Running-related injuries in middle school cross-country runners: Prevalence and characteristics of common injuries

Alexander C. Wu, Mitchell J. Rauh, Stephanie DeLuca, Margo Lewis, Kathryn E. Ackerman, Michelle T. Barrack, Bryan Heiderscheit, Brian J. Krabak, William O. Roberts, Adam S. Tenforde

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


BACKGROUND: Understanding the prevalence and factors associated with running-related injuries in middle school runners may guide injury prevention.

OBJECTIVE: To determine the prevalence of running-related injuries and describe factors related to a history of injury.

DESIGN: Retrospective cross-sectional study.

SETTING: Survey distributed online to middle school runners.

METHODS: Participants completed a web-based survey regarding prior running-related injuries, training, sleep, diet, and sport participation.

MAIN OUTCOME MEASUREMENTS: Prevalence and characteristics differentiating girls and boys with and without running-related injury history adjusted for age.

PARTICIPANTS: Youth runners (total: 2113, average age,  13.2 years; boys: n = 1255, girls: n = 858).

RESULTS: Running-related injuries were more prevalent in girls (56% vs. 50%, p = .01). Ankle sprain was the most common injury (girls: 22.5%, boys: 21.6%), followed by patellofemoral pain (20.4% vs. 7.8%) and shin splints (13.6% vs. 5.9%); both were more prevalent in girls (p < .001). Boys more frequently reported plantar fasciitis (5.6% vs. 3.3%, p = .01), iliotibial band syndrome (4.1% vs. 1.4%, p = .001) and Osgood-Schlatter disease (3.8% vs. 1.2%, p = .001). Runners with history of running-related injuries were older, ran greater average weekly mileage, ran faster, had fewer average hours of sleep on weekends, skipped more meals, missed breakfast, and consumed less milk (all p < .05). Girls with history of running-related injuries reported higher dietary restraint scores, later age of menarche, more menstrual cycle disturbances, and higher likelihood of following vegetarian diets and an eating disorder diagnosis (all p < .05). Runners with no history of running-related injuries were more likely to have participated in ≥2 years of soccer or basketball (p < .001).

CONCLUSIONS: Most middle school runners reported a history of running-related injuries and certain injuries differing by gender. Modifiable factors with the greatest association with running-related injuries included training volume, dietary restraint, skipping meals, and less sleep. Sport sampling, including participation in ball sports, may reduce running-related injury risk in this population.

Original languageEnglish (US)
Pages (from-to)793-801
Number of pages9
JournalPM and R
Issue number7
Early online dateMay 30 2021
StatePublished - Jul 2022

Bibliographical note

Publisher Copyright:
© 2021 American Academy of Physical Medicine and Rehabilitation.


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