title: Running more than three kilometers during the first week of a running regimen may be associated with increased risk of injury in obese novice runners.
abstract: BACKGROUND
  Training guidelines for novice runners are needed to reduce the risk of injury. The purpose of this study was to investigate whether the risk of injury varied in obese and non-obese individuals initiating a running program at different weekly distances.
  
  
  METHODS
  A volunteer sample of 749 of 1532 eligible healthy novice runners was included in a 3-week observational explorative prospective cohort study. Runners were categorized into one of six strata based on their body mass index (BMI) (≤30=low; >30=high) and running distance after 1 week (<3 km = low; 3 to 6 km = medium; >6 km = high). Data was collected for three weeks for the six strata. The main outcome measure was running-related injury.
  
  
  RESULTS
  Fifty-six runners sustained a running-related injury during the 3-week data collection. A significantly greater number of individuals with BMI>30 sustained injuries if they ran between 3 to 6 km (cumulative risk difference (CRD) = 14.3% [95%CI: 3.3% to 25.3%], p<0.01) or more than 6 km (CRD = 16.2% [95%CI: 4.4% to 28.0%], p<0.01) the first week than individuals in the reference group (low distance and low BMI). The effect-measure modification between high running distance and BMI on additive scale was positive (11.7% [-3.6% to 27.0%], p=0.13). The number of obese individuals needed to change their running distance from high to low to avoid one injury was 8.5 [95%CI: 4.6 to 52].
  
  
  CONCLUSIONS
  Obese individuals were at greater risk of injury if they exceeded 3 km during the first week of their running program. Because of a considerable injury risk compared with their non-obese peers, individuals with a BMI>30 may be well advised to begin running training with an initial running distance of less than 3 km (1.9 miles) the first week of their running regime. Large-scale trials are needed to further describe and document this relationship.
  
  
  METHODS
  Level 2b.
authors.forename: Rasmus Oestergaard
authors.initials: RO
authors.lastname: Nielsen
authors.forename: Michael Lejbach
authors.initials: ML
authors.lastname: Bertelsen
authors.affiliation: Department of Public Health, Section of Biostatistics, Aarhus University, DK-8000 Aarhus.
authors.forename: Erik Thorlund
authors.initials: ET
authors.lastname: Parner
authors.affiliation: Department of Public Health, Section of Sport Science, Aarhus University, DK-8000 Aarhus.
authors.forename: Henrik
authors.initials: H
authors.lastname: Sørensen
authors.affiliation: Department of Orthopaedics, Aarhus University Hospital, DK-8000 Aarhus.
authors.forename: Martin
authors.initials: M
authors.lastname: Lind
authors.forename: Sten
authors.initials: S
authors.lastname: Rasmussen
keywords: Body mass index; Running; distance; injury risk