Rev. bras. ortop. vol.50 número5

r e v b r a s o r t o p . 2015;50(5):537–540

w w w . r b o . o r g . b r

Original

article

Injuries

among

amateur

runners

夽

Mariana

Korbage

de

Araujo,

Ricardo

Maletta

Baeza

_,

_Sandro

_Ricardo

_Benites

_Zalada,

Pedro

Benzam

Rodrigues

Alves,

Carlos

Augusto

de

Mattos

OrthopedicsandTraumatologyService,HospitaleMaternidadeCelsoPierro,PontifíciaUniversidadeCatólicadeCampinas (PUC-Campinas),Campinas,SP,Brazil

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Articlehistory:

Received10August2014 Accepted7October2014

Availableonline8September2015

Keywords:

Running/injuries Traumainathletes Exercise

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b

s

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t

Objectives: Todeterminethefrequencyandseverityofinjuriesthataffectamateurrunners.

Methods:Thisstudywasconductedbymeansofaquestionnaireappliedto204amateur runners.Individualswhowereundertheageof18yearsandthosewhowereunpracticed runnerswereexcluded.Thedatagatheredcomprisedthenumber,type,siteanddegreeof severityoftheinjuriesandtheindividuals’ageandsex.

Results:Itwasobservedthatmaleathletespredominated.Themeanagewas32.6±9.3years witharangefrom18to68years,andtheinjurieswereclassifiedasmild,keepingtheathlete awayfrompracticingrunningforfewerthaneightdays.Sprains,blistersandabrasionswere themostfrequentinjuries,locatedmostoftenonthelowerlimbsandpredominantlyon thefeet.

Conclusion: Inpracticingrunning,sprains,blistersandabrasionsoccurfrequently,butare mildinjuries.Theymostlyaffectthelowerlimbs.

©2015SociedadeBrasileiradeOrtopediaeTraumatologia.PublishedbyElsevierEditora Ltda.Allrightsreserved.

Lesões

em

praticantes

amadores

de

corrida

Palavras-chave:

Corrida/lesões

Traumatismosematletas Exercício

r

e

s

u

m

o

Objetivos:Verificar a frequência e a gravidade das lesões que acometem praticantes amadoresdecorrida.

Métodos:O estudo foi conduzido por meio de questionário aplicado a 204 corredores amadores.Foramexcluídosdoestudomenoresdeidadeepessoassempráticadecorrida. Número,tipo,topografiaegraudegravidadedaslesões,alémdeidadeesexo,foramos dadoscoletados.

夽

WorkperformedintheOrthopedicsandTraumatologyService,HospitaleMaternidadeCelsoPierro,PontifíciaUniversidadeCatólica deCampinas,Campinas,SP,Brazil.

∗ _{Correspondingauthor.}

E-mail:[email protected](R.M.Baeza).

http://dx.doi.org/10.1016/j.rboe.2015.08.012

538

Resultados: Observou-sepredomíniodeatletasdosexomasculino,idademédiade32,6±9,3 anoscomvariac¸ãode18a68anos.Aslesõesforamclassificadascomoleveseafastaramo atletadapráticadecorridapormenosdeoitodias.Entorses,lesõesbolhosaseescoriac¸ões foramaslesõesmaisfrequentes,localizadasmaisfrequentementenosmembrosinferiores, compredomínionospés.

Conclusão: Napráticadecorrida,entorses,lesõesbolhosaseescoriac¸õessãofrequentes, porémsãoleveseacometemmaisosmembrosinferiores.

©2015SociedadeBrasileiradeOrtopediaeTraumatologia.PublicadoporElsevier EditoraLtda.Todososdireitosreservados.

Introduction

Theimportanceofphysicalactivitywithinthefieldof health-carehasbeenincreasing.Thishasbeenjustifiedbythelarge amountofevidenceshowingthatregularexercisepractices havebeneficialeffectsonindividuals,asafactorfor improv-ingtheirhealthandqualityoflife.Itisknownthatregular practicingofrunningisassociatedwithimprovementofblood glucose levels, cholesteroland cholesterolfraction concen-trationsandleanmassandbonepercentages,amongother benefits.1

However,practicingsportsactivitiesexposesindividualsto physicalinjuries,whichmaysometimesbeevengreaterthan the injuriesamong workers who perform repetitive move-ments.Forexample,thiscanoccuramongsoccerplayersand suchinjurieskeeptheseplayersawayfromtheirsportforafew days.2_{BennellandCrossley}3_{demonstratedthatexercisingto} exhaustion,withoutguidanceorwithinadequateguidance, maycontributetowardahigherinjuryrate.

Runningmaygiveriseparticularlytoknee,ankleandfoot injuries.Thesemayaffectedupto83%ofamateuror com-petitiverunnersandthusimpairtheirqualityoflife,either temporarilyordefinitively.4–8

Somestudieshavesoughttoascertaintheepidemiology ofsports injuriesinorder to providebetter indicationsfor safersports practicesforgivenpopulationsand todevelop injurypreventionstrategies.Higherbodymassindex, pres-ence previous injuries, use of improper footwear with an inappropriatelylowheelandafallennavicularboneinwomen havebeen foundto bepredictive factors forinjurieswhile running.6,9,10

TheclassicaldefinitionofinjurieswaspresentedbyDvorak andJunge10_{:aninjuryisaneventthatoccursduringtraining} oramatchthatcausesthesportsplayertobeabsentfromthe nexttrainingsessionormatch.Inthiscase,theinjuryisthen followedbyaninvestigationinordertomakeananatomical diagnosisandprovidetreatment.

Injuryclassificationaccordingtoseverityisbasedonthe lengthofabsence from sportspractice.Absences ofoneto sevendaysaretakentobemild;eightto28days,moderate; andgreaterthan28days,severe.11

Theobjectiveofthisstudywastoascertainthefrequency andseverityofinjuriesthataffectindividualswhoare ama-teurrunners.

Materials

and

methods

Thisstudywasapprovedbyourinstitution’smedicalethics committeeunderthenumber20817613.8.0000.5481and the approval number 407.082.Itwas conductedbymeans ofa questionnairethatwasappliedtoindividualsfrequentinga publicparkthathastworunningtracks:onethatiscemented andtheotherthatisirregularwithsmallstones.

Theindividualsincludedinthestudywereadultamateur runners,andthoseundertheageof18yearswereexcluded.

Throughthequestionnaire,thefollowingdatawere gath-ered:age,sex,schoolinglevel,numberoftrainingsessionsper weekandmeandurationoftrainingperweek,lengthoftime forwhichtheindividualhadbeenarunner,anyoccurrences ofinjurieswhilerunning,locationoftheinjury,anyneedto taketimeoffrunningandthelengthofsuchabsences.

The severity of the injuries was classified as described byCarteretal.,12_{inaccordancewiththelengthofabsence} fromrunningaftertheinjuryreportedbytherunner.These absenceswereclassifiedasmild(onetosevendays),moderate (eightto28days)orsevere(greaterthan28days).8

Results

Interviews were conductedwith 204amateur athletes: 117 males (57.4%)and 87 females(42.6%). Their meanage was 32.6±9.3years,witharangefrom18to68years.

Noneoftheintervieweeswereilliterate.Eleven(5.4%)had not completedhigh school education;35 (17.1%)had com-pletedhighschooleducation;78(38.3%)hadstartedbutnot completedauniversity-levelcourse;and80(39.2%)had com-pletedauniversity-levelcourse.

Theseathletesreportedpracticingrunningtwiceaweekin 22.6%ofthecases(46);fromthreetofivetimesaweekin65.6% (134);andmorethanfivetimesaweekin11.8%(24).For32.5% oftheathletes(66),theirtrainingwaseveryday,witha dura-tionoflessthan1hand30min;for53.8%(110),itsduration wasfrom1hand30minto3h;andfor13.7%(28),itsduration wasmorethan3h.Amongalltheinterviewees,36(17.7%)had beentrainingforlessthansixmonths,47(23%)forsixmonths tooneyear;and121(59.3%)formorethanoneyear.

rev bras ortop.2015;50(5):537–540

539

Table1–Distributionofthenumberofathletesinjuredaccordingtoagegroup.

Age(years) Totalnumber ofathletes

Numberof athleteswith

injuries

%injuredoutoftotal numberofathletes

injured

%injuredoutofnumber ofathletesinthesame

agegroup

18–30 104 49 57.7 47.1

31–60 81 30 35.3 37.0

>60 19 6 7.0 31.5

Total 204 85 41.6 –

Table2–Typesofinjuryresultingfromthissport.

Typesofinjury N (%)

Sprain 45 29.9

Blister 30 19.9

Excoriation 30 19.9

Distension 15 9.9

Contusion 12 7.9

Flexuraleczema 8 5.3

Dislocation 3 2.0

Fracture 2 1.3

Others 6 3.9

Total 151 100

Table3–Anatomicallocationsoftheinjuriesresulting fromthissport.

Location N (%)

Head/neck 4 2.6

Shoulder 8 5.2

Elbow 12 7.8

Wrist 6 3.9

Entireupperlimb 26 17.3

Hip 8 6.7

Thigh 3 2.4

Knee 56 46.2

Lowerleg 6 4.9

Foot 28 23.2

Ankle 20 16.6

Entirelowerlimb 121 80.1

Total 151 100

Friction between foot and shoe, sprains and falling to the groundwerethemechanismsmostoftenreportedas respon-siblefortheseinjuries.

Table1presentsthe injurydistributionaccordingtothe athletes’agegroup.

Inrelationtotheperiodsincestartingtopracticerunning, 71athletesreportedthattheyhadsufferedonlyonetypeof injury,32reportedtwotypes,fivereportedthreetypesand onereportedfourtypes;thustotaling151injuriesin85 ath-letes,whichcorrespondedtoameanof1.8injuriesperathlete. Inrelationtothediagnosis,wefoundthatthemostfrequent typesweresprainsofthefootandankle,blistersand excoria-tions.Table2presentsthetypesofinjuryresultingfromthis sportthattheathletesreported.

Regarding the anatomical location of the injuries, they occurredinthelowerlimbs(78.9%),upperlimbs(18.54%)and head (2.6%). Injuries to the feet and ankles predominated (40.3%).Table 3presents the anatomicallocations ofthese injuries.

Inrelationtothedegreeofinjury,amongthe85runners whohadpresentedsometypeofinjury,19(22.3%)hadsuffered

Table4–Degreeofseverityoftheinjuriesresultingfrom thissport.

Degreeofinjuries Numberofathletes Percentageof allinjuries

Mild 40 47.0

Moderate 26 30.6

Severe 19 22.4

Total 85 100

injuriesclassifiedassevereandthusremainedabsentfrom runningpracticeformorethan28days.Twooftheserunners hadpresentedfractures(oneinthewristandtheotherinthe ankle),14hadpresentedfootandanklesprainsandthreehad sufferedhipdislocation.Moderateinjuries,withabsencefrom runningpracticeofbetweeneightand28 days,werefound among26athletes. However,themajority ofthe caseshad presentedmildinjurieswithabsencesoflessthaneightdays.

Table4presentsthedegreeofseverityoftheinjuries.

Discussion

Popularparticipationinstreetrunning hasbeenincreasing significantlywithinoursettingandindividualswithregular moderatetraining activitiescanbecalledamateurrunners. Regularrunningpracticebringsaseriesofphysicalandmental benefitstoitspractitioners,butinjuriesrelatingtorunningare commonamongamateurrunners,atratesrangingfrom14to 50%peryear.11,13–15_{Theseinjuriesseemtohavemanycauses,} suchasage,sex,experience,fitness,weatherconditions,use ofappropriatefootwear,typeoffootfall,typeofgroundand excessiveuse,amongothers.13

Thisstudyconfirmedthattheincidenceoftheseinjuries ishigh.Inasystematicreviewontheincidenceoflower-limb injuriesamonglong-distancerunners,vanGentetal.6_found thattherateoflow-limbinjuriesrangedfrom26to92.4%.

The injury distribution according to sex in the present study was in line withdata inthe literature showingthat injuriesoccurpredominantlyamongmales,13_{althoughother} studieshavenotfoundthisdifference.4

Runnersbetweentheagesof18and30yearssufferedmore injuriesthanolderrunners,whichwasdiscordantwithother studies,whichfoundmoreinjuriesamongrunnersaged30–45 years.13,14

Thepresentstudyshowedthattheinjurieswere predomi-nantlyinthelowerlimbs.Theknees,anklesandfeetwerethe regionsmostaffected.16

540

9to32.2%,footinjuriesin5.7to39.3%,thighinjuriesin3.4 to38.1%,ankleinjuriesin3.9to16.6%andhipinjuriesin3.3 to11.5%.6_Lunetal.17_{foundamongrecreationalrunnersthat} 79%ofthemhadinjuriesaftersixmonthsoftrainingwitha meanfrequencyofthreetrainingsessionsperweek.Themen hadhigherfrequencyofkneeinjuries,whilethewomenhad higherfrequencyoffootinjuries.

The types of injury most commonly reported in the presentstudy wereskininjuries(blistersandexcoriations), followedbysprains.Itisknownthatskininjuriesandsprains are frequently found among runners, along with cramps, hematomasandanklesprains,6_{althoughanotherstudyfound} thattendinopathyandmuscleinjuriespredominatedamong marathonrunnersinSãoPaulo.14

Itwasalsoobserved thatthe greatmajorityofthe ath-letesinterviewedhad mildinjuries,whichkeptthemaway from sports practicefor up toeightdays. This showsthat becauserunning isasportwithout directphysicalcontact, it leads to injuries of lower severity than those of other sportsinwhichphysicalcontactismorecommon,suchas soccer.

Becausethisstudywasbasedoninterviews,onelimiting factorwasthatthebodymassindex,typeoffootwearusedand typeoffootfallwerenotanalyzed,whichmayhaveinfluenced theresults.

Conclusions

Thepractice ofrunning may give rise to high numbers of knee, footand ankle injuriesamongits practitioners, such assprains,blistersand excoriations.However,themajority oftheseareclassifiedasmild,witharapidreturntosports practice.

Conflicts

of

interest

Theauthorsdeclarenoconflictsofinterest.

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