Original Research

Should Adolescents Run Marathons?: Youth Marathon Training Injury Epidemiology and Risk Factors

Goldman, Joshua T. MD, MBA^{*,†,‡,§,¶}; Miller, Emily MD^*,†,‡,§; Runestad, Summer ATC^†; Serpa, Rebecka BS^†; Beck, Jennifer MD^†,‡

Author Information

^*UCLA Division of Sports Medicine, Department of Family Medicine, Los Angeles, California;

^†Center for Sports Medicine, Orthopedic Institute for Children, Los Angeles, California;

^‡UCLA Department of Orthopedic Surgery, Los Angeles, California;

^§UCLA Department of Intercollegiate Athletics, Los Angeles, California; and

^¶Department of Neurosurgery, UCLA Steve Tisch BrainSPORT Program, Los Angeles, California.

Corresponding Author: Joshua T. Goldman, MD, MBA, Division of Sports Medicine, Departments of Family Medicine & Orthopedic Surgery, University of California, 1920 Colorado Ave, Santa Monica, CA 90404 ([email protected]).

The authors report no conflicts of interest.

This study was reviewed by University of California, Los Angeles Institutional Review Board, IRB #17-001160. The UCLA Office of the Human Research Protection Program determined that the project does not meet the definition of human subjects research and was considered IRB-exempt.

Students Run Los Angeles, a community-based program in operation for more than 25 years, offers at-risk middle school and high school adolescents the opportunity to participate in team-based training for the Los Angeles Marathon. In 2016, the Orthopedic Institute for Children offered their clinical services to the program to ensure these children had access to medical care during their training program. As a result of this partnership, the opportunity to evaluate the prevalence of running injuries in this unique population evolved. Coaches participate in data collection on a voluntary, uncompensated basis. Coaches were informed of the questions being studied and offered suggestions for improvement. Research findings and results of data analyses are presented to the coaches at their pre-season and mid-season coaching meetings. As the partnership continues to grow, we hope to expand our access to care for these runners and provide education to volunteer coaches to better inform the structure of their training programs based on our research.

Contributorship: Joshua T. Goldman, MD, MBA, Principal Investigator; Emily Miller, MD, Co-Investigator; Summer Runestad, ATC, Research Coordinator; Rebecka Serpa, BS, Research Assistant; Jonathan Grotts, Biostatistician; Jennifer Beck, MD, Co-Investigator; Christine Pajak, Director of Development and Research Coordinator

Clinical Journal of Sport Medicine 32(3):p e293-e299, May 2022. | DOI: 10.1097/JSM.0000000000000870

Abstract

Objective:

Youth participation in distance running has increased, yet little data exist about the injury patterns and safety of such activity. This study seeks to determine the types and rates of injuries seen in an adolescent marathon training program.

Design:

Observational prospective cohort study.

Setting:

Community-based adolescent marathon training program.

Participants:

The study enrolled 1927 students from 50 high schools (HS) and 34 middle schools (MS) participating in the 2017 to 2018 Students Run Los Angeles marathon training program.

Assessment of Risk Factors:

Weekly injury reports completed by running coaches. Data elements included participant demographics, weekly training distance, injury type, injury acuity, and missed training time.

Main Outcome Measures:

Epidemiology of self-reported injury in adolescent runners.

Results:

A total of 583 injuries occurred in 18% of runners during the training program. High schools runners were more likely to be injured than MS runners (20.8% vs 14.2%, P < 0.001). Seventy-two percent of injuries were acute with a mean missed training time of 4.8 days (SD 4.8). The most frequent site of injury was the knee (33%). Overall, runners with injuries ran a significantly greater distance per week than uninjured runners (14.6 mi vs 12.0 mi, P < 0.001). Ninety-nine percent of marathon participants completed the race.

Conclusions:

During a 28-week marathon training program, 18% of adolescent participants reported an injury. More injuries occurred in HS students, were acute, and involved the knee. This study represents one of the largest descriptions of injury prevalence in adolescent distance running and highlights a lower injury rate than adults during marathon training.

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Should Adolescents Run Marathons?: Youth Marathon Training Injury Epidemiology and Risk Factors