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Course and Predicting Factors of Lower-Extremity Injuries After Running a Marathon

van Middelkoop, Marienke MSc; Kolkman, Jelle MSc; van Ochten, John MD; Bierma-Zeinstra, Sita M. A PhD; Koes, Bart W PhD

Clinical Journal of Sport Medicine: January 2007 - Volume 17 - Issue 1 - p 25-30
doi: 10.1097/JSM.0b013e3180305e4d
Original Research
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Objectives: To investigate in recreational runners the 3 month prognosis of and medical consumption caused by running injuries occurring shortly before or during a marathon. Possible prognostic factors for persistent complaints were also evaluated.

Design: Prospective cohort study.

Setting: Rotterdam, the Netherlands.

Participants: One hundred sixty-five recreational marathon runners who reported a new running injury in the month before or during the Rotterdam Marathon 2005 and who were available for follow-up.

Assessment of Determinants: Demographic, running (training distance, frequency and duration, experience, etc), lifestyle (other sports, smoking), and injury-related factors were collected at baseline.

Main Outcome Measurements: Persistent complaints of running injuries occurring in the month before or during the Rotterdam marathon at 3 month follow-up. Potential prognostic factors for persistent complaints were analyzed by multivariate logistic regression.

Results: At 3 month follow-up, 25.5% of the 165 injured runners reported persistent complaints; they had little pain during exercise and almost no pain in rest. Of all 165 male runners, 27 (16.4%) visited a general practitioner because of their running injury and 40 (24.2%) visited a physiotherapist (218 times in total). Persistent complaints at 3 month follow-up were associated with nonmusculoskeletal comorbidities [odds ratio (OR), 3.23; confidence interval (CI), 1.24-8.43], and calf injuries (OR, 0.37; CI, 0.13-1.05).

Conclusions: One quarter of the runners had persistent complaints of their marathon-related running injury at 3 month follow-up. However, the clinical and social consequences of the injuries seem to be relatively mild. Nonmusculoskeletal comorbidities at baseline are related to poor recovery, whereas recovery is also location specific.

From the Department of General Practice, Erasmus Medical Centre, Rotterdam, The Netherlands.

Submitted for publication April 27, 2006; Accepted August 17, 2006.

Correspondence: Marienke van Middelkoop, Erasmus MC, Department of General Practice, Postbox 2040, 3000 CA Rotterdam, The Netherlands (e-mail: m.vanmiddelkoop@erasmusmc.nl).

© 2007 Lippincott Williams & Wilkins, Inc.