title: Epidemiology of musculoskeletal injuries among high school cross-country runners.
abstract: To determine the incidence of lower-extremity injury among high school cross-country runners and to identify risk factors for injury, the authors prospectively monitored a cohort of 421 runners competing on 23 cross-country teams in 12 Seattle, Washington, high schools during the 1996 cross-country season. Collected were daily injury and athletic exposure (AE) reports, a baseline questionnaire on prior running and injury experience, anthropometric measurements, and coaches' training logs. The overall incidence rate of injury was 17.0/1,000 AEs. Girls had a significantly higher overall injury rate (19.6/1,000 AEs) than boys did (15.0/1,000 AEs) (incidence rate ratio = 1.3, 95% confidence interval: 1.0, 1.6). Compared with boys, girls had significantly higher rates of injuries resulting in >or=15 days of disability. For the overall sample and for girls, Cox regression revealed that a quadriceps angle of >or=20 degrees and an injury during summer running prior to the season were the most important predictors of injury. For boys, a quadriceps angle of >or=15 degrees and a history of multiple running injuries were most associated with injury. Results suggest that the incidence of lower-extremity injuries is high for cross-country runners, especially girls. Preseason screening to determine risk factors should be examined as a preventive approach for identifying high-risk runners.
authors.affiliation: Graduate Program in Orthopaedic and Sports Physical Therapy, School of Rehabilitation Sciences, Rocky Mountain University of Health Professions, Provo, UT 84601, USA. mrauh@rmuohp.edu
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Rauh
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Koepsell
authors.forename: Frederick P
authors.initials: FP
authors.lastname: Rivara
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Margherita
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Rice
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007869:Leg Injuries / Q000453:epidemiology*; D008297:Male; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012420:Running / Q000293:injuries*; D011795:Surveys and Questionnaires; D014861:Washington / Q000453:epidemiology