Too little too late? Runners seeking footwear and gait advice are already injured.

INTRODUCTION: Participation in recreational and distance running has increased in recent years, in part due to the low cost and accessibility, but despite evidence of benefits to health and wellbeing, injury prevalence is high and running-related injuries constitute a major health concern. The multifactorial nature of such injuries make prevention challenging, with factors such as running distance, footwear, muscle weakness, faulty mechanics and poor training strategy linked to increased risk. This study aimed to investigate injury patterns and risk factors in runners attending a footwear prescription clinic for gait and foot assessment. METHODS: A retrospective cohort study was designed to investigate the prevalence of running related injuries and determine trends in the population. Anonymised self-reported data relating to 1000 runners (614 males and 386 females) who attended a sports clinic for gait analysis and footwear prescription were sampled and analysed to determine injury prevalence and patterns. Pearson chi-square tests for independence were used to analyse categorical variables to compare groups based on running distance and gender. RESULTS: Injury prevalence in the analysed population was 81.5% and a greater proportion of runners reported multiple (2 or more) injuries (26.0%) than no injuries (18.5%). No significant difference in injury risk was found between short- (n=660), middle- (n=256) or long- (n=84) distance runners (short = 81.2%, middle = 80.5%, long = 86.9%; p>0.05). Females reported significantly greater injury prevalence than males overall (p<0.05) and within each distance group, with the greatest difference observed in middle distance runners (females 91.5%, males 76.0%). Knee injuries were the most common injuries reported, followed by those of the foot and shank and a significantly higher number of hip injuries were reported by females than males (males = 4.6%, females = 11.8%; p<0.05). CONCLUSIONS: Overall, prevalence of injury was very high in the analysed population, suggesting that most of those seeking advice on gait and footwear are already injured. With previous injury being one of the most commonly identified risk factors in research to date and both appropriate footwear and gait training identified as potentially effective strategies for injury reduction, further research should focus on development of strategies to protect from running related injury through gait education, exercise intervention and footwear recommendation.