Epidemiology of Musculoskeletal Injuries among High School Cross-Country Runners

• Published in: American journal of epidemiology 2006-01, Vol.163 (2), p.151-159
• Main Authors: Rauh, Mitchell J., Koepsell, Thomas D., Rivara, Frederick P., Margherita, Anthony J., Rice, Stephen G.
• Format: Article
• Language: English
• Subjects: Adolescent; Analysis. Health state; athletic exposure; athletic injuries; Athletic Injuries - epidemiology; Biological and medical sciences; Cross country running; Epidemiology; Female; Gender differences; General aspects; Humans; Incidence; Injuries; Leg Injuries - epidemiology; Male; Medical sciences; Miscellaneous; Musculoskeletal Diseases - epidemiology; Musculoskeletal system; Proportional Hazards Models; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Q-angle; quadriceps angle; Risk Factors; running; Running - injuries; schools; Secondary school students; sports; Surveys and Questionnaires; Washington - epidemiology
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwj022

To determine the incidence of lower-extremity injury among high school cross-country runners and to identify risk factors for injury, the authors prospectively monitored a cohort of 421 runners competing on 23 cross-country teams in 12 Seattle, Washington, high schools during the 1996 cross-country season. Collected were daily injury and athletic exposure (AE) reports, a baseline questionnaire on prior running and injury experience, anthropometric measurements, and coaches' training logs. The overall incidence rate of injury was 17.0/1,000 AEs. Girls had a significantly higher overall injury rate (19.6/1,000 AEs) than boys did (15.0/1,000 AEs) (incidence rate ratio = 1.3, 95% confidence interval: 1.0, 1.6). Compared with boys, girls had significantly higher rates of injuries resulting in ≥15 days of disability. For the overall sample and for girls, Cox regression revealed that a quadriceps angle of ≥20° and an injury during summer running prior to the season were the most important predictors of injury. For boys, a quadriceps angle of ≥15° and a history of multiple running injuries were most associated with injury. Results suggest that the incidence of lower-extremity injuries is high for cross-country runners, especially girls. Preseason screening to determine risk factors should be examined as a preventive approach for identifying high-risk runners.