Impact acceleration, kinematic and training-related risk factors of running Injuries: a prospective trial

Running-related injuries (RRIs) are a prevelant and challenging issue for runners and clinicians alike, fundamentally attributed to excessive overload on the body. The proposed aetiology of RRIs is vast, with several factors thought to be influential, including but not limited to a multifactorial myriad of impact loading, running technique, training practices and previous injury. This thesis applied a unique dual approach of risk factor identification by taking a retrospective and prospective vantage of RRIs on a large sample size of recreational runners. Retrospectively, high rates of acceleration at the sacrum were found to distinguish recently injured from never injured and acquired injury resistance runners. This is a promising finding for clinicians as accelerometer devices are readily usable outside of the laboratory, and thus may inform injury rehabilitation practices. Elsewhere, recently injured runners were found to exhibit riskier training practices such as high speeds, hill runs, changes of gradient and running with a niggle than their injury resistant counterparts, all factors which are easily modifiable for injury avoidance. Prospectively, risk factors for injury included a non-rearfoot strike pattern, lesser knee valgus, greater knee rotation, greater thorax drop to the contralateral side, marathon training, previous injury and frequent changes of footwear. Contrary to the hypothesis, baseline measures of impact loading and training were not found to predict injury. This suggests the need for more frequent assessments of internal and external loads. Although the findings from the retrospective and prospective studies differ, this highlights the value of both vantages, affording researchers and clinicians the opportunity to determine the potential causes and effects of RRIs with greater confidence than looking at either retrospective or prospective injury mechanisms in isolation. Future studies may benefit from a more continuous measure of loading, technique and training practices in order to further develop our understanding of RRI development