Trail Running Injury Risk Factors | A Quick and Critical Look at a Systematic Review | Find Your Stride | Edinburgh Podiatrist

Introduction

Trail running has surged in popularity as a thrilling way to explore nature while staying fit. However, with this increased enthusiasm comes a heightened risk of injuries. A recent systematic review titled "Trail Running Injury Risk Factors: A Living Systematic Review" by Viljoen et al. (2022) seeks to shed light on the incidence, types, and risk factors associated with injuries in this unique sport. While the review presents important findings, it also raises several critical points worth discussing.

Exploring trails is incredibly rewarding but carries a number of risks

Strengths of the Review

One of the most commendable aspects of this systematic review is its comprehensive examination of injury incidence and prevalence in trail running. By collating data from various studies, the authors present a clear picture of the scope of injuries, highlighting that lower limb injuries are the most common. Such detailed insights are invaluable for both runners and healthcare professionals, allowing for better awareness and preventive strategies.

Moreover, the identification of key risk factors provides an essential guide for trail runners. By understanding the intrinsic and extrinsic factors that contribute to injuries—such as lack of proper warm-up and the type of terrain—they can take proactive measures to mitigate risks. The commitment to creating a living systematic review is another strong point, as it allows for continuous updates that incorporate the latest research findings and practical implications.

Weaknesses and Areas for Improvement

Despite its merits, the review has noteworthy limitations. The injury prevention strategies recommended are somewhat generic and lack specificity to trail running’s distinct challenges. For instance, while the review mentions the importance of training methodologies, it does not delve into specific training programs tailored for trail runners, which could be more beneficial for practitioners seeking targeted solutions.

Furthermore, the sample demographics reveal a concerning skew towards male participants (80.6%), potentially limiting the applicability of findings to female trail runners. This gender imbalance in sports research is not uncommon, but it nonetheless points to a significant gap in understanding how injuries might manifest differently across genders.

Additionally, the moderate quality rating of the included studies raises questions about the robustness of the conclusions drawn. Relying on studies with small sample sizes and varied methodologies can undermine the overall reliability of the findings. Future research should prioritise larger, well-controlled trials to create a more comprehensive view of trail running injuries.

Identified Risk Factors

At the time of publication Viljoen et al. (2022) identified the following risk factors for injury in trail running. These are numerous and highlight the complexity of injury risk in trail running, indicating that multiple factors contribute rather than a single cause. Understanding these risk factors can help in designing more effective injury prevention strategies for runners.

Intrinsic Factors:

1. Running Experience: More experience in running is associated with a higher risk of injury.

2. Level of Runner: Being a 'level A runner' increases injury risk.

3. Psychological Factors: Higher total propensity to sports accident score (PAD-22) indicates a greater risk.

4. Previous Cramping History: Past instances of cramping increase the likelihood of cramping during subsequent events.

5. Biomarkers of Muscle Damage: Elevated post-race blood urea nitrogen and creatine kinase are linked to muscle cramping.

6. Younger Age: Associated with a higher risk of sunburn.

7. Low Skin Phototype: Low phototypes (I and II) significantly elevate the risk of sunburn.

Extrinsic Factors:

1. Neglecting Warm-Up: Failing to warm up increases injury risk.

2. Lack of a Specialised Running Plan: Not having a tailored training regimen is associated with higher injury risk.

3. Training Surface: Regularly training on asphalt increases the likelihood of injury.

4. Training Frequency: Engaging in double training sessions per day heightens injury risk.

5. Occupational Factors: Physical labor occupations are associated with greater injury risks

Conclusion

In conclusion, the "Trail Running Injury: Systematic Review" makes a significant contribution to the literature by providing insights into the nature of injuries in trail running. While it serves as a useful resource for both runners and healthcare providers, the paper could benefit from addressing its limitations and exploring more targeted prevention strategies. As the sport continues to gain popularity, further research is essential to enhance understanding of trail running injuries, ultimately promoting a safer experience for all enthusiasts. For trail runners, this review is a reminder to stay informed, train wisely, and remain vigilant about the risks involved in taking the path less traveled.

Find Your Stride!