Lower Extremity Complaints in Runners and Other Athletes

Running is one of the most accessible sports, and probably for this reason, is practiced by many persons all over the world. However, besides the positive health effects of running there are some concerns about the high incidence of running injuries, especially to the lower extremities. The results of a systematic review on lower extremity injuries of long-distance runners showed an incidence of running injuries ranging from 19.4% to 79.3%. The results of the Rotterdam marathon revealed a one-year prevalence of 48.3%. The incidence of lower extremity injuries occurring during the marathon was 18.2%; most of these injuries occurred in the calf, knee and thigh. The following factors were associated with the occurrence of lower extremity injuries: participating more than six times in a race in the previous 12 months (OR 1.66), a history of running injuries (OR 2.62), high education level (OR 0.73) and daily smoking (OR 0.23). Among the modifiable risk factors studied, a training distance less than 40 kilometres a week is a strong protective factor of future calf injuries, and regular interval training is a strong protective factor for knee injuries. At 3-months 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, 16.4% visited a general practitioner because of their running injury and 24.2% visited a physiotherapist. Non-musculoskeletal co-morbidities at baseline are related to poor recovery, whereas recovery is also location specific.

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