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The epidemiology and associated risk factors for muscle strain injuries in endurance athletes

Dissertation (MSc Sports Science (Biokinetics))--University of Pretoria, 2023.

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Other Authors: Nolte, Kim
Format: Thesis
Language:English
Published: University of Pretoria 2023
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access_status_str Open Access
author2 Nolte, Kim
author_browse Nolte, Kim
author_facet Nolte, Kim
collection Thesis
dc_rights_str_mv © 2022 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria.
description Dissertation (MSc Sports Science (Biokinetics))--University of Pretoria, 2023.
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institution University of Pretoria (South Africa)
language English
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provenance_str_mv Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository
publishDate 2023
publishDateRange 2023
publishDateSort 2023
publisher University of Pretoria
publisherStr University of Pretoria
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spelling oai:repository.up.ac.za:2263/90399 The epidemiology and associated risk factors for muscle strain injuries in endurance athletes Nolte, Kim lize@kroonbio.co.za Wood, Paola Silvia Schwellnus, Martin Peter Kroon, Lize UCTD Distance running Muscle strains Two Oceans Marathon Running related injuries Muscular injuries Dissertation (MSc Sports Science (Biokinetics))--University of Pretoria, 2023. Long-distance running continues to increase in popularity owing to its easy accessibility and people’s growing interest in disease prevention. Over the last 25 years, increasing participation in long-distance has been observed. The incidence of running injuries, especially to the lower extremities, has increased as the number of participants in long-distance running increased. Lower extremity muscle injuries (MInj) are multifactorial in nature and certain associated risk factors have been identified in long-distance endurance athletes as potential causes. This study investigated the epidemiology and risk factors associated with lower extremity MInj in long-distance runners participating in the Two Ocean Marathon (2012-2015). Over 4 years 106 743 runners entered the Two Oceans Marathon; 64 740 of the total number entered the 21.1 km and 42 003 runners the 56 km race. In this descriptive cross-sectional observational study of the Two Oceans Marathon (2012 – 2015), 76 654 consenting runners completed an online pre-race medical screening questionnaire of which 62 708 (58.8% of all entrants) were included in the study. A total of 2110 (3.4%) runners reported lower extremity MInj in the last 12 months before race entry. Using univariate and multi-regression analyses, the following categories of factors associated with lower extremity MInj were explored: runner demographics (sex, age, race distance), training/racing history, history of existing chronic disease and allergies. The crude unadjusted risk ratio {prevalence ratios (PRs) and 95% confidence intervals (CIs)} of lower extremity MInj were calculated separately for each risk factor and were reported for all the results. Independent risk factors associated with MInj were explored in the multi-regression analyses and reported as PRs with 95% CI. A main finding of this study was a retrospective annual incidence of 3.4% regarding lower extremity MInj in the lower limbs (n=2110). The anatomical sites at which runners reported most lower extremity MInj (% of all lower extremity MINJ) were the calves (35.4%), followed by the hamstrings (27.4%) and the hips/gluteals (22.8%). Of all lower extremity MInj that reported severity grading (n=1869) 56.6% were in the severe category (grade III-IV) of which 18.7% were severe enough to prevent training or competing. Just less than half (45.5%) reported symptoms of the lower extremity MInj lasting longer than 7 months. The most frequently reported treatment modalities were rest (67.8%) and physiotherapy (66.8%), followed by stretches (50.2%) and strength exercises (42.4%). When comparing race entrants who reported a lower extremity MInj to those who did not (control group) the following factors were associated with a higher prevalence of lower extremity MInj (univariate analyses): male sex (PR=1.27; p<0.0001), older age (> 41 years PR=2.76; p<0.0001), and longer race distance (56 km vs. 21.1 km)(PR=2.09; p<0.0001), increased average weekly training/racing frequency (PR=1.10 for every 1-unit increase, p<0.0001), and increased weekly training/running distance (PR=1.04 for every 5-unit increase, p<0.0001). From the multi-regression analyses, novel independent risk factors associated with lower extremity MInj were increased years of being a recreational runner (PR=1.16 for every 5-year increase, p<0.0001) a higher chronic disease composite score (PR=2.37 for every 2-unit increase, p<0.0001), and a history of allergies (PR=2.08; p<0.0001). To our knowledge the main strength of our study is that it is the largest study conducted on the epidemiology, clinical characteristics and treatment of lower extremity MInj in recreational long-distance runners. In addition, the overall response rate was 58.8% (% of all runner entrants) highlighting the good response rate in our study. Novel independent risk factors associated with lower extremity MInj could be explored using multiple regression analyses. This is the first study to report such independent risk factors. Information gathered in this study enables clinicians and researchers to evaluate potential risk factors and institute appropriate treatment options to better and improve related interventions for lower extremity MInj in long-distance runners. A prospective cohort study design could be used for future studies to establish the cause-and-effect relationship. Physiology MSc Sports Science (Biokinetics) Unrestricted 2023-04-12T12:09:57Z 2023-04-12T12:09:57Z 2023-09-01 2023 Dissertation * S2023 http://hdl.handle.net/2263/90399 DOI: https://doi.org/10.25403/UPresearchdata.22647463.v1 10.25403/UPresearchdata.22647463 en © 2022 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria
spellingShingle UCTD
Distance running
Muscle strains
Two Oceans Marathon
Running related injuries
Muscular injuries
The epidemiology and associated risk factors for muscle strain injuries in endurance athletes
title The epidemiology and associated risk factors for muscle strain injuries in endurance athletes
title_full The epidemiology and associated risk factors for muscle strain injuries in endurance athletes
title_fullStr The epidemiology and associated risk factors for muscle strain injuries in endurance athletes
title_full_unstemmed The epidemiology and associated risk factors for muscle strain injuries in endurance athletes
title_short The epidemiology and associated risk factors for muscle strain injuries in endurance athletes
title_sort epidemiology and associated risk factors for muscle strain injuries in endurance athletes
topic UCTD
Distance running
Muscle strains
Two Oceans Marathon
Running related injuries
Muscular injuries
url http://hdl.handle.net/2263/90399