Lower extremity alignment and risk of overuse injuries in runners

Med Sci Sports Exerc. 1997 Oct;29(10):1291-8. doi: 10.1097/00005768-199710000-00003.


A group of 304 runners enrolling in a marathon training program had alignment measurements performed and completed a questionnaire on training practices and injuries over the previous 12 months. The alignment measures consisted of arch index (AI), heel valgus (HV), knee tubercle-sulcus angle (TSA), knee varus (KV), and leg-length difference (LLD). Results indicated few consistent statistical associations between these alignment measures and risk of injuries, either bivariately or multivariately: left AI with hamstring injuries; right AI with shin injuries; right HV with back injuries; left TSA with ankle injuries; KV with hip injuries; and LLD with back, ankle, and foot injuries. A few statistically significant relationships were also found between other training and anthropometric factors and injuries: mileage with hamstring injuries; interval training with shin injuries; hard surfaces with back and thigh injuries; shoe use patterns with foot and overall injuries; and body mass index with heel injuries. We conclude that lower-extremity alignment is not a major risk factor for running injuries in our relatively low mileage cohort; however, prospective studies are necessary to confirm or refute these findings.

MeSH terms

  • Adult
  • Aged
  • Anthropometry
  • Biomechanical Phenomena
  • Chi-Square Distribution
  • Cohort Studies
  • Cumulative Trauma Disorders / etiology*
  • Female
  • Humans
  • Leg / anatomy & histology*
  • Logistic Models
  • Male
  • Middle Aged
  • Physical Fitness
  • Retrospective Studies
  • Risk Factors
  • Running / injuries*
  • Shoes
  • Surveys and Questionnaires