Injury Prevention in Marathon Runners J Nathan, A Silman The University of Manchester Introduction More people run recreationally today than ever before, this ranges from those who run a couple of miles to those who train for marathon and ultra marathon distances 2. During the course of a year two thirds of long distance runners sustain an injury that interrupts their training programme 3. There have been many suggestions that running not only increases likelihood of acute or overuse injuries but that they are also long term complications associated. However very few of these are supported by scientific evidence. Aims This project investigates the factors that may predispose marathon runners to injury. These are, number of marathons completed in the past, time taken to complete the London Marathon, previous history of injury, following a marathon training plan, experience of pain whilst running during training, age, sex and number of training runs per week. Each factor was compared with injury sustained whilst running the London Marathon which took place on Sunday 22 nd April Injury is defined as any time a runner has to stop, this does not take into account toilet breaks. Methods Survey Monkey, an online survey website was used to generate each questionnaire which then produced a unique link which was sent out to all runners via . The first questionnaire was sent three weeks before the London Marathon and asked basic demographic information, history of running injury and the distance runners expected to cover in the two months leading up to the marathon. As the first survey exceeded ten questions it was spread over two links (1A and 1B). Response Rate Discussion This report finds that there is a connection between running a marathon in less than 4 hours and reduced rates of injury. This may be because fewer novices were present in the group that completed the marathon in under 4 hours and therefore were more experienced. These results highlight how difficult it is to determine who gets an injury whilst training for or running a marathon. There is also a lack of scientific evidence for many anecdotal associations between marathon running and injury such as early onset of Osteoarthritis and more frequent lower limb injuries. It is important to consider and further to understand factors contributing to injury and if these are identifiable to provide guidelines to those training for a marathon to help prevention and improve enjoyment. References : 1 [Accessed on Thursday 11 th October 2012], 2 – Nicholl JP, Coleman P, Williams BT. The epidemiology of sports and exercise related injury in the United Kingdom. Br J Sports Med. 1995;29(4):232-8, 3- Lysholm J, Wiklander J. Injuries in runners. Am J Sports Med. 1987;15(2):168-71, [Accessed on Thursday 11th October 2012] 4 1 The second questionnaire (2) was sent three weeks after the marathon and asked about injury on the day, time taken to complete the marathon and whether training was considered to have been sufficient. Runners were then asked how long it took them to feel free of any aches or pains and how long it took them to return to running. Chi squared was then used to determine whether there was a significant relationship between injury rates observed and expected in the different categories compared. SurveyTotal number of runners (n) Total completed (% of total runners) Males completed (% of total males) Females completed (% of total females) 1A8953 (60)36 (65)17 (50) 1B8956 (63)36 (65)17 (50) (62)33 (60)22 (65) 15% more males completed the first survey compared with females. However 5% more females completed the second survey compared with men. Despite the first survey being online for a month longer than the second it does not seem to have had an effect on the response rate. Results FactorsP Value Number of marathons ran0.688 Previous history of running Injury0.947 Following a training plan0.601 Pain during training runs0.204 Age0.376 Gender0.138 Number of runs per week0.770 Marathon time0.003 There is a significant relationship found between a slower time and increased rates of injury injury whilst running the London Marathon (p = 0.003). 13% of people who completed the marathon in under 4 hours sustained an injury whilst this was significantly higher in those who finished between hours and over 5 hours at 70% and 47% respectively. No other significant relationships were found. Figure 1 – Response Rates of Runners Figure 3 – Rates of Injury in Different Time Categories Figure 2 – P Values for factors compared