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.