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Risk Factors and Protective Factors for Lower Extremity Running Injuries

by MASS4D® Prescription Orthotics September 11, 2017


The aims of this article were to analyse scientific literature published in the past 20 years on the most common running injuries and to identify risk factors and potential protective factors (mainly those related to footwear).

In total, 276 articles were identified by electronic search, and 25 of these met the inclusion criteria and were deemed suitable for review by the authors.

Injuries were found to be due to inadequate interaction between the runner (his or her biomechanics) and external factors (ground stiffness, footwear and training).

The most important risk factors were stated as advanced age (not taking into account the risk threshold), difference in length between the lower limbs, genu varum or bow-leggedness, the height of male athletes, the intake of alcohol, previous injuries and weekly training distance.

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It was estimated that approximately 50 percent of running injuries are due to overuse. Of those, two-thirds occur in the knee or below the knee.

The most common injuries caused by overuse include Achilles tendinosis, patellofemoral pain syndrome, medial tibial stress syndrome, shin splints, stress fractures, periostitis and compartment syndrome.

Runners with severe overpronation have greater torsional strengths that result in associated instability and lead to injuries.

Footwear traction is one of the leading causes of non-contact lower extremity injuries.

Rotational traction happens when the footwear comes in contact with the surface. As footwear traction increases, there is a steady increase in joint and muscle forces.

It has been shown that 90 percent of injuries to the ligament is caused by rotational traction.

It has also been shown that low- and high-arched individuals are more prone to experience injuries than runners with normal feet.

Proper footwear is suggested by the authors to modify the biomechanical changes of running, reducing the risk of injuries by 50 percent.

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  1. Gijon-Nogueron, G., Fernandez-Villarejo, M. (2015) Risk Factors and Protective Factors for Lower Extremity Running Injuries. Journal of the American Podiatric Medical Association: November/December 2015, Vol. 105, No. 6, pp. 532-540.

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