Paper
Risk Factors for Running-Related Injury in High School and Collegiate Cross Country Runners: A Systematic Review.
Published Nov 16, 2023 · Mikel R. Joachim, Matthew L Kuik, B. Krabak
The Journal of orthopaedic and sports physical therapy
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Abstract
OBJECTIVE: To summarize and describe risk factors for running-related injuries (RRI) among high school and collegiate cross country runners. DESIGN: Descriptive systematic review. LITERATURE SEARCH: Four databases (Scopus, SPORTDiscus, CINAHL, Cochrane) were searched from inception to August 2023. STUDY SELECTION CRITERIA: Studies assessing RRI risk factors in high school or collegiate runners using a prospective design with at least one season of follow-up were included. DATA SYNTHESIS: Results across each study for a given risk factor were summarized and described. The NOS and GRADE frameworks were used to evaluate quality of each study and certainty of evidence for each risk factor. RESULTS: Twenty-four studies were included. Overall, study quality and certainty of evidence was low to moderate. Females or runners with prior RRI or increased RED-S risk factors were most at-risk for RRI, as were runners with a quadriceps angle >20° and lower step rates. Runners with weaker thigh muscle groups had increased risk of anterior knee pain. Certainty in evidence regarding training, sleep, and specialization was low, but suggests changes in training volume, poorer sleep, and increased specialization may increase RRI risk. CONCLUSION: The strongest predictors of RRI in high school and collegiate cross country runners are sex and RRI history, which are non-modifiable. There is moderate certainty that increased RED-S risk factors increase RRI risk, particularly bone stress injuries. There is limited evidence that changes in training and sleep quality influence RRI risk, but these are modifiable factors that should be studied further in this population.
Sex and prior running-related injuries are the strongest predictors of running-related injuries in high school and collegiate cross country runners, while increased RED-S risk factors and poorer sleep quality may also increase the risk.
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