Dallin Christensen and Ben Ogles, Department of Psychology

INTRODUCTION

While training for and participation in marathons provides substantial health benefits, there is also a high incidence of musculoskeletal injury in marathon runners. Previous research has identified correlation between various cognitive running strategies and running related injury. In particular, association, which is exemplified when runners focus on and maintain awareness of their body and physical factors crucial to performance, has been shown to predict injury (Masters and Ogles). Dissociation is employed when a runner diverts attention away from their body and physical feedback to anything external to themselves. While dissociation was originally hypothesized to increase injury risk, previous research suggests that this is not the case. Additionally, runners who attribute their participation to performance-based motivations, such as competitiveness or goal orientation, were also more likely to be injured (Masters and Ogles). However, the runners surveyed in previous studies were predominately male. Increasing numbers of female marathon participants render work limited to men to be insufficient.

In this study, we first consider the anatomical distribution of running related injuries, as well as the impact of these injuries on the runner. We then test the effects of association, dissociation, and motivational factors (competition, personal goal achievement, and affiliation) on injury in both male and female marathon runners. We believe that a more complete understanding of the distribution and correlates of injury will lead to an increased ability to prevent and treat future injuries.

METHOD

Participants in this study ran in a western United States marathon. Subjects completed a series of three on-line surveys: a pre-race survey given six weeks prior to the marathon, a post-race survey given the week following the marathon, and the follow-up survey taken eight months later. One hundred sixty two subjects (81 men and 81 women) completed all surveys with usable data. The first two surveys gathered basic demographic information, training variables (such as miles run per week), and finish time. It also included the Attentional Focus Questionnaire (AFQ), which was used to assess a runner’s use of association and/or dissociation as cognitive strategies. An abbreviated version of the Motivations of Marathoners Scale (MOMS; Masters et al) was also included to determine the degree to which runners were motivated by competitiveness, goal orientation, and affiliation. The final survey was sent as an eight month follow up, and asked participants to report current training habits and any running related injuries incurred since the marathon, as well as the anatomical location of the injury, and if they had reduced their running, sought medical attention, or missed school or work as a result of the injury.

RESULTS

Of the 162 participants, 67 (41%) reported having been injured in the 8 months following the marathon. Of these, 32 were male (47.8% of injured, 39.5% of males) and 35 were female (52.2% of injured, 43.2% of females). There were no significant differences in injury between men and women (p > .05). Of those who were injured, 70.6% reported that they continued running after the injury was incurred. However, on average, those injured missed 25.3 days of running due to injury in the eight month time frame. The range was 0 to 180 with a standard deviation of 35.0 days of missed running.

The most common injuries were to the foot (28%), followed by the knee (15%), lower leg (14%), and upper leg (13%). Overall, 85.1% of all injuries incurred were reported to lead to a reduction in running, 41.4% caused the runner to seek medical care, and 5.7% led to the runner missing time at work or school. When asked how the injury occurred, 37 (22.8% of all participants) runners reported a running related cause such as intensity of training, overuse or repetitive use.

To consider the relationship of attentional focus (association and dissociation), motivation (competition and goal achievement) and training variables (miles training per week) as potential correlates of running related injury, we conducted a series of univariate two-way ANOVAs with sex and injury status as independent variables. Results are displayed in Table 1.

Table 1. Means, Standard Deviations, and Univariate F Tests for attentional style, motivation, and training variables for men and women by injury category

	Injured – overuse		Injured – other		Not injured
Variable	men X (SD)	women X (SD)	men X (SD)	women X (SD)	men X (SD)	women X (SD)
Association a	56.1 (9.6)	52.4 (10.1)	47.1 (11.7)	46.2 (15.1)	51.2 (10.8)	50.7 (10.6)
Dissociation b	30.1 (6.5)	37.0 (7.9)	34.4 (7.8)	34.0 (10.6)	33.2 (8.4)	37.0 (10.9)
Competition a	3.9 (1.9)	3.2 (1.8)	2.8 (1.8)	2.6 (1.3)	2.8 (1.5)	2.4 (1.3)
Goal achievement a	5.9 (1.7)	6.1 (.84)	4.7 (1.7)	5.3 (1.3)	5.0 (1.7)	4.8 (1.5)
Miles per week a,b	33.9 (20.3)	24.3 (11.5)	24.2 (10.3)	20.6 (12.5)	24.8 (13.0)	20.9 (14.4)

Note: N = 162; ^a Main effect for injury p < .05, ^b Main effect for sex p < .05.

CONCLUSION

As can be seen in Table 1, women were more likely to employ the use of a dissociative strategy, but this did not affect injury occurrence. Those who incurred overuse injuries were also more likely to associate, be motivated by competitiveness and goal achievement, and run more miles per week. This suggests that a focus on performance outcomes, rather than simply participation, seems to increase risk of injury in male and female marathon participants.

SOURCES

Masters, K. S., & Lambert, M. J. (1989). The relations between cognitive coping strategies, reasons for running, injury, and performance of marathon runners. Journal of Sport and Exercise Psychology, 11(2), 161-170.
Masters, K. S., Ogles, B. M., & Jolton, J. A. (1993). The development of an instrument to measure motivation for marathon running: The Motivations of Marathoners Scales (MOMS). Research Quarterly for Exercise and Sport, 64(2), 134-143.
Masters, K. S., & Ogles, B. M. (1998). The relations of cognitive strategies with injury, motivation, and performance among marathon runners: Results from two studies. Journal of Applied Sport Psychology, 10(2), 281-296.