Keypoints
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Prevalence and incidence of LBP among runners seem basically low if compared with general population and other popular sports activities;
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Running could, cautiously, be considered a protective factor for the lumbar spine;
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Risk factors for the onset of LBP are generally physical impairments or training methods-related factors that could be partly modified and managed in clinical practice;
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Scarcity and methodological weakness of the available studies invite to conduct further research about actual prevalence and incidence as well as risk factors for LBP among runners;
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LBP may be better defined as Running Related Disorder instead of Running Related Injury.
Background
Methods
Study design and protocol
Search strategy
Eligibility criteria
Study selection
Data collection
Quality assessment
Agreement
Data analysis
Results
Study selection process
First Author, Year | Journal, Title | Reasons For Exclusion |
---|---|---|
Aggrawal ND, 1979 | Br J Sports Med A Study of changes in the spine in weight-lifters and other athletes | Data for prevalence, incidence or risk factors running related low back injuries are not reported This study evaluates the spine complaints in weight-lifters and track and field athletes |
Bertelsen ML, 2017 [24] | Scand J Med Sci Sports A framework for the etiology of running-related injuries | Study design is not included |
Brill PA, 1995 | Sports Med The influence of running patterns on running injuries. | Study design is not included |
Buist I, 2010 | Am J Sports Med Predictors of running-related injuries in novice runners enrolled in a systematic training program: a prospective cohort study | Primary and secondary outcomes are not evaluated |
Burrows M, 2003 | Br J Sports Med Physiological factors associated with low bone mineral density in female endurance runners | Primary and secondary outcomes are not evaluated This study analyzes the BMD (bone mass index) of several body segments after physical exercises |
Cai C, 2015 | J Orthop Sports Phys Ther Low Back and Lower Limb Muscle Performance in Male and Female Recreational Runners with Chronic Low Back Pain | Primary and secondary outcomes not evaluated This study evaluates some physical test such as muscular strength and length |
Cole AJ, 1995 | J Back Musculoskelet Rehabil Spine injuries in runners: A functional approach | Data for prevalence, incidence or risk factors running related low back injuries are not reported Study design is not relevant |
Damsted C, 2019 | J Orthop Sports Phys Ther Preparing for half-marathon: The association between changes in weekly running distance and running-related injuries – does it matter how the running is scheduled? | Primary and secondary outcomes are not evaluated. This study evaluates only running-related injuries localized in the lower limb |
Fokkema T, 2018 | J Sci Med Sport Prognosis and prognostic factors of running-related injuries in novice runners: a prospective cohort study | Data for prevalence, incidence or risk factors running related low back injuries are not reported |
Franke TPC, 2019 [5] | J Orthop Sports Phys Ther Running Themselves Into the Ground? Incidence, Prevalence, and Impact of Injury and Illness in Runners Preparing for a Half or Full Marathon | Data for prevalence, incidence or risk factors running related low back injuries are not reported This study grouped the data for head, spine and trunk |
Fredericson M, 2007 | Sports Med Epidemiology and aetiology of marathon running injuries | Study design is not included |
Garbutt G, 1990 [60] | Med Sci Sports Exerc Running speed and spinal shrinkage in runners with and without low back pain | Data for prevalence, incidence or risk factors running related low back injuries are not reported This study analyzes the spinal shrinkage in runners. The authors consider LBP as an independent of the shrinkage induced by running |
Hamill J, 2009 | Res Sports Med Lower extremity joint stiffness in runners with low back pain | Primary and secondary outcomes are not evaluated. This study evaluates the joint stiffness of hip, knee and ankle in runners with current LBP, resolved LBP and controls |
Hespanhol Junior LC, 2016 | Scand J Med Sci Sports Health and economic burden of running-related injuries in runners training for an event: a prospective cohort study | Data for prevalence, incidence or risk factors running related low back injuries are not reported |
Jacobs S, 1986 | Am J Sports Med Injuries to runners: a study of entrants to a 10,000-m race. | Primary and secondary outcomes are not evaluated |
Kemler E, 2018 [12] | Phys Sportsmed The relationship between the use of running applications and running-related injuries | Data for prevalence, incidence or risk factors running related low back injuries are not reported |
Kluitenberg B, 2013 | BMC Public Health The NLstart2run study: health effects of a running promotion program in novice runners, design of a prospective cohort study | Study design is not included |
Kluitenberg B, 2016 | J Sci Med Sport The NLstart2run study: training-related factors associated with running-related injuries in novice runners | Primary and secondary outcomes are not evaluated. This study analyzes the risk factors for running-related injury without referring to specific anatomical sites for each participant |
Lee SP, 2018 | Phys Ther Sport Adaptations of lumbar biomechanics after four weeks of running training with minimalist footwear and technique guidance: Implications for running-related lower back pain | Primary and secondary outcomes are not evaluated The authors report only that incorporating minimalist footwear and technique coaching into a runners’ training may induce changes in lumbar biomechanics associated with reduced risk of running related LBP, without any statistical analysis |
Lewis G, 2000 | ISMJThe etiology and clinical features of low back pain in distance runners: a review | Study design is not relevant |
Linton L, 2018 | J Sci Med Sport Running with injury: a study of UK novice and recreational runners and factors associated with running related injury | Data for prevalence, incidence or risk factors running related low back injuries are not reported |
Lopes AD, 2011 | J Physiother Musculoskeletal pain is prevalent among recreational runners who are about to compete: an observational study of 1049 runners | Data for prevalence, incidence or risk factors running related low back injuries are not reported This study evaluated the general spine complaints |
Nielsen RO, 2019 | BMJ Open The Garmin-RUNSAFE Running Health Study on the aetiology of runningrelated injuries: rationale and design of an 18-month prospective cohort study including runners worldwide | Study design is not included |
Nielsen RO, 2013 [61] | Int J Phys Ther Classifying running-related injuries based upon etiology, with emphasis on volume and pace | Study design is not included |
Noormohammadpour P, 2015 | Eur Spine J Low back pain status of female university students in relation to different sport activities | Data for prevalence, incidence or risk factors running related low back injuries are not reported This study evaluates the LBP status in 9 sports, but not among runner |
Ogon M, 1999 | Foot Ankle Int Does arch height affect impact loading at the lower back level in running? | Primary and secondary outcomes are not evaluated |
Oliveira RR, 2017 | Int J Sports Phys Ther There are no biomechanical differences between runners classified by the functional movement screen | Primary and secondary outcomes are not evaluated This study evaluates the timing of TrA (transversus abdominis muscle) activation and the sit and reach test such as possible factors for LBP development |
Preece SJ, 2016 | Gait Posture How do elite endurance runners alter movements of the spine and pelvis as running speed increases? | Primary and secondary outcomes are not evaluated This study analyzes some cinematics parameters of the spine and pelvis without any consideration for LBP |
Sado N, 2017 | Sports Biomech The three-dimensional kinetic behaviour of the pelvic rotation in maximal sprint running | Primary and secondary outcomes are not evaluated This study analyzes the lumbosacral cinematic to improve the sprint performance in running |
Schafer WE, 1985 | Stress Health Life changes, stress, injury and illness in adult runners | Data for prevalence, incidence or risk factors running related low back injuries are not reported |
Scheer BV, 2011 [62] | Clin J Sport Med Al Andalus Ultra Trail: an observation of medical interventions during a 219-km, 5-day ultramarathon stage race | Data for prevalence, incidence or risk factors running related low back injuries are not reported |
Seay JF, 2014 | Eur J Sport Sci Trunk bend and twist coordination is affected by low back pain status during running | Data for prevalence, incidence or risk factors running related low back injuries are not reported This study analyzes the differences in trunk sagittal kinematics between 3 groups of runners, with current LBP, resolved LBP or controls |
Smits DW, 2018 | Res Sports Med Validity of injury self-reports by novice runners: comparison with reports by sports medicine physicians | Data for prevalence, incidence or risk factors running related low back injuries are not reported This study examines the criterion validity of self-reported running related injuries, compared to an injury consultation by a sport medicine physician |
Sugisaki N, 2011 | Int J Sport Health Sci The Relationship between 30-m Sprint Running Time and Muscle Cross-sectional Areas of the Psoas Major and Lower Limb Muscles in Male College Short and Middle Distance Runners | Primary and secondary outcomes are not evaluated |
Tam N, 2018 | J Sports Sci Bone health in elite Kenyan runners | Primary and secondary outcomes are not evaluated |
Tauton JE, 2002 | Br J Sports Med A retrospective case-control analysis of 2002 running injuries | Data for prevalence, incidence or risk factors running related low back injuries are not reported This study evaluates the running-related injury in athletes of different sports such as cycling, swimming, weight-lifting, etc. who referred to had an injury during running activity |
Villavicencio AT, 2006 | Neurosurg Focus Back and neck pain in triathletes | Data for prevalence, incidence or risk factors running related low back injuries are not reported The study population is triathlon athletes |
Wen DY, 2007 | Curr Sports Med Rep Risk Factors for Overuse Injuries in Runners | Study design is not included |
Winter SC, 2018 | J Phy Fit Treatment & Sports Centre of Mass Acceleration-Derived Variables Detects Differences between Runners of Different Abilities and Fatigue-Related Changes during a Long Distance Over ground Run | Primary and secondary outcomes are not evaluated. This study evaluates the differences in running movements using a wireless accelerometers |
Winter SC, 2019 | Res Sports Med Overuse injuries in runners of different abilities-a one-year prospective study. | Data for prevalence, incidence or risk factors running related low back injuries are not reported This study provides the total amount of injuries for the groups of running level. The single anatomical site of injury for each runner was not included |
Characteristics of the included studies
General informations (Author, years, study design, country) | Title of the study (Journal) | Aims of the study | Population | Incidence or Prevalence | RRI definition | RUNNER definition | LBP (definition, characteristics, anatomical area) | Outcomes and outcome measures |
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Bach KD, 1985 [72] Prospective Cohort study USA | A comparison of muscular tightness in runners and nonrunners and the relation of muscular tightness to low back pain in runners. (The Journal Of Orthopaedic And Sports Physical Therapy) | To compare muscular tightness at the hip between runners and nonrunners, and to determine if there is a relation between muscular tightness and low back pain in runners. | N = 45 Age = 18–43 years M = 28 (19.4 years) F = 17 (25.7 years) LBP = 10 (M = 7 F = 3). Running experience > 1 years | I = 22% (1-year incidence) | Injury severe enough to temporarily give up the running activity. | Runners was defined according to the following criteria: individuals who run 18 or more miles per week, who run on a regular basis, and who have engaged in running for a minimum of 1 year | Low Back Pain | Goniometric range of motion measurements of three hip movements, abduction, flexion with the knee extended, and extension, were taken on two subject populations, runners, and non-runners, in order to determine tightness of the hip adductor, extensor, and flexor muscles, respectively. |
Besomi M, 2019 [66] Cross-sectional study Chile | Training volume and previous injury as associated factors for Running-Related Injuries by race distance: A Cross-Sectional Study. (Journal of Human Sport & Exercise) | To determine the relationship between weekly pre-competition running volume and the presence of running-related injuries (RRIs) by race distance. | N = 4380 Age = 36 10 km = 1316 21 km = 2168 42 km = 896 LBP = 31 (point prevalence); 307 (1-year overall prevalence; 77 = 10 km; 163 = 21 km; 67 = 42 km) Running experience = < 1 year = 704; 1–4 years = 2226; > 4 years = 1450. | P = 13.5% (1-year prevalence); 0.7%(point prevalence) | A running-related injury was defined as “any injury to muscles, tendons, joints and/or bones caused by running. The injury had to be severe enough to cause or be expected to cause a reduction in distance, speed, duration, or frequency of running for at least 7 days. Conditions such as muscle soreness, blisters, and muscle cramps were not considered as injuries”. | Participants was defined as runners if have competed in one of the three SM running distances (10–21-42 km) | Lower Back | |
Buist I, 2008 [73] Prospective cohort study Netherlands | Incidence and risk factors of running-related injuries during preparation for a 4-mile recreational running event. (British Journal of Sports Medicine) | The purpose of this study is to determine the incidence of RRI and to identify sex-specific predictors of RRI among a group of novice and recreational runners training during an 8-week period for a 4-mile running event. | N = 629 M = 207 F = 422 Age = 43.7 years Running experience = novice runners, runners with previous experience who have taken up running again or runners who were already engaged in regular running. LBP = 31 | I = 4.8% (8 weeks) | A running-related injury was defined as any musculoskeletal pain of the lower limb or back causing a restriction in running (mileage, pace or duration) for at least 1 day. | The participants had to categorize themselves as novice runners, runners with previous experience who have taken up running again or runners who were already engaged in regular running. . The training program for novice runners started with ten 1-min repetitions of running alternated by 1 min of walking. The training program for experienced runners started with 30 min of continuous running. The exposure time of running in the training program for novice and recreational runners varied, respectively, between 10 and 40 and 20–60 min per training. | Back Lower Back | |
Chang WL, 2012 [67] Cross-sectional study Taiwan | Running injuries and associated factors in participants of ing taipei marathon. (Physical Therapy in Sports) | To investigate the distribution of lower extremity running injuries and their associated factors. | N = 893 M = 714 (80%) F = 179 (20%) Age = 20–50 y full marathon group (38.8 11.6 years) 10 km group (33.6 9.8 years) Full marathon = 127 (14.3%); Half marathon = 337 (37.7%);10 km = 429 (47.9%) Running experience: < 1 year = 179; 1-5 years = 435; 5-10 years = 130; > 10 years = 146 LBP = 29; 8 (Full marathon); 11 (Half marathon); 10 (10 km) | P = 3.2% (lifetime prevalence) | Questionnaire did not specifically ask the participants to identify if they currently had any symptoms. We would not know how many of the runners only had previous injuries or they also suffered from current injuries. The severity of the running symptoms was not defined in the questionnaire. | Regular running was defined as a minimum of 30 min running at least twice a week. | Lower Back Pain | |
Clement DB, 1981 [69] Retrospective survey Canada | A survey of overuse running injuries. (The Physician and Sportsmedicine) | To give an accurate indication of age and sex distributions, training mileage, etiological factors, and the incidence of specific disorders to physicians in sportsmedicine clinics. | N = 1650 M = 987 (59.8%) F = 663 (40.2%) Age = 28 years Running experience = recreational runners LBP = 68 (M = 36 F = 32); Nonspecific lower back pain = 54 M = 27 F = 27; Sciatica = 10 M = 10 F = 3; Spondylolysis = 3 M = 2 F = 1; Spondylolisthesis = 1 F = 1; | I = 3.7% (2 years) | Physician diagnosis of RRI | To be regarded as a runner, a patient had to be running at least 2 miles (3 km) three days a week at the time of injury. | Lower back injuries: Nonspecific lower back pain; Sciatica; Spondylolysis; Spondylolisthesis | |
Dallinga J, 2019 [80] Prospective cohort study Netherlands | Injury incidence and risk factors: a cohort study of 706 8-km or 16-km recreational runners. (BMJ Open Sport & Exercise Medicine) | To report (1) the injury incidence in recreational runners in preparation for a 8-km or 16-km running event and (2) which factors were associated with an increased injury risk. | N = 706 M = 375 F = 331 Age = 43.9 years Running experience = novice and recreational runners LBP = 13 8 km =128 16 km = 521 both distances = 29 | I = 1.9% (protocol-event incidence, 12 weeks) | Every physical complaint that caused at least 1 week of training loss. | Participants was defined as runners if have competed at least in one of the two distances of the run (8-16 km). | Lower Back | OSTRC and questionnaire of running training and injury related to running |
Ellapen TJ, 2013 [70] Retrospective descriptive study Africa | Common running musculoskeletal injuries among recreational half-marathon runners in kwazulu-natal. (The South African Journal of Sports Medicine) | To document the prevalence and nature of running-related musculoskeletal injuries among recreational half-marathon runners over a 12-month period (1 July 2011–31 June 2012). | N = 200 M = 120 F = 80 Age = 43.6 years Running experience = cohort regularly participated in half-marathons (21.1 km), with an average road-running history of 12.2 years. LBP = 28. | *P = 14% (overall 1-year prevalence) *P = 9% male *P = 10% female (* the data of prevalence are related to lower back/hip) | A sensation of distress or agony, and which prevented them from physical activity for a minimum of 24 h | To be regarded as a runners, participants have to had run at least an half marathon (21.1 km) | Lower Back/Hip | |
Kluitenberg B, 2015 [76] Prospective cohort study Netherlands | The Nlstart2run Study: Incidence and risk factors of Running-Related Injuries in novice runners. (The Scandinavian Journal of Medicine & Science in Sports) | The purposes of the study were to assess the incidence of RRIs and to identify risk factors for RRIs in a large group of novice runners. In total,1696runnersofa6-weeksupervised“StarttoRun” program were included in the NLstart2run study. | N = 1696 M = 364 F = 1332 Age = 43.3 years Running experience = novice runners LBP = 6 | I = 0.3% | RRI was defined as a musculoskeletal complaint of the lower extremity or back that the participant attributed to running and hampered running ability for three consecutive training sessions at the same body part. Muscle soreness and blisters were not registered. | Pelvis/Sacrum/Buttock | ||
Lysholm J, 1987 [74] Prospective cohort study Sweden | Injuries in runners. (The American Journal of Sports Medicine) | To study injury-provoking factors in training and competition, and to compare differences in injury pattern between different groups runners. | N = 60 M = 39 F = 11 Age = Sprinters (20.6 ± 3.8), middle-distance runners (18.6 ± 2.4), and long-distance/marathon runners (34.5 ± 7.4) Running experience = 4 years (sprinters) 3 years (middle distance) 5 years (long distance/marathon) LBP = 3 | I = 5% | Any injuries that markedly hampered training or competition for at least 1 week were noted. | The participants have a previous experience of running training (7 h per week or more). | Low Back Pain | |
Marti B, 1988 [68] Cross-sectional survey Switzerland | On the epidemiology of running injuries, the 1984 bern grand-prix study. (The American Journal of Sports Medicine) | - How frequent are jogging injuries in a representative population comparing all participants in a popular running event, and how often do such injuries lead to medical consultation and absence from work? - Is the incidence of jogging injuries related to behavior and/or characteristics of runners (training mileage, type of running shoes, age, number of years of training, etc.)? - What are the site and nature of the most common injuries? - Is there a relation between specific runner characteristics and specific running injuries? | N = 4358 M = 4358 Age = 35.0 years LBP = 30 | P = 0.7% overall 1-years LBP - Grade III injuries (2.2% lower back; 0.6% pelvic crest; 0.9% buttock) | Runners were asked to classify jogging injuries that had occurred during the previous 12 months according to their effect on running. Grade I injuries involved maintenance of full training activity in spite of symptoms; Grade II, a reduction of training activity, and Grade III, full training interruption, defined as involuntary complete interruption of running of at least two weeks’ duration. | Lower Back Buttock Pelvic Crest | ||
Malliaropoulos N, 2015 [64] Cross-sectional study Greece | Prevalence of injury in ultra trail running. (Human Movement) | The purpose of the study was to try to determine the prevalence of lower extremity and lower back musculoskeletal injuries in ultra-trail runners by considering injuries and related symptoms. Additionally, the predicting factors associated with these injuries were investigated in order to aid in the prevention and rehabilitation of trail running injuries. | N = 40 ultra-trail runners M = 36 F = 4 Age = 38.4 years (22–59) Running experience = Level A = 13; Level B = 27; < 6 years = 21; > 6 years = 19 LBP = 17 | P = 20.2% (lifetime) | If symptoms were severe enough to forgo training for at least 1 day or causing them to quit a race. | According to the International Trail running Association, trail running takes place on various natural terrain (mountain, desert, or forest) while minimizing running on paved or asphalt surfaces (no more than 20% of the total distance in competition). It can involve uphill, downhill, and horizontal trails and is similar in duration to an ultra-marathon, which is considered any race beyond the marathon distance of 42.195 km. | Lower Back Lower Back Pain | |
Messier SP, 2018 [79] Prospective cohort study USA | A 2-year prospective cohort study of overuse running injuries, the runners and injury longitudinal study (TRAILS). (The American Journal of Sports Medicine) | To determine the risk factors that differentiate recreational runners who remain uninjured from those diagnosed with an overuse running injury during a 2-year observational period. | N = 300 M = 172 F = 128 Age = 41.15 Running experience = 11.2% LBP = 18 | I = 6% (2 years) | Overuse running injuries were graded with the method defined by Marti et al.: grade 1, maintained full activity in spite of symptoms; grade 2, reduced weekly mileage; and grade 3, interrupted all training for at least 2 weeks | Participants was defined as runners if they run a minimum of 5 miles per week. | Back | -Exercise Self-efficacy Scale (0, lowest self-efficacy; 100, highest self-efficacy)—which assesses beliefs in the ability to continue to run at one’s training pace for periods of 1 to 8 weeks24. − 12-Item Short Form Health Survey (SF-12) healthrelated quality-of-life survey (0, low; 100, high)—which measures perceived health (mental subscale) and functioning (physical subscale). -Satisfaction With Life Scale (5, extremely dissatisfied; 35, highly satisfied)—which assesses global judgment of life satisfaction. -Positive and Negative Affect Scale (PANAS) (10, very slightly; 50, extremely for each scale). -State-Trait Anxiety Inventory–S Scale (20, not at all; 80, very much)—which asks participants to report how they feel right now. -Visual analog scale for pain (0, no pain; 10, extreme pain). |
Rasmussen CH, 2013 [71] Retrospective cohort study Denmark | Weekly running volume and risk of running-related injuries among marathon runners. (The International Journal of Sports Physical Therapy) | The purpose of this study was to investigate if the risk of injury declines with increasing weekly running volume before a marathon race | N = 662 M = 535 F = 127 Age = 41.4 Running experience = marathon runners: < 2 years = 49; 2–5 years = 262; > 5 years = 351; LBP = 3 | I = 0.5% point incidence | The running-related injury definition was modified based on the injury definition used by Macera et al.; a running-related injury was defined as an injury to muscles, tendons, joints and/or bones caused by running; The injury had to be severe enough to cause or be expected to cause a reduction in distance, speed, duration, or frequency of running for at least 14 days. Conditions like muscle soreness, blisters, and muscle cramps were not considered as injuries. | Completion of the H.C. Andersen marathon | Lower Back | |
Tauton JE, 2003 [75] Prospective cohort study Canada | A prospective study of running injuries: the vancouver sun run “in training” clinics. (British Journal of Sports Medicine) | To determine the injury pattern in a sample of the “In Training” clinics during their 13 weeks program, and identify associated risk factors for injury. | N = 840 M = 205 F = 635 Age = 30–56 years Running experience = novice runners LBP = 37 | I = 1.6% Low back = 7% (4 men), =5% (10 women) -Hip/pelvis: =7% (4 men), =10% (19 women) | -The novice group is primarily sedentary and deconditioned people interested in establishing a running program probably to improve health and fitness. The program for this group incorporates run/walk repeats that eventually lead to a continuous running session in the 12th week. -The intermediate program is designed for people who have completed the novice walk/run program and would like to increase their running endurance and intensity in a safe and effective way. Hill training, interval, and fartlek sessions are implemented. | Low Back | ||
Teixeira RN, 2016 [65] Cross-sectional study Brazil | Prevalence of musculoskeletal pain in marathon runners who compete at the elite level. (The International Journal of Sports Physical Therapy) | The purpose of this research was to assess the prevalence, location and intensity of running related musculoskeletal pain over the previous 12 months in marathon runners who compete at the elite level and to verify whether certain training characteristics are associated with musculoskeletal pain. | N = 199 M = 164 F = 35 Age = 34 (30–39) Running experience = marathon runners at elite level, on average of 11 years; LBP = 28 (Lumbar Spine 20; Pelvic/Sacral/Gluteus 8) | P = 14% (1-year prevalence) | Runners who compete at the elite level, defined as those competing at international and/or national level; Their training is characterized by a high training volume, with weekly training loads of up to 160 km/week. | Lumbar Spine Pelvic/Sacral/Gluteus | VAS | |
van der Worp MP, 2016 [77] Prospective cohort study Netherlands | The 5- or 10-km Marikenloop run: a prospective study of the etiology of running-related injuries in women. (Journal of Orthopaedic & Sports Physical Therapy) | To determine the incidence and characteristics (site and recurrence) of running-related injuries and to identify specific risk factors for running-related injuries. | N = 373 (5 km = 189; 10 km = 184) F = 373 Age = 37.55 Running experience = novice runners LBP = 10 (4 Lower Back; 6 Buttock) | I = 2.7% | Defined as running-related pain of the lower back and/or the lower extremity that restricted running for at least 1 day. | Adult women (aged ≥18 years) who had signed up for the ‘Marikenloop 2013’ running event were eligible for inclusion. The ‘Marikenloop’ is a run over 5- or 10 km in Nijmegen, the Netherlands, and is a female-only event. | Lower Back Buttock | |
Von Rosen P, 2017 [78] Prospective cohort study Sweden | Etiology of running-related injuries in women. (The International Journal of Sports Physical Therapy) | The aims of this study were to describe the injury prevalence/incidence, severity grade, injury location, risk factors and the prevalence of illness in running (RU), orienteering (OR) and cross-country skiing athletes (CR). | N = 189 F = 189 Age = range 18–24 Running experience = elite athletes LBP = 5 | I = 2.8% | As any physical complaint that affected participation in normal training or competition, led to reduced training volume, experience of pain or reduced performance in sports; * A substantial injury was defined as an injury leading to moderate or severe reductions in training volume, or moderate or severe reduction in performance, or complete inability to participate in sports; * A new injury was categorized as a recurrent or a non-recurrent injury, based on if the injury occurred in the same body site as the previous injury within the last year. | Low Back Pain Lower Back | OSTRC | |
Walter SD, 1989 [81] Prospective cohort study USA | The Ontario Cohort Study of Running-Related Injuries. (Archives of Internal Medicine) | The purpose of this study was to investigate the incidence and causes of running injuries. | N = 1288 M = 985 F = 303 Age = 41.4 Running experience= LBP = 23 new injuries; 56 old injuries | I = 1.8% (point incidence) P = 4.3% (1-year prevalence) | All registered entrants to these events: 16-km (10-mile) race, 4-km (2.5-mile) fun run in St Catharines. 22.4-km (14mile) run and a four-member 5.6-km (3.5-mile) team relay in Burling ton were included. | Back Back Injuries | ||
Woolf SK, 2002 [63] Cross-sectional survey USA | The Cooper River Bridge Run of low back pain in runners and walkers. (Journal of the Southern Orthopaedic Association) | The purpose of this study was to investigate the incidence, prevalence, and possible risk factors for LBP among a group of runners and walkers. | N = 436 M = 227 F = 209 Age = 36.45 years Running experience = any kind of runner from novice to athletes LBP = 59 | P = 13.6% (point prevalence) | Low Back Pain LBP |
Risk of Bias of the included studies
Clement DB. 1981 [69] | Ellapen TJ. 2013 [70] | Rasmussen CH. 2013 [71] | |
---|---|---|---|
Were the groups comparable other than the presence of disease in cases or the absence of disease in controls? | Not applicable | Not applicable | Not applicable |
Were cases and controls matched appropriately? | Not applicable | Not applicable | Not applicable |
Were the same criteria used for identification of cases and controls? | Not applicable | Not applicable | Not applicable |
Was exposure measured in a standard, valid and reliable way? | Unclear | Yes | Yes |
Was exposure measured in the same way for cases and controls? | Not applicable | Not applicable | Not applicable |
Were confounding factors identified? | Yes | Yes | Yes |
Were strategies to deal with confounding factors stated? | Yes | Yes | Yes |
Were outcomes assessed in a standard, valid and reliable way for cases and controls? | Yes | Yes | Yes |
Was the exposure period of interest long enough to be meaningful? | Yes | Yes | Yes |
Was appropriate statistical analysis used? | Unclear | Yes | Yes |
Dallinga J. 2019 [80] | Bach DK. 1985 [72] | Buist I. 2008 [73] | Lysholm J. 1987 [74] | Tauton JE. 2003 [75] | Van der Worp MP. 2016 [77] | Messier SP. 2018 [79] | Kluitenberg B. 2015 [76] | Von Rosen P. 2017 [78] | Walter SD. 1989 [81] | |
---|---|---|---|---|---|---|---|---|---|---|
Were the two groups similar and recruited from the same population? | Yes | Yes | Not applicable | Yes | Not applicable | Not applicable | Yes | Not applicable | Not applicable | Not applicable |
Were the exposures measured similarly to assign people to both exposed and unexposed groups? | Yes | Yes | Not applicable | Yes | Not applicable | Not applicable | Yes | Not applicable | Not applicable | Not applicable |
Was the exposure measured in a valid and reliable way? | Yes | Yes | Yes | Yes | Unclear | Unclear | Yes | Unclear | Unclear | Unclear |
Were confounding factors identified? | Yes | Unclear | Yes | Unclear | Yes | Yes | Yes | Yes | Yes | Yes |
Were strategies to deal with confounding factors stated? | Unclear | Unclear | Yes | Unclear | Yes | Yes | Yes | Yes | Yes | Yes |
Were the groups/participants free of the outcome at the start of the study (or at the moment of exposure)? | Unclear | Yes | Unclear | Yes | Unclear | Unclear | Yes | Yes | Unclear | Unclear |
Were the outcomes measured in a valid and reliable way? | Yes | Yes | Yes | Unclear | Yes | Yes | Yes | Yes | Yes | Yes |
Was the follow up time reported and sufficient to be long enough for outcomes to occur? | Yes | Not applicable | Unclear | Yes | Yes | Yes | Yes | Unclear | Yes | Yes |
Was follow up complete, and if not, were the reasons to loss to follow up described and explored? | Yes | Not applicable | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Were strategies to address incomplete follow up utilized? | Yes | Not applicable | Yes | Not applicable | Unclear | No | Yes | Yes | Not applicable | Yes |
Was appropriate statistical analysis used? | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Chang WL. 2012 [67] | Malliaropoulos N. 2015 [64] | Marti B. 1988 [68] | Woolf S. 2002 [63] | Teixeira RN. 2016 [65] | Besomi M., 2019 [66] | |
---|---|---|---|---|---|---|
Were the criteria for inclusion in the sample clearly defined? | Yes | Yes | No | No | Yes | Yes |
Were the study subjects and the setting described in detail? | Yes | Yes | Yes | Yes | Yes | Yes |
Was the exposure measured in a valid and reliable way? | Yes | Yes | Yes | Yes | Yes | Yes |
Were objective, standard criteria used for measurement of the condition? | No | Yes | Yes | Yes | Yes | Yes |
Were confounding factors identified? | Unclear | Yes | Yes | Yes | Yes | Yes |
Were strategies to deal with confounding factors stated? | Unclear | Yes | Yes | Unclear | Yes | Yes |
Were the outcomes measured in a valid and reliable way? | Unclear | Yes | Yes | Unclear | Yes | Yes |
Was appropriate statistical analysis used? | Yes | Yes | Yes | Yes | Yes | Yes |
Chang WL. 2012 [67] | Marti B. 1988 [68] | Ellapen TJ. 2013 [70] | Malliaropoulos N. 2015 [64] | Walter SD. 1989 [81] | Teixeira RN. 2016 [65] | Woolf S. 2002 [63] | Besomi M. 2019 [66] | |
---|---|---|---|---|---|---|---|---|
Was the sample frame appropriate to address the target population? | Yes | Yes | Yes | Unclear | Yes | Yes | Yes | Yes |
Were study participants sampled in an appropriate way? | Yes | No | Unclear | Yes | Yes | Unclear | Unclear | Yes |
Was the sample size adequate? | Yes | Yes | Yes | Unclear | Yes | Yes | Yes | Yes |
Were the study subjects and the setting described in detail? | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Was the data analysis conducted with sufficient coverage of the identified sample? | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Were valid methods used for the identification of the condition? | Yes | No | Yes | Yes | Yes | Yes | Unclear | Yes |
Was the condition measured in a standard, reliable way for all participants? | Yes | No | Yes | Yes | Yes | Yes | Yes | Yes |
Was there appropriate statistical analysis? | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Was the response rate adequate, and if not, was the low response rate managed appropriately? | Yes | Yes | Yes | Yes | Yes | Yes | Unclear | Yes |
Summary of findings
Author, year | Study design | Incidence | Prevalence | ||||||
---|---|---|---|---|---|---|---|---|---|
Lifetime | 1 year | Point | Other | Lifetime | 1 year | Point | Other | ||
Bach DK, 1985 [72] | Prospective Cohort | 22% | |||||||
Besomi M, 2019 [66] | Cross Sectional Survey | 13.5% | 0.7% | ||||||
Buist I, 2008 [73] | Prospective Cohort | 4.8% (protocol event: 8 weeks) | |||||||
Chang WL, 2012 [67] | Cross Sectional Survey | 3.2% | |||||||
Clement DB, 1981 [69] | Retrospective Survey | 3.7% (2 years) | |||||||
Dallinga J, 2019 [80] | Prospective Cohort | 1.9% (protocol event: 12 weeks) | |||||||
Ellapen TJ, 2013 [70] | Retrospective Descriptive | 14% | |||||||
Kluitenberg B, 2015 [76] | Prospective Cohort | 0.3% (protocol event: 6 weeks) | |||||||
Lysholm J, 1987 [74] | Prospective Cohort | 5% | |||||||
Marti B, 1988 [68] | Cross Sectional Survey | 0.7% | |||||||
Malliaropoulos N, 2015 [64] | Cross Sectional | 20.2% | |||||||
Messier SP, 2018 [79] | Prospective Cohort | 6% (2 years) | |||||||
Rasmussen CH, 2013 [71] | Retrospective Cohort | 0.5% | |||||||
Tauton JE, 2003 [75] | Prospective Cohort | 1.6% (protocol event: 13 weeks) | |||||||
Teixeira RN, 2016 [65] | Cross Sectional | 14% | |||||||
Van der Worp MP, 2016 [77] | Prospective Cohort | 2.7% (12 weeks) | |||||||
Von Rosen P, 2017 [78] | Prospective Cohort | 2.8% | |||||||
Walter SD, 1989 [81] | Prospective Cohort | 1.8% | 4.3% | ||||||
Woolf SK, 2002 [63] | Cross Sectional Survey | 13.6% |
Prevalence of LBP
Incidence of LBP
Risk factors for LBP
Author | Risk Factors For LBP | P -Value | Odds Ratio |
---|---|---|---|
Clement DB, 1981 [69] | - Leg-length discrepancy - Reduced hamstrings flexibility - Reduced back flexibility | / / / | |
Ellapen TJ, 2013 [70] | - Hip flexion angles (female) -(Thomas Test + goniometer) | p < 0.01 | †3.0488 |
Malliaropoulos N, 2015 [64] | - > than 6 years of experience in running | P = 0.012 | †5.4857 |
Woolf SK, 2002 [63] | - Not equal wear of heels1 - BMI ≥ 241 - Not performing Weekly aerobics activity1 - Not Play in contact sports regularly1 (i.e. football, soccer, basketball, wrestling, boxing, rugby - Not using orthotics + not equal wear of heels1 - Outside pattern of weara,1 - Running without Inside pattern of wear2 - Higher Physical height; - Flexibility exercises routine for a longer time before working out2 - Not doing Traditional aerobics activity2 | p = 0.034 p < 0.01 p < 0.05 p < 0.04 p = 0.011 p = 0.013 p ≤ 0.02 p ≤ 0.02 p ≤ 0.05 p < 0.05 | ‡1.263 (female ^BMI) ‡1.122 (male ^BMI) |