Mr Carel Viljoen, a Physiotherapist at SEMLI (Sport, Exercise Medicine and Lifestyle Institute at the University of Pretoria) who is also completing his PhD at the University of Pretoria delivered an award-winning presentation at the 2021 World Physiotherapy Congress on 7 April 2021. The presentation shared research published this year in Physical Therapy in Sport on the injuries sustained by race entrants during the 12 months training preceding the 2019 SkyRun race.

Trail running is a demanding sport that allows avid runners to conquer varied and challenging natural terrain (mountain, desert, forest), in all sorts of weather conditions. Despite its popularity, trail running has not been well researched, but Section Sports Medicine and the Department of Physiotherapy in collaboration with Vrije University in Amsterdam and SEMLI, the Sport, Exercise Medicine and Lifestyle Institute at the University of Pretoria, is looking to change that. Physical activity in outdoor environments has been shown to have a positive impact on mental wellbeing, and although running has multiple proven health benefits, a high risk for injury remains.  Researchers at SEMLI have been investigating the injuries, illnesses and other medical complications experienced by trail runners.  This is an effort to help guide the development of injury and illness prevention strategies for trail runners, as well as medical support strategies for event organizers on race day.

Driven by the principal investigators (Carel Viljoen and Prof Christa Janse van Rensburg) of the trail running research project, a recent review published by this group suggests that the foot is the most common anatomical site of trail running injury followed by the knee, lower leg, thigh, and ankle. Skin lacerations/abrasions are the most common injury diagnoses, followed by skin blisters, muscle strains, muscle cramping, and ligament sprains - although most injuries are of minor severity. The most common trail running illnesses reported relates to the gastro-intestinal tract (GIT), followed by the metabolic and cardiovascular systems. Symptoms of nausea and vomiting related to GIT distress and dehydration are commonly reported, although most illnesses are also of minor severity.

Another study by this group looked specifically at trail runners competing in the SkyRun races (38 km, 65 km or 100 km) in South Africa in 2019.  The participants were asked to complete a pre-race medical screening questionnaire that included details of injuries they had sustained in the previous 12 months.  Data collected showed that approximately 1 in every 4 SkyRun trail runners reported at least one injury in the 12 months leading up to the race. Most of these injuries (nearly 90%) occurred in the lower limb, with the knee, ankle and foot being the most commonly injured areas; and tendinopathy, joint sprain and muscle injuries being the most common pathology types reported.  Based on these results, the researchers emphasized the need to establish injury risk factors to assist in the design of specific injury prevention strategies, as the recurrence of injury during a trail running race may have dire consequences.

Publications related to this article:

Epidemiology of Injury and Illness Among Trail Runners: A Systematic Review. Sports Medicine, 2021 Feb 4. 

Carel T. Viljoen, Dina C. Janse van Rensburg, Evert Verhagen, Willem van Mechelen, Rita Tomás, Marlene Schoeman, Susan Scheepers, Elzette Korkie

https://pubmed.ncbi.nlm.nih.gov/33538997/

One in four trail running race entrants sustained an injury in the 12 months training preceding the 2019 SkyRun race. Physical Therapy in Sport 47 (2021) 120-126.

Carel T. Viljoen, Dina C.(Christa) Janse van Rensburg, Audrey Jansen van Rensburg, Evan Booysen, Shihluke Chauke, Petro Coetzee, Amy Hurlimann, Mignette Jooste, Yoliswa Nibe, Chene Schulenburg, Elzette Korkie, Dimakatso Ramagole, Catharina Grant, Tanita Cronje

https://pubmed.ncbi.nlm.nih.gov/33254101/