Factors related to the incidence of running injuries. A review.

The term incidence is interpreted in many different ways in the literature. Running injury epidemiology should include denominator-based incidence rates, in which the number of new injuries observed during 1 year is related to the population of runners at risk. In 10 studies with denominator-based incidences selected from the literature, the annual incidence rates of injured runners vary from 24 to 65%. Comparison of denominator-based incidence rates from different studies requires a discussion of the denominator and of the numerator; i.e. the study population and the definition of running injury. Injury definitions differ from one study to another. Study populations are particular subgroups of the total running population and they differ from one study to another. Subgroups may differ in origin: volunteers, runners from a mailing list or entrants of a road race. Incidence rates are higher among supervised volunteers than among listed runners, and higher among both these groups than among race-entrants. The choice from the universe of the running population and the used injury definition are methodological issues. Incidence is dependently associated with the prevalence of predisposing running injury factors. There is consistent epidemiological support for the role of a few aetiological factors; i.e. higher mileage per week, previous running injury, higher running speed and lesser running experience. Higher mileage per week is probably the strongest predictor. In the selected injury studies, mileage per week differs from one study population to another. Differences in mileage per week do not explain differences in incidence rate between these studies. In conclusion, caution must be taken when comparing annual incidence rates of different studies. Methodological issues are at least as important as aetiological factors. Study populations may refer to different selections of the universe of the running population. The lengths of observation periods and 'running injury' definitions may differ from one study to another.