Course and predicting factors of lower-extremity injuries after running a marathon

Objectives: To investigate in recreational runners the 3 month prognosis of and medical consumption caused by running injuries occurring shortly before or during a marathon. Possible prognostic factors for persistent complaints were also evaluated. Design: Prospective cohort study. Setting: Rotterdam, the Netherlands. Participants: One hundred sixty-five recreational marathon runners who reported a new running injury in the month before or during the Rotterdam Marathon 2005 and who were available for follow-up. Assessment of Determinants: Demographic, running (training distance, frequency and duration, experience, etc), lifestyle (other sports, smoking), and injury-related factors were collected at baseline. Main Outcome Measurements: Persistent complaints of running injuries occurring in the month before or during the Rotterdam marathon at 3 month follow-up. Potential prognostic factors for persistent complaints were analyzed by multivariate logistic regression. Results: At 3 month follow-up, 25.5% of the 165 injured runners reported persistent complaints; they had little pain during exercise and almost no pain in rest. Of all 165 male runners, 27 (16.4%) visited a general practitioner because of their running injury and 40 (24.2%) visited a physiotherapist (218 times in total). Persistent complaints at 3 month follow-up were associated with non-musculoskeletal comorbidities [odds ratio (OR), 3.23; confidence interval (0), 1.24-8.43], and calf injuries (OR, 0.37; CI, 0.13-1.05). Conclusions: One quarter of the runners had persistent complaints of their marathon-related running injury at 3 month follow-up. However, the clinical and social consequences of the injuries seem to be relatively mild. Nommusculoskeletal comorbidities at baseline are related to poor recovery, whereas recovery is also location specific.