ORIGINAL ARTICLE  SPORT INJURIES AND REHABILITATION 

The Journal of Sports Medicine and Physical Fitness 2023 August;63(8):934-40

DOI: 10.23736/S0022-4707.23.14787-6

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Risk factors associated with gradual onset running-related injuries in 5770 ultramarathon race entrants - SAFER XXXII

Kobus SLABBER ^{1, 2}, Martin P. SCHWELLNUS ^{2, 3} ✉, Dimakatso RAMAGOLE ¹, Jeremy BOULTER ⁴, Marlise DYER ², Esme JORDAAN ^{5, 6}, Nicola SEWRY ^{2, 3}

¹ Section of Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; ² Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Healthy Sciences, University of Pretoria, Pretoria, South Africa; ³ IOC Research Centre of South Africa, Pretoria, South Africa; ⁴ Comrades Marathon, Pietermaritzburg, South Africa; ⁵ Biostatistics Unit, South African Medical Research Council (SAMRC), Cape Town, South Africa; ⁶ Statistics and Population Studies, University of the Western Cape, Cape Town, South Africa

BACKGROUND: There is limited evidence available on contributing factors for gradual onset running-related injuries (GORRIs) in ultramarathon runners. The aim was to determine if selected risk factors were associated with a history of GORRIs in 90-km ultramarathon race entrants.
METHODS: Descriptive cross-sectional study. GORRI and medical data using an online pre-race medical screening tool was collected from 5770 consenting race entrants from the 2018 90-km Comrades Marathon. Selected risk factors associated with 12-months history of GORRIs (age, sex, training, chronic diseases and allergies) were analyzed using a multiple model (Poisson regression). Prevalence and prevalence ratios (PR, 95% CIs) are reported.
RESULTS: The overall 12-month prevalence of GORRIs was 11.6% (95% CI: 10.8-12.5) and this was higher in females versus males (PR=1.6; 1.4-1.9) (P<0.0001). Novel independent risk factors associated with a history of GORRIs were: history of chronic disease (PR=1.3; P=0.0063); history of allergies (PR=1.7 increased risk for every disease; P<0.0001); fewer training sessions/week (PR=0.8 decreased risk for every two additional training sessions per week; P=0.0005); and increased number of years as a recreational runner (PR=1.1 increased risk per 5 years of running; P=0.0158).
CONCLUSIONS: There is a complex interaction between the internal and external risk factors associated with GORRIs in 90-km distance runners. These data can inform injury prevention programs targeted at subgroups of ultradistance runners.

KEY WORDS: Athletic injuries; Marathon running; Chronic disease; Hypersensitivity