Scheer Volker, Krabak Brian J
Ultra Sports Science Foundation, Pierre-Bénite, France.
University of Washington and Seattle Children's Sports Medicine, Seattle, WA, United States.
Front Physiol. 2021 Mar 31;12:664071. doi: 10.3389/fphys.2021.664071. eCollection 2021.
Ultra-endurance running (UER) has seen an important increase in participation over the last few decades. Long hours of UER can lead to excessive stress on the body, resulting in musculoskeletal injuries (MSKI). UER is not a uniform sport and events can differ considerably in distance (over 42.195 km), time (e.g., events over 6 h) and multi-day or multi-stage events on various surfaces (e.g., track, on-road, off-road). The aims of this scoping review were therefore: (1) to examine the current evidence of MSKI, providing a synthesis of the most common MSKI by anatomical region and specific diagnosis; (2) categorize MSKI by type of UER activity (competition: time-limited; multi-stage; continuous UER events and training); (3) describe knowledge gaps in the literature and provide advice on potential further research. Our electronic literature search (PubMed, SPORTDiscus, Web of Science) identified a total of 13 studies (9 in competition, and 4 in training). Anatomical site, diagnosis and rate of injuries differ between competition and training as well as between different UER types. MSKI are observed in 18% of multi-stage events (0.7-1.8 injuries/runner and 7.2 injuries/1000 h). Most MSKI involve the lower leg (35.0%), ankle (16.8%), knee (13.1%) and foot (12.6%), with main diagnosis of medial tibial stress syndrome (30.1%) and patella femoral pain syndrome (PFPS; 7.2%). Single, continuous UER events differ between a 1005 km road race with almost all of the injuries due to overuse, with the main anatomical site of the knee (31%), ankle (28%) and lower leg (14%) and main diagnosis of PFPS (15.6%), compared to a 65 km trail race, with 32.8% of MSKI, mainly on the foot [plantar fasciitis (28.6%)], ankle [sprain (28.6%)] and knee. Timed-UER events (injury rate of 2.1 injuries/athlete) observed most injuries on the ankle (36%) and knee (19%), with the main diagnosis of tendinitis of the foot dorsiflexors (30%). Injuries during training most commonly affect, the back (42%), and knee (40%) and bone stress injuries (22%). Main diagnoses include ankle sprain (18%), iliotibial band injury (16%) and Achilles tendinopathy (11%). Future considerations include examining MSKI in different UER events, environments and surfaces, and on larger study populations. Establishing risk factors, examining sex differences and using a standard reporting system of MSKI in UER are also important.
在过去几十年中，超耐力跑（UER）的参与人数显著增加。长时间的超耐力跑会给身体带来过大压力，导致肌肉骨骼损伤（MSKI）。超耐力跑并非一项统一的运动，其赛事在距离（超过42.195公里）、时间（如超过6小时的赛事）以及在各种路面（如跑道、公路、越野）上的多日或多阶段赛事方面差异很大。因此，本综述的目的是：（1）审查肌肉骨骼损伤的现有证据，按解剖区域和具体诊断对最常见的肌肉骨骼损伤进行综合分析；（2）根据超耐力跑活动类型（比赛：限时；多阶段；连续超耐力跑赛事和训练）对肌肉骨骼损伤进行分类；（3）描述文献中的知识空白，并为潜在的进一步研究提供建议。我们通过电子文献检索（PubMed、SPORTDiscus、科学网）共确定了13项研究（9项关于比赛，4项关于训练）。比赛和训练之间以及不同超耐力跑类型之间，解剖部位、损伤诊断和损伤发生率存在差异。在多阶段赛事中，18%的参与者出现肌肉骨骼损伤（每位跑步者0.7 - 1.8次损伤，每1000小时7.2次损伤）。大多数肌肉骨骼损伤涉及小腿（35.0%）、脚踝（16.8%）、膝盖（13.1%）和足部（12.6%），主要诊断为胫骨内侧应力综合征（30.1%）和髌股疼痛综合征（PFPS；7.2%）。单次连续超耐力跑赛事有所不同，在一场1005公里的公路赛中，几乎所有损伤都是由于过度使用造成的，主要解剖部位是膝盖（31%）、脚踝（28%）和小腿（14%），主要诊断为髌股疼痛综合征（15.6%）；相比之下，在一场65公里的越野赛中，32.8%的参与者出现肌肉骨骼损伤，主要集中在足部[足底筋膜炎（28.6%）]、脚踝[扭伤（28.6%）]和膝盖。限时超耐力跑赛事（每位运动员的损伤率为2.1次损伤）中，大多数损伤发生在脚踝（36%）和膝盖（19%），主要诊断为足背屈肌腱炎（30%）。训练期间的损伤最常影响背部（42%）、膝盖（40%）和骨应力损伤（22%）。主要诊断包括脚踝扭伤（18%）、髂胫束损伤（16%）和跟腱病（11%）。未来需要考虑的方面包括在不同的超耐力跑赛事、环境和路面以及更大规模的研究人群中研究肌肉骨骼损伤。确定风险因素、研究性别差异以及在超耐力跑中使用肌肉骨骼损伤的标准报告系统也很重要。
