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Official Journal of the American College of Sports Medicine investigate the risk factors for running-related injuries were included in this review. We excluded articles that studied specific injuries on running (e.g. stress fractures), studies aimed to analyse risk factors and/or injuries of other sports (e.g. triathlon) and studies comparing the effectiveness of interventions on running injuries or prevention programs. Each article was screened by three independent reviewers and, if they did not reach a consensus, a fourth reviewer decided whether or not the article should be included. The risk factors were divided into intrinsic and extrinsic factors. rEsuLTs:A total of 1934 studies were found through the database search. After the analysis of the title, abstract and full text 12 articles were eligible to be included in this systematic review. The main intrinsic risk factor reported was previous injury in the past 12 months and the main extrinsic factor reported was weekly running distance more than 64 km. BMI, age and running experience showed conflicting results. Biomechanical factors, behaviour and running shoes showed limited evidence, i.e. few studies reported an association with running injuries. There was no evidence for an association between stretching and running injuries. CONCLusIONs:The main risk factors identified in this review were previous injury and weekly running distances. We observed that majority of risk factors are still inconclusive, which reflects the lack of prospective studies investigating risk factors on running injury 1731 Board #5 May 30, 3:15 PM - 5:15 PM Physical activity Injuries: Not so Bad after all! Erica N. Howard 1 , Laura F. DeFina 1 , Michelle A. Custodio 1 , James R. Morrow, FACSM 2 . 1 The Cooper Institute, Dallas, TX. 2 University of North Texas, Denton, TX. (No relationships reported) PurPOsE: Increased injury rates have been associated with increased physical activity (PA); however, it is not known if the types of musculoskeletal injuries (MSI) resulting from PA are substantially different from those occurring within the same timeframe, yet are unrelated to PA. The purpose of this study is to qualitatively and quantitatively describe the pattern of PA and non-PA MSI incurred by communitydwelling women. METhOds: Data were extracted from The Women’s Injury Study (WIN), a web-based observational study that tracked PA behaviors and self-reported MSI of community-dwelling adult women during 2007-2009. Data were collected via a secure website where participants reported weekly PA and injury occurrence. An MSI was defined as “an injury (new, old, or recurrent) this week that caused you to see a health care provider or interrupt your daily activities for 2 or more days.” Follow-up telephone reporting of a PA-related MSI including body part, self-treatment, specific activity, and other relevant information provided the opportunity to fully describe the MSI. rEsuLTs: A total of 323 and 330 musculoskeletal injuries were reported during PA and non-PA events respectively across 83,241 person-weeks of reporting. Communitydwelling women injured during non-PA events were more likely to incur injuries of the head/jaw/neck; however, lower limb injuries were the most prevalent PA-related MSI. The risk of injury coming “...on suddenly with no apparent cause” was 54% for non-PA MSI vs. 8% for PA-related MSI. Reported PA-related MSIs were generally minor and less likely to require treatment from health care providers (60% vs. 80%) and resulted in less initial reporting of missed days of work/school (11%) compared to non-PA MSIs (17%). CONCLusION: Overall, the nature of MSIs occurring during PA is not dramatically different than MSIs reported during community-dwelling non-PA behaviors. This provides additional validation of the important role that PA behaviors can have on quality of life without substantially increasing the MSI risk beyond that in general living activities. This work was supported in part by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases R01 AR052459. 1732 Board #6 May 30, 3:15 PM - 5:15 PM Incidence, Mechanisms, and severity of Collegiate Women’s soccer Injuries on artificial Turf Versus Natural Grass Michael C. Meyers, FACSM. College of Western Idaho, Nampa, ID. Supported by M.C. Meyers: Contracted Research - Including Principle Investigator; Partial support by FieldTurf, USA. Numerous injuries have been attributed to playing on artificial turf. Newer generations of artificial turf, however, were developed to duplicate the playing characteristics of natural grass. Minimal long-term studies have been conducted comparing matchrelated collegiate women’s soccer injuries between the two surfaces. PurPOsE: To quantify incidence, mechanisms, and severity of match-related collegiate women’s soccer injuries on artificial turf versus natural grass. METhOds: A total of 13 universities were evaluated over 5 competitive seasons for injury incidence, injury category, time of injury, injury time loss, player position, injury mechanism and situation, primary type of injury, injury grade and anatomical location, field location at time of injury, injury severity, head and lower extremity trauma, cleat design, turf age, and environmental factors. Vol. 45 No. 5 Supplement S333 rEsuLTs: A total of 797 collegiate matches were evaluated for soccer injuries sustained on artificial turf or natural grass during 5 seasons, with 355 team matches (44.5%) played on artificial turf versus 442 team matches (55.5%) played on natural grass. A total of 693 injuries were documented, with 272 (39.2%) occurring during play on artificial turf, and 421 (60.8%) on natural grass. Multivariate analysis per 10 team matches indicated a significant playing surface effect, F 2,690 = 6.435, P = .002, n - β = 0.904. Significantly lower total injury incidence rates (IIR), 7.7 (95% confidence interval [CI], 7.2-8.1) versus 9.5 (95% CI, 9.3-9.7, P = .0001), and substantial IIRs, 0.7 (95% CI, 0.5-1.0) versus 1.5 (95% CI, 1.2-1.9, P = .001), were documented on artificial turf versus natural grass, respectively. Analyses also indicated significantly less trauma (P = 0.040 to 0.0001) on artificial turf when comparing injury time loss, player position, injury situation, injury grade, injuries under various field conditions and temperature, cleat design and turf age. CONCLusION: Although similarities existed between artificial turf and natural grass during competitive match play, artificial turf is a practical alternative when comparing injuries in collegiate women’s soccer. It must be reiterated that the findings of this study may be generalizable to only collegiate women’s competition and this specific artificial surface. D-55 Thematic Poster - Mechanics of Strike Patterns in Running May 30, 2013, 3:15 PM - 5:15 PM Room: 104 1733 Chair: Irene Davis, ACSM. Harvard Medical School, Boston, MA. (No relationships reported) 1734 Board #1 May 30, 3:15 PM - 5:15 PM No differences in self-reported Injuries or Performance Between Characterized Foot-strike Patterns amongst us army soldiers Bradley J. Warr 1 , Rebecca E. Fellin 1 , Peter N. Frykman 1 , Shane G. Sauer 1 , Donald L. Goss 2 , Joseph J. Seay 1 . 1 U.S. Army Research Institute of Environmental Medicine, Natick, MA. 2 U.S. Army/Baylor University Physical Therapy Program, San Antonio, TX. (Sponsor: Dr. Edward J. Zambraski, FACSM) (No relationships reported) There is currently little data characterizing Soldiers’ foot-strike (FS) patterns and the potential relationship to running related injuries and performance. Literature has characterized FS pattern distribution in marathon runners reporting a heel-strike (HS) prevalence of 75%-94% in marathoners, with the remainder (6-25%) exhibiting a midfoot or fore-foot pattern (non heel-strike, NHS). Recent studies have reported that NHS runners had fewer running related injuries and better performance. PurPOsE: To characterize the distribution of FS patterns in US Army Soldiers and determine if FS patterns are related to self-reported running injuries and performance. METhOds: 342 male Soldiers (24.7±5.1 y/o, 177.3+7.3 cm, 81.7+16.9 kg) from a US Army Combined Arms Battalion completed a FS analysis and survey. Multiple foot-strikes were recorded in the sagittal plane using a high-definition video camera as each Soldier ran through a designated lane at a typical training pace. Soldiers then completed a survey related to training habits and injury history. The association between FS and the occurrence of a running-related injury was analyzed using a Chisquared test. Kruskal-Wallis test evaluated relationship between reported days that training was modified due to injury as well as 2-mile run time between Soldiers with NHS and HS patterns. rEsuLTs: 13% of the participating Soldiers were characterized as NHS runners and 87% were characterized as HS. There was no significant difference (p≥.05) in the percentage of Soldiers reporting a running-related injury between those characterized with a NHS versus a HS (55.6 v 51.0%). There were no significant difference between NHS pattern versus HS pattern in the number of days training was modified due to injury (21.8±78.4 v 13.9±49.5 days/yr), or 2-mile run time (14.8±1.6 v 14.8±1.7 min). CONCLusIONs: This cohort of US Army Soldiers demonstrated a prevalence of HS similar to what has previously been reported in marathon runners. Based on this preliminary analysis, neither FS pattern is advantageous in terms of impact on selfreported, retrospective injury or performance. Abstracts were prepared by the authors and printed as submitted. Thursday, May 30, 2013
Thursday, May 30, 2013 S334 Vol. 45 No. 5 Supplement 1735 Board #2 May 30, 3:15 PM - 5:15 PM Foot strike Pattern during a 161-km ultramarathon Mark E. Kasmer 1 , Jeremy J. Wren 2 , Martin D. Hoffman, FACSM 3 . 1 Medical College of Wisconsin, Milwaukee, WI. 2 University of California - Davis, Sacramento, CA. 3 VA Northern California Health Care System and University of California - Davis, Sacramento, CA. (No relationships reported) PurPOsE: The purpose of this study was to characterize the foot strike pattern of ultramarathon runners during a 161-km mountain trail run; examine the effect of fatigue on foot strike pattern; examine the effect of a downhill gradient on foot strike pattern; determine if foot strike pattern is related to performance; and ascertain if postrace blood creatine phosphokinase (CK) concentrations differ by foot strike pattern. METhOds: Foot strike pattern was determined for race participants of the 2012 Western States Endurance Run at three level sites and one downhill site (9% gradient). Post-race blood samples were collected immediately after finishing and analyzed for CK concentration. Chi-square analyses were used to compare foot strike patterns at each level site with prior published data from road marathons. Finish time and blood CK concentration were compared among foot strike group categories for each filming location and collectively across all three sites with Kruskal-Wallis tests followed by Dunn’s multiple comparison post-tests as data did not pass the normality test and could not be successfully normalized. rEsuLTs: Observed rear-foot strike (RFS) prevalence was 79.9% at 16.5 km, which was less than (p=0.02) previously observed in one study at a road marathon. RFS prevalence increased significantly to 89.0% at 90.3 km (n=246, p=0.04), then decreased significantly to 83.9% at 161.1 km (n=225, p=0.03). RFS prevalence was 84.8% at the downhill site (90.7 km), which was not significantly different (p=0.8) from the level site at 90.3 km. There was no significant effect (p=0.3) of foot strike pattern on performance. There was a trend toward greater blood CK values among non-RFS compared to RFS runners, reaching statistical significance (p
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