Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
©Journal of Sports Science and Medicine (2019) 18, 21 - 31

Review article
The Proportion of Lower Limb Running Injuries by Gender, Anatomical Location and Specific Pathology: A Systematic Review
Peter Francis1, , Chris Whatman2, Kelly Sheerin2, Patria Hume2, Mark I. Johnson3
Author Information
1 Musculoskeletal Health Research Group, School of Clinical and Applied Sciences, Leeds Beckett University, UK
2 Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand
3 Centre for Pain Research, School of Clinical and Applied Sciences, Leeds Beckett University, UK

Peter Francis
✉ PhD Director of the Musculoskeletal Health Research Group, School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, LS13HE, United Kingdom
Publish Date
Received: 08-10-2018
Accepted: 20-11-2018
Published (online): 11-02-2019

Running is associated with a higher risk of overuse injury than other forms of aerobic exercise such as walking, swimming and cycling. An accurate description of the proportion of running injuries per anatomical location and where possible, per specific pathology, for both genders is required. The aim of this review was to determine the proportion of lower limb running injuries by anatomical location and by specific pathology in male and female runners (≥800m - ≤ marathon). The preferred reporting items for systematic reviews and meta-analyses guidelines were followed for this review. A literature search was performed with no restriction on publication year in Web of Science, Scopus, Sport-Discus, PubMed, and CINAHL up to July 2017. Retrospective, cross-sectional, prospective and randomised-controlled studies which surveyed injury data in runners were included. 36 studies were included to report the overall proportion of injury per anatomical location. The overall proportion of injury by specific pathology was reported from 11 studies. The knee (28%), ankle-foot (26%) and shank (16%) accounted for the highest proportion of injury in male and female runners, although the proportion of knee injury was greater in women (40% vs. 31%). Relative to women, men had a greater proportion of ankle-foot (26% vs. 19%) and shank (21% vs. 16%) injuries. Patellofemoral pain syndrome (PFPS; 17%), Achilles tendinopathy (AT; 10%) and medial tibial stress syndrome (MTS; 8%) accounted for the highest proportion of specific pathologies recorded overall. There was insufficient data to sub-divide specific pathology between genders. The predominate injury in female runners is to the knee. Male runners have a more even distribution of injury between the knee, shank and ankle-foot complex. There are several methodological issues, which limit the interpretation of epidemiological data in running injury.

Key words: Running, injury, injury prevention, epidemiology

           Key Points
  • The highest proportion of running injury occurs from the knee downwards.
  • The top 3 anatomical locations for running injuries are common to both genders but women seem to suffer more knee injuries relative to men.
  • Injuries reported using medical diagnosis appear to mirror the anatomical locations most commonly injured.
  • Greater standardisation of injury audit tools are required in order to be able to perform meta-analysis on the prevalence and incidence of injury in runners.
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