Can we keep running forward?: On running-related injuries and the effects of compression garments in marathon runners

Abstract

In the Netherlands, over two million people regularly participate in running. While running offers numerous health benefits, it also leads to running-related injuries (RRIs). This thesis aims to understand RRI monitoring in half- and full-marathon runners and the effects of lower leg compression garments (CGs). In 2016, we monitored 161 runners preparing for the Utrecht half and full marathons in an observational cohort study (SUMMUM-2016 study). Results showed that 88.8% of runners experienced at least one RRI or illness symptom during a 16-week preparation period leading up to the running event. Furthermore, we found that preventive measures, such as seeking advice on running shoes and using supportive materials, were more common among seriously injured runners. Using data from the consecutive observational cohort study (the SUMMUM-2017 study), we evaluated the Oslo Sports Trauma Research Center questionnaire's ability to detect changes in RRI severity on an individual and group level. We report that the questionnaire could distinguish important changes in injury severity at a group level but not for individual runners. In the second part of the thesis, the focus was on CGs. A study involving 512 athletes revealed that many used CGs to prevent re-injury or reduce symptoms of current injuries. The athletes who used CGs reported positive perceived effects from the CGs. However, through a systematic review, we found no significant evidence that CGs prevent lower extremity sports injuries. In the final study, we studied the effects of CGs on the occurrence of lower extremity sports injuries by attempting to emulate a randomized controlled trial (RCT) using data from the aforementioned SUMMUM-2017 study. We identified no positive or negative effects of the CGs. Further research is needed to understand the relationship between CGs and RRIs. We suggest that future studies should common frameworks for injury and illness definitions and methodology. Furthermore, the use of tailor-made CGs and innovative methods like target trial emulation and artificial intelligence might further improve injury prevention strategies for runners.