{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:46:49Z","timestamp":1789728409746,"version":"4.0.1"},"reference-count":34,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Trail running involves running on varying natural terrains, often including large elevation gains\/losses. Trail running has a high risk of injury, and runners often participate in remote regions where medical support is challenging. The aim of this study was to determine the epidemiology, clinical characteristic, and associated injury risk factors among trail runners. A modified Oslo Sports Trauma Research Center Questionnaire for Health Problems (OSTRC-H) was used biweekly to collect running-related injury (RRI) and training history data prospectively, among 152 participants (males n = 120, females n = 32) over 30 weeks. We report an overall injury rate of 19.6 RRIs per 1000 h and an RRI mean prevalence of 12.3%. The leading anatomical site of RRIs was the lower limb (82.9%), affecting the knee (29.8%), shin\/lower leg (18.0%), and the foot\/toes (13.7%). A history of previous RRI in the past 12 months (p = 0.0032) and having a chronic disease (p = 0.0188) are independent risk factors for RRIs among trail runners. Two in three trail runners sustain an RRI mainly affecting the knee, shin\/lower leg, and foot\/toes. A history of previous RRI in the past 12 months and a having chronic disease is independently associated with RRI among trail runners. These results could be used to develop future RRI prevention strategies, combined with clinical knowledge and experience.<\/jats:p>","DOI":"10.3390\/ijerph182312620","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T23:22:28Z","timestamp":1638314548000},"page":"12620","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Epidemiology, Clinical Characteristics, and Risk Factors for Running-Related Injuries among South African Trail Runners"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3548-5509","authenticated-orcid":false,"given":"Carel T.","family":"Viljoen","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa"},{"name":"Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, VU University Medical Center, 1081 HV Amsterdam, The Netherlands"},{"name":"Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Pretoria 0186, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1058-6992","authenticated-orcid":false,"given":"Dina C.","family":"Janse van Rensburg","sequence":"additional","affiliation":[{"name":"Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Pretoria 0186, South Africa"},{"name":"Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evert","family":"Verhagen","sequence":"additional","affiliation":[{"name":"Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, VU University Medical Center, 1081 HV Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem","family":"van Mechelen","sequence":"additional","affiliation":[{"name":"Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, VU University Medical Center, 1081 HV Amsterdam, The Netherlands"},{"name":"School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD 4072, Australia"},{"name":"Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa"},{"name":"School of Public Health, Physiotherapy and Population Sciences, University College Dublin, D04 V1W8 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elzette","family":"Korkie","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8861-4466","authenticated-orcid":false,"given":"Tanita","family":"Botha","sequence":"additional","affiliation":[{"name":"Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0028, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1055\/a-1096-0980","article-title":"Defining off-road running: A position statement from the ultra sports science foundation","volume":"41","author":"Scheer","year":"2020","journal-title":"Int. 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