Injuries common among cross-county runners

By Charnicia E. Huggins

NEW YORK (Reuters Health) – Theirs may not be a contact
sport, but high school cross-country runners are not exempt
from injury. In fact, injuries are quite common among these
athletes, new study findings show.

“The results from our study suggest that the injury rates
of high school cross country runners continue to be
consistently high, per athletic exposure (i.e., actual runner
participation in a practice or meet), especially for girls, and
that the causes of running injuries are likely multi-faceted,”
study author Dr. Mitchell J. Rauh told Reuters Health.

During the 2003-2004 school year, more than 364,000
students in the United States participated in high school
cross-country running, which was ranked as the seventh most
popular high school sport nationwide for girls and boys,
respectively. Previous reports suggest that the incidence of
injury among cross-country runners ranges from less than 2
percent to nearly 50 percent, but little research on the topic
has been conducted among high school athletes.

To investigate, Rauh, of the Rocky Mountain University of
Health Professions in Provo, Utah, and his team followed 421
male and female runners from 23 cross-country teams at 12 high
schools in Seattle, Washington during the 1996 cross-country
running season.

Overall, 162 runners experienced a total of 316 injuries
during the season, the investigators report in the American
Journal of Epidemiology.

The rate of injury was generally higher for girls than for
boys, the study findings show, and girls were four times more
likely than boys to experience an injury that kept them from
running for 15 or more days.

Why the girls had higher injury rates than boys is unclear,
Rauh told Reuters Health.

Preliminary findings revealed differences in pre-season
summer training among girls versus boys, which, according to
Rauh, may explain some of the gender differences in injury
rates.

The runners’ quadriceps angle, or Q-angle, which is formed
from a point on the hip to the middle of the kneecap and from
the kneecap to a point on the upper shin, was also associated
with their risk of injury.

A Q-angle of 20 degrees or greater, which was more common
among girls than boys, was associated with a nearly two-fold
increased risk of injury in comparison to a Q-angle of less
than 20 degrees, the report indicates. Boys with a Q-angle of
15 degrees or more were also more likely to be injured.

“Our findings suggest that coaches may want to screen
runners for large Q-angle and other lower limb malalignment at
the beginning of the season,” Rauh noted.

Athletes were injured more frequently during practices than
during meets, and the body parts most commonly affected
included the shin, the knee, and the ankle.

The researchers did not investigate potential methods of
injury prevention, but, according to Rauh, the findings suggest
that pre-season screening may be needed to identify athletes
with prior injuries that have not yet been fully rehabilitated.
Coaches should allow these athletes, as well as those who are
injured during the running season, to fully recuperate before
returning to cross-country running, he recommended.

Further, the findings also suggest that “coaches should
progressively increase the intensity and duration rather than
compressing the amount and intensity of workouts during the
first part of the season, ” Rauh added.

Despite the high injury rate reported in the current study,
however, “there are many benefits related to participating in
high school cross-country running,” Rauh told Reuters Health.

SOURCE: American Journal of Epidemiology, January 15, 2006.