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Monitoring perceived stress, recovery and non-traumatic lower extremity injuries in competitive runners

Runners often sustain lower extremity injuries (19-79%) (van Gent et al, 2007). In a theoretical model it has been described that a disturbance in perceived stress and recovery can increase the risk of sustaining an injury (Williams & Andersen, 1998). Therefore, the purpose of this study was to investigate changes in perceived stress and recovery preceding an injury of competitive runners.Methods: Twenty-four competitive runners were monitored over one full training season (46 weeks). Every week, the runners filled an on-line RESTQ-sport (Nederhof et al, 2008). Furthermore, runners and their coaches kept a log with injuries and physical complaints. A non-traumatic injury was defined as any pain, soreness or injury that was not caused by trauma and resulted from training and led to a decrease in training duration or training intensity for at least one week (Jacobsson et al, 2013). Because baseline levels of perception of stress and recovery vary largely between runners, the 19 scales of the RESTQ-Sport were normalized to Z-scores based on the runner’s individual average and standard deviation of the whole season (excl. injured periods). The normalized scores of 1, 2 and 3 weeks before the first sustained injury were compared to 0, which is the average normalized score, by repeated measures ANOVA’s.Results: Twenty-two runners sustained a non-traumatic lower extremity injury. Eight of these runners filled out the RESTQ-Sport all 3 weeks preceding the injury and their data was used for further analysis. The injuries sustained were non-traumatic injuries of the knee, Achilles tendon, ankle, foot and shin. It was shown that 1 week preceding the injury, runners scored lower than the average normalized score on “Success” (Z-score: -0.68±0.62) and 2 weeks preceding the injury runners scored higher than their average on “Fitness/Injuries” (Z-score: 1.04±1.12).Discussion: A decrease in perceived success may be a marker to predict a non-traumatic lower extremity injury. Also an increase in the perception of muscle ache, soreness, pain and vulnerability to injury (“Fitness/Injury”) preceded injuries. Thereby, monitoring changes in individual stress and recovery may help to prevent non-traumatic injuries.

Jump landing characteristics predicts lower extremity injuries in indoor team sports

The aim of this study is to investigate the predictivevalue of landing stability and technique togain insight into risk factors for ankle and kneeinjuries in indoor team sport players. Seventyfivemale and female basketball, volleyball orkorfball players were screened by measuringlanding stability after a single-leg jump landingand landing technique during a repeated countermovement jump by detailed 3-dimensional kinematicsand kinetics. During the season 11 acuteankle injuries were reported along with 6 acuteand 7 overuse knee injuries by the teams’ physicaltherapist. Logistic regression analysis showedless landing stability in the forward and diagonaljump direction (OR 1.01–1.10, p ≤ 0.05) in playerswho sustained an acute ankle injury. Furthermorelanding technique with a greater ankle dorsiflexionmoment increased the risk for acuteankle injury (OR 2.16, p ≤ 0.05). A smaller kneeflexion moment and greater vertical groundreaction force increased the risk of an overuseknee injury (OR 0.29 and 1.13 respectively,p ≤ 0.05). Less one-legged landing stability andsuboptimal landing technique were shown inplayers sustaining an acute ankle and overuseknee injury compared to healthy players. Determiningboth landing stability and technique mayfurther guide injury prevention programs.

Characteristics and risk factors of sport injuries in physical education students

'Take a Mental Break!' study

Background Running-related injuries (RRIs) can be considered the primary enemy of runners. Most literature on injury prediction and prevention overlooks the mental aspects of overtraining and under-recovery, despite their potential role in injury prediction and prevention. Consequently, knowledge on the role of mental aspects in RRIs is lacking. Objective To investigate mental aspects of overtraining and under-recovery by means of an online injury prevention programme. Methods and analysis The ‘Take a Mental Break!’ study is a randomised controlled trial with a 12 month follow-up. After completing a web-based baseline survey, half and full marathon runners were randomly assigned to the intervention group or the control group. Participants of the intervention group obtained access to an online injury prevention programme, consisting of a running-related smartphone application. This app provided the participants of the intervention group with information on how to prevent overtraining and RRIs with special attention to mental aspects. The primary outcome measure is any self-reported RRI over the past 12 months. Secondary outcome measures include vigour, fatigue, sleep and perceived running performance. Regression analysis will be conducted to investigate whether the injury prevention programme has led to a lower prevalence of RRIs, better health and improved perceived running performance. Ethics and dissemination The Medical Ethics Committee of the University Medical Center Utrecht, the Netherlands, has exempted the current study from ethical approval (reference number: NL64342.041.17). Results of the study will be communicated through scientific articles in peer-reviewed journals, scientific reports and presentations on scientific conferences.

Injury incidence and risk factors

Objectives To report (1) the injury incidence in recreational runners in preparation for a 8-km or 16-km running event and (2) which factors were associated withan increased injury risk. Methods Prospective cohort study in Amsterdam, the Netherlands. Participants (n=5327) received a baseline survey to determine event distance (8 km or 16 km), main sport, running experience, previous injuries, recent overuse injuries and personal characteristics. Three days after the race, they received a follow-up survey to determine duration of training period, running distance per week, training hours, injuries during preparation and use oftechnology. Univariate and multivariate regression models were applied to examine potential risk factors for injuries. Results 1304 (24.5%) participants completed both surveys. After excluding participants with current health problems, no signed informed consent, missing or incorrect data, we included 706 (13.3%) participants. In total, 142 participants (20.1%) reported an injury during preparation for the event. Univariate analyses (OR: 1.7, 95% CI 1.1 to 2.4) and multivariate analyses (OR: 1.7, 95% CI 1.1 to 2.5) showed that injury history was a significant risk factor for running injuries (Nagelkerke R-square=0.06). Conclusion An injury incidence for recreational runners in preparation for a running event was 20%. A previous injury was the only significant risk factor for runningrelated injuries.

Sports injuries and illnesses in first-year physical education teacher education students

Background/aim We aimed to investigate the magnitude and characteristics of injuries and illnesses in Dutch physical education teacher education (PETE) students.Methods During the first 21 weeks of the academic year, 245 first-year students registered their health problems online using the Oslo Sports Trauma Research Centre (OSTRC) Questionnaire on Health Problems.Results A total of 276 injuries, 140 illnesses and 69 unclassified health problems were reported. We found an injury incidence rate of 11.7 injuries per 1000 hours (95% CI 10.4 to 13.2). Injury characteristics were: 42% overuse injuries, 62% causing absence from sports (median injury time loss=2 days) and 64% reinjuries. Most injuries were located at the knee, lower leg (anterior) and ankle. The duration of the illnesses was short (<1 week).Summary and conclusions We implemented a new registration method in the PETE academic programme. The results show that the risk for health problems is high for PETE students. Prevention is necessary, and to decrease injuries prevention programmes should focus on the lower extremities.