Photo: Illustration: Pontus Andersson, Pontus Art Production

Pia Desai - Running-related injuries in recreational athletes. lncidence, risk factors and effectiveness of an injury-prevention programme


Pia Desai defended her thesis for Medicine Doctorate at Sahlgrenska Academy, Institute of Clinical Sciences, Department of Orthopaedics on December 3, 2021

Title of the thesis: Running-related injuries in recreational athletes. lncidence, risk factors and effectiveness of an injury-prevention programme

Pia Desai
Pia Desai, legitimerad fysioterapeut, som även varit affilierad med Center for Health and Performance, vid Göteborgs universitet
Photo: Rúnar Sigmundsson

Link to thesis


Running as a form of physical activity continues to grow in popularity and is accompanied by a number of health benefits, but one of the greatest threats that challenge these benefits is running-related injuries. The overall aim of this thesis is to identify the proportion of runners who sustain a running-related injury (incidence), possible reasons as to why they sustain these injuries (risk factors) and, finally, whether general injury-prevention guidelines can be effective in reducing the number of running-related injuries in recreational runners. This thesis comprises four studies.

Studies I and II of this thesis are prospective cohort studies comprising more than 200 recreational runners from the Gothenburg Half Marathon. Baseline testing prior to study start included range of motion and flexibility tests, a running analysis and isometric strength tests. Weekly training and injury information was collected during a 52-week period. The cumulative incidence proportion of running-related injuries after 52 weeks was 46%. The results revealed that runners with a late timing of maximal eversion, or low hip abductor strength compared with hip adductor strength, sustained more injuries compared with their counterpart runners (Study I). Additionally, runners with a previous injury were found to be almost twice as likely to sustain a new injury compared with runners with no previous injury (Study II).

Studies III and IV of this thesis are prospective, observational, comparative studies comprising 433 male and female recreational runners recruited from the Gothenburg Half Marathon. Participants were allocated to either an intervention group (n=228) or a control group (n=205) and submitted weekly information on their training habits and any running-related injury/pain for 18 weeks. The intervention group performed an injury-prevention programme consisting of neuromuscular control and foam-rolling exercises, twice a week for the duration of the study. No significant differences were found when investigating exposure states of weekly running distance and running-related injuries. However, increasing the weekly running distance by more than 30% appeared to be accompanied by a higher risk of injury, compared with keeping within a 10% increase or decrease, despite these findings lacking statistical significance (Study III). When exploring the effects of the intervention programme, we found that runners with high compliance with the intervention were 85% less likely to sustain an injury compared with the control group (Study IV).

Injury proportions and anatomical location of injuries
Frequencies and proportions of injury locations in (A) females (n=29) and (B) males (n=46). (Figur 8, page 37 in the thesis)
Photo: Figur: Pia Desai
Skadeförebyggande träningsprogrammet
Illustration: Pontus Andersson (Pontus Art Production), Fig 7 page 31 in the thesis
Photo: Illustration: Pontus Andersson (Pontus Art Production)

Supervisor: Jón Karlsson
Co-supervisor: Stefan Grau och Mats Börjesson
Opponent:  Toni Arndt, institutionen för fysiologi, nutrition och biomekanik GIH, Stockholm
Examining Committee:  John Paoli, Björn Rydevik and Suzanne Werner