included exercise programmes focusing on either (1) hip and core or (2) ankle and foot muscles. The control group performed static stretching exercises. All groups were supervised by a physiotherapist and performed the same running programme. Injuries and running exposure were registered using weekly questionnaires during the 24-week study. Primary outcome was running-related LE injury.

Results The incidence of LE injuries was lower in the hip and core group compared with the control group (HR 0.66; 95% CI 0.45 to 0.97). The average weekly prevalence of overuse injuries was 39% lower (prevalence rate ratio, PRR 0.61, 95% CI 0.39 to 0.96), and the prevalence of substantial overuse injuries was 52% lower (PRR 0.48, 95% CI 0.27 to 0.90) in the hip and core group compared with the control group. No significant difference was observed between the ankle and foot group and control group in the prevalence of overuse injuries. A higher incidence of acute injuries was observed in the ankle and foot group compared with the control group (HR 3.60, 95% CI 1.20 to 10.86).

Conclusion A physiotherapist-guided hip and core-focused exercise programme was effective in preventing LE injuries in novice recreational runners. The ankle and foot programme did not reduce LE injuries and did not protect against acute LE injuries when compared with static stretching.

  • Running
  • Sporting injuries
  • Randomized Controlled Trial
  • Recreation
  • Accident Prevention

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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Footnotes

  • JP and KP are joint senior authors.

  • X @mari_leppanen, @KatiPasanen

  • Contributors KP and PJ were responsible for the conception and design of the study with inputs from ML, PK, TV, BMN, TK and PW. ML, TV, PJ and KP acquired funding for the project. KP designed the intervention programmes with inputs from ML and PJ. PK designed the running training programme. ML coordinated the study. ML was responsible for data collection, management and data preparation. JV participated in data preparation. KT and ML conducted the data analyses. ML wrote the first draft of the paper with input from JV. All authors contributed to the final manuscript and accepted the final version of the manuscript. ML is the guarantor.

  • Funding This study was funded by the Ministry of Education and Culture, Finland, and by the State funding for university-level health research, Tampere University Hospital, Wellbeing services county of Pirkanmaa (Project No. 9AB055).

  • Disclaimer The funders had no role in planning, execution or reporting of the study.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.