Journal Article

Epidemiology of Musculoskeletal Injuries among High School Cross-Country Runners

Mitchell J. Rauh, Thomas D. Koepsell, Frederick P. Rivara, Anthony J. Margherita and Stephen G. Rice

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 163, issue 2, pages 151-159
Published in print January 2006 | ISSN: 0002-9262
Published online November 2005 | e-ISSN: 1476-6256 | DOI:
Epidemiology of Musculoskeletal Injuries among High School Cross-Country Runners

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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.

Keywords: adolescent; athletic injuries; female; prospective studies; risk factors; running; schools; sports; AE, athletic exposure; Q-angle, quadriceps angle

Journal Article.  4547 words.  Illustrated.

Subjects: Public Health and Epidemiology

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