Running-related injuries in middle school cross-country runners: Prevalence and characteristics of common injuries

Background: Understanding the prevalence and factors associated with running-related injuries in middle school runners may guide injury prevention. Objective: To determine the prevalence of running-related injuries and describe factors related to a history of injury. Design: Retrospective cross-sectional study. Setting: Survey distributed online to middle school runners. Methods: Participants completed a web-based survey regarding prior running-related injuries, training, sleep, diet, and sport participation. Main Outcome Measurements: Prevalence and characteristics differentiating girls and boys with and without running-related injury history adjusted for age. Participants: Youth runners (total: 2113, average age, 13.2 years; boys: n = 1255, girls: n = 858). Results: Running-related injuries were more prevalent in girls (56% vs. 50%, p =.01). Ankle sprain was the most common injury (girls: 22.5%, boys: 21.6%), followed by patellofemoral pain (20.4% vs. 7.8%) and shin splints (13.6% vs. 5.9%); both were more prevalent in girls (p <.001). Boys more frequently reported plantar fasciitis (5.6% vs. 3.3%, p =.01), iliotibial band syndrome (4.1% vs. 1.4%, p =.001) and Osgood-Schlatter disease (3.8% vs. 1.2%, p =.001). Runners with history of running-related injuries were older, ran greater average weekly mileage, ran faster, had fewer average hours of sleep on weekends, skipped more meals, missed breakfast, and consumed less milk (all p <.05). Girls with history of running-related injuries reported higher dietary restraint scores, later age of menarche, more menstrual cycle disturbances, and higher likelihood of following vegetarian diets and an eating disorder diagnosis (all p <.05). Runners with no history of running-related injuries were more likely to have participated in ≥2 years of soccer or basketball (p <.001). Conclusions: Most middle school runners reported a history of running-related injuries and certain injuries differing by gender. Modifiable factors with the greatest association with running-related injuries included training volume, dietary restraint, skipping meals, and less sleep. Sport sampling, including participation in ball sports, may reduce running-related injury risk in this population.