Intrinsic risk factors for injury in the youth runner
| Topic | Statement | SORT rating |
| ALL INJURIES | ||
| Sex | Evidence strongly supports girls are at higher risk for running related injury and greater time loss from injury than boys. | A |
| Previous Injury | Evidence strongly supports prior injury as risk factor for future injury in the lower extremity in adolescent runners. | A |
| Height and Weight | Evidence does not support height or weight as risk factors for injury in adolescent cross country runners. There are no studies assessing how the change in height and weight impacts injury in the pre-adolescent youth runner. | B |
| Body mass index (BMI) | Evidence supports low-normal BMI as a risk factor for stress fracture in adolescent girls. Higher BMI may be a risk factor for medial tibial stress syndrome in adolescent cross country runners. There are no studies assessing how the change in BMI impacts injury in the pre- adolescent youth runner. | B |
| Age | To date, there are no consistent data addressing either age or developmental stage as a risk factor for injury among youth runners. | B |
| Alignment and Strength | Limited evidence supports quadriceps angle>20 degrees, muscle weakness (hip abductors, knee extensor and knee flexors), and leg-length inequality (boys>1.5 cm) as risk factors for injury in youth runners. | B |
| Alignment and Strength | Exercise-based programmes containing elements of high intensity neuromuscular training, jumping/plyometrics, and balance training may help reduce injury risk in youth runners, but prospective studies are needed. | C |
| BONE HEALTH | ||
| Bone Stress Injury | Limited evidence supports primary amenorrhea, BMI<19 kg/m2, prior participation in gymnastics or dance and prior fracture as risk factors for bone stress injury in female adolescent runners. | B |
| Low BMD | Limited evidence supports menstrual dysfunction, low BMI, prior bone stress injury or fracture, and longer participation in endurance running as risk factors for low BMD in female adolescent runner. | B |
| Low BMD | Limited evidence for risk factors for low BMD in male runners include: low BMI, prior bone stress injury, low dairy intake, running>30 miles per week, and the belief that being thinner leads to faster running performances. | B |
| Menstrual Dysfunction | Limited evidence supports primary amenorrhea and menstrual dysfunction as risk factors for bone stress injury and low BMD in female adolescent runners. | B |
BMD, bone mineral density; BMI, body mass index; SORT, strength of recommendation taxonomy.