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Background: Sudden changes (increases and decreases) in training load have been suggested to play a key role in the development of running-related injuries. However, the compiled evidence for an association between change in training load and running-related injury does not exist., Purpose: The purpose of the present systematic review was to compile the evidence from original articles examining the association between changes in training load and running-related injuries., Study Design: Systematic review., Methods: Four databases (Pubmed/Medline, SPORTDiscus, Embase, and Scopus) were systematically searched. Two reviewers screened titles, abstracts, and full-text articles independently. Articles were included if i) the study design was a randomized trial, a prospective cohort study, a cross-sectional study or a case-control study, ii) participants were runners between 18-65 years, and iii) specific information on changes in training load was provided. Methodological quality of included articles was assessed using the Newcastle Ottawa Scale and the PEDro rating scale., Results: Four articles fulfilled the eligibility criteria of which three found an association between increases in training load and an increased risk of running-related injuries: This association was shown by an increased injury risk amongst runners: i) if they recently had performed one or more changes in either velocity and/or distance and/or frequency compared with the non-injured runners (p = 0.037), ii) increasing their average weekly running distance by more than 30% compared to an increase less than 10% (Hazard Ratio  =  1.59 (95% Confidence Interval: 0.96; 2.66)), iii) increasing their total running distance significantly more the week before the injury origin compared with other weeks (mean difference: 86%; 95% Confidence Interval: 12%; 159%, p = 0.026). However, no difference was found between a 10% and a 24% average increase in weekly volume (HR = 0.8, 95% CI: 0.6; 1.3)., Conclusion: Very limited evidence exists supporting that a sudden change in training load is associated with increased risk of running-related injury., Level of Evidence: 2.

Background: Behavioral science methods have rarely been used in running injury research. Therefore, the attitudes amongst runners and their coaches regarding factors leading to running injuries warrants formal investigation., Purpose: To investigate the attitudes of middle- and long-distance runners able to compete in national championships and their coaches about factors associated with running injury development., Methods: A link to an online survey was distributed to middle- and long-distance runners and their coaches across 25 Danish Athletics Clubs. The main research question was: "Which factors do you believe influence the risk of running injuries?". In response to this question, the athletes and coaches had to click "Yes" or "No" to 19 predefined factors. In addition, they had the possibility to submit a free-text response., Results: A total of 68 athletes and 19 coaches were included in the study. A majority of the athletes (76% [95%CI: 66%; 86%]) and coaches (79% [95%CI: 61%; 97%]) reported "Ignoring pain" as a risk factor for running injury. A majority of the coaches reported "Reduced muscle strength" (79% [95%CI: 61%; 97%]) and "high running distance" (74% [95%CI: 54%; 94%]) to be associated with injury, while half of the runners found "insufficient recovery between running sessions" (53% [95%CI: 47%; 71%]) important., Conclusion: Runners and their coaches emphasize ignoring pain as a factor associated with injury development. The question remains how much running, if any at all, runners having slight symptoms or mild pain, are able to tolerate before these symptoms develop into a running-related injury., Level of Evidence: 3b.

Introduction: In clinical practice, joint kinematics during running are primarily quantified by two-dimensional (2D) video recordings and motion-analysis software. The applicability of this approach depends on the clinicians' ability to quantify kinematics in a reliable manner. The reliability of quantifying knee- and hip angles at foot strike is uninvestigated., Objective: To investigate the intra- and inter-rater reliability within and between days of clinicians' ability to quantify the knee- and hip angles at foot strike during running., Methods: Eighteen recreational runners were recorded twice using a clinical 2D video setup during treadmill running. Two blinded raters quantified joint angles on each video twice with freeware motion analysis software (Kinovea 0.8.15)., Results: The range from the lower prediction limit to the upper prediction limit of the 95% prediction interval varied three to eight degrees (within day) and nine to 14 degrees (between day) for the knee angles. Similarly, the hip angles varied three to seven degrees (within day) and nine to 11 degrees (between day)., Conclusion: The intra- and inter rater reliability of within and between day quantifications of the knee- and hip angle based on a clinical 2D video setup is sufficient to encourage clinicians to keep using 2D motion analysis techniques in clinical practice to quantify the knee- and hip angles in healthy runners. However, the interpretation should include critical evaluation of the physical set-up of the 2D motion analysis system prior to the recordings and conclusions should take measurement variations (3-8 degrees and 9-14 degrees for within and between day, respectively) into account., Level of Evidence: 3.