{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T14:01:28Z","timestamp":1780322488989,"version":"3.54.1"},"reference-count":42,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p> Trail running is characterized by elevation changes, with uneven and varying running surfaces. Risk factors that may predict gradual-onset running-related injuries (GORRIs) in short-distance trail running have not been explored. The objective was to determine risk factors that predict GORRIs in trail running race entrants who entered mass community-based trail running events. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> In this descriptive cross-sectional study, data were collected prospectively from a prerace medical screening questionnaire over 4 trail run events held annually. Using a Poisson regression model, runner demographics, race distance, running training\/racing variables, history of chronic diseases (number of chronic diseases reported as a cumulative \u201cchronic disease composite score\u201d), and allergies were investigated to determine factors predicting self-reported GORRI history in the previous 12 mo. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> This study included 2824 race entrants (80% of entrants). The retrospective annual incidence for GORRIs was 13%. Independent risk factors predicting GORRIs were longer race distance ( P&lt;0.0001), increasing chronic disease composite score ( P=0.0012), and a history of allergies ( P=0.0056). The lower limb (94%) was the main anatomic region of GORRIs, and soft tissue injuries accounted for most (83%) GORRIs. Common specific GORRIs were iliotibial band syndrome (22%), Achilles tendon injury (10%), and hamstring injury (9%). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Independent risk factors predicting GORRIs among trail running entrants included longer race distance, a higher chronic disease composite score, and a history of allergies. This study has highlighted trail running race entrants at risk for sustaining GORRIs who could be targeted for future injury prevention interventions. <\/jats:p><\/jats:sec>","DOI":"10.1016\/j.wem.2021.04.002","type":"journal-article","created":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T22:41:58Z","timestamp":1626129718000},"page":"293-301","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Independent Risk Factors Predicting Gradual Onset Injury in 2824 Trail Running Race Entrants: SAFER XVIII Study"],"prefix":"10.1177","volume":"32","author":[{"given":"Carel T.","family":"Viljoen","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa"},{"name":"Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa"},{"name":"Amsterdam Collaboration for Health and Safety 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