Predicting Lower Leg Injuries in Runners

Is it possible to predict the risk of lower leg injuries in middle to long distance runners by examining well known risk factors and the quality of foot-core training?

The authors of “Predictive Effect of Well-Known Risk Factors and Foot-Core Training in Lower Limb Running-Related Injuries in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial,” tackled that, perhaps, provocative question in this new study.

The authors of the study, which was published online November 17, 2021, in The American Journal of Sports Medicine, found that predicting injuries is a hard nut to crack but, importantly, “The foot-core training was identified as a protective effect against lower limb running-related injuries.”

As to the predictive effects of well-known risk factors, the research team pretty much threw up their hands after looking at the data, concluding, “Running carries the risk of several types of running-related injuries, especially in the lower limbs. The variety of risk factors and the lack of strong evidence for several of these injury risks hinder the ability to draw assertive conclusions about them.”

To reach these conclusions, the team collected data from 118 middle- and long-distance recreational runners. The study subjects were randomly assigned to either an intervention or a control group (57 runners vs. 61 runners). Those runners in the intervention group took an 8-week foot-core training program that met three times a week.

After a baseline assessment, all the recreational runners were followed for a year. Predictor variables included age, sex, body mass index, years of running practice, number of races, training volume, training frequency, previous running-related injury, and the foot-core exercise training.

Overall, the researchers confirmed that foot-core training is a protective factor for running injuries (OR, 0.40; 95% CI, 0.15-0.98) while older age (OR, 1.07; 95% CI, 1.00-1.14) and higher training volume (OR, 1.02; 95% CI, 1.00-1.03) were risk factors.

“The foot-core training was identified as a protective effect against lower limb running-related injuries which can be negatively influenced by older age and higher weekly training volume. The predictive model showed that running-related injuries should be considered a multivariate entity owing to the interaction among several factors,” the authors wrote.

The study authors included Eneida Yuri Suda, Ph.D., Ricky Watari, Ph.D., Alessandra B. Matias, P.T., Ulisses T. Taddei, Ph.D., and Isabel C.N. Sacco, Ph.D., all of Universidade de São Paulo, São Paulo, Brazil.