Research article - (2021)20, 204 - 215
DOI:
https://doi.org/10.52082/jssm.2021.204
Factors Associated With Lower Limb Injuries in Recreational Runners: A Cross-Sectional Survey Including Mental Aspects and Sleep Quality
Seyed Hamed Mousavi1,2,3,, Juha M Hijmans1, Hooman Minoonejad2, Reza Rajabi2, Johannes Zwerver3,4
1University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
2University of Tehran, Faculty of Physical Education and Sport Sciences, Department of Health and Sport Medicine, Tehran, Iran
3University of Groningen, University Medical Center Groningen, Center for Human Movement Science, The Netherlands
4Department of Sports Medicine, Gelderse Vallei Hospital, Ede, The Netherlands

Seyed Hamed Mousavi
✉ University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.
Email: s.h.mousavi@umcg.nl
Received: 05-06-2020 -- Accepted: 02-02-2021
Published (online): 05-03-2021

ABSTRACT

Knowledge about prevalence and etiology of running-related injuries (RRIs) is important to design effective RRI prevention programs. Mental aspects and sleep quality seem to be important potential risk factors, yet their association with RRIs needs to be elucidated. The aims of this study are to investigate the epidemiology of RRIs in recreational runners and the association of mental aspects, sleep, and other potential factors with RRIs. An internet-based questionnaire was sent to recreational runners recruited through social media, asking for personal and training characteristics, mental aspects (obsessive passion, motivation to exercise), sleep quality, perceived health, quality of life, foot arch type, and RRIs over the past six months. Data were analyzed descriptively and using logistic regression. Self-reported data from 804 questionnaires were analyzed. Twenty-five potential risk factors for RRIs were investigated. 54% of runners reported at least one RRI. The knee was the most-affected location (45%), followed by the lower leg (19%). Patellofemoral pain syndrome was the most-reported injury (20%), followed by medial tibial stress syndrome (17%). Obsessive passionate attitude (odds ratio (OR):1.35; 95% confidence interval (CI):1.18-1.54), motivation to exercise (OR:1.09; CI:1.03-1.15), and sleep quality (OR:1.23; CI:1.15-1.31) were associated with RRIs, as were perceived health (OR:0.96; CI:0.94-0.97), running over 20 km/week (OR:1.58; CI:1.04-2.42), overweight (OR:2.17; CI:1.41-3.34), pes planus (OR:1.80; CI:1.12-2.88), hard-surface running (OR:1.37; CI:1.17-1.59), running company (OR:1.65; CI:1.16-2.35), and following a training program (OR:1.51; CI:1.09-2.10). These factors together explained 30% of the variance in RRIs. A separate regression analysis showed that mental aspects and sleep quality explain 15% of the variance in RRIs. The association of mental aspects and sleep quality with RRIs adds new insights into the multifactorial etiology of RRIs. We therefore recommend that besides common risk factors for RRI, mental aspects and sleep be incorporated into the advice on prevention and management of RRIs.

Key words: Running, injury, etiology, epidemiology, injury prevention, rehabilitation

Key Points
  • 54% of runners reported at least one RRI.PFPS (20%) and MTSS (17%) were the most-reported injuries.
  • The knee (45%) and lower leg/Achilles (26%) were the most-reported injury locations.
  • More obsessive passionate attitude and poor sleep quality were associated with most of RRIs.
  • Lower perceived health and pes planus or cavus were also associated with most of RRIs.








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