Two-Year Injury Incidence and Movement Characteristics Among Division-I Cross-Country Athletes

Abstract

While research on running injuries is common, there is a lack of definitive causal relationships between running injuries and gait mechanics. Additionally, there is a paucity of longitudinal research to understand the development of running injuries. The purpose of this study was to assess the incidence of running injuries and investigate movement characteristics as they relate to injury development in Division-I cross-country athletes over a two-year period. Athletes were evaluated at pre- and post-season with three-dimensional kinematic and kinetic gait analyses. A total of 17 female athletes were evaluated, though sample size varied at each time point. Self-reported injury occurrence data was collected via questionnaires and injury reports were obtained from athletic training staff. Sixteen of the athletes reported at least one injury during the study. The percentage of participants self-reporting injury was greater than the percentage of participants who were evaluated and diagnosed by medical staff each year (year one: 67% vs. 33%; year two: 70% vs. 50%). The most common self-reported and medically confirmed injury location was the left foot, with 7 total reports out of 17 participants. Inferential statistics were not feasible due to an inherently limited sample size, thus effect size (Cohen's d _s ) was used to assess differences in mechanics between athletes with and without left foot injury. Several variables, including peak ankle plantarflexion, dorsiflexion, and inversion, peak knee abduction, and hip abduction and adduction were associated with moderate-to-large effect sizes (d _s > 0.50). This study demonstrates that injury rates in the literature may be influenced by reporting method. Additionally, this study provides promising information regarding movement characteristics in injured runners and demonstrates the necessity of longitudinal studies of homogenous groups.

Keywords: Biomechanical analysis; female NCAA runners; injury reporting; overuse running injuries.

Figure 1

Ensemble vertical ground reaction force versus time curves of three athletes (a–c) who sustained foot injuries during Year 2. The dotted line and shaded region represent the group mean and standard deviation, respectively. The y-axis represents force in Newtons and the x-axis represents time normalized to stance phase. Each line represents one representative trial collected while running at a preferred pace.