Strategies to prevent and manage running-related knee injuries: a systematic review of randomised controlled trials. Issue 22 (23rd September 2022)

• Record Type: Journal Article
• Authors: Alexander, James L N; Culvenor, Adam G; Johnston, Richard R T; Ezzat, Allison M; Barton, Christian J
• Is Part Of: British journal of sports medicine. Volume 56:Issue 22(2022)
• Page Start: 1307
• Page End: 1319
• Publication Date: 2022-09-23
• Subjects: Running -- Knee injuries -- Exercise Therapy -- Sporting injuries -- Preventive Medicine; Sports medicine -- Periodicals; 617.1027
• DOI: 10.1136/bjsports-2022-105553
• Languages: English
• ISSNs: 0306-3674

Abstract

Abstract : Objective: To evaluate the effectiveness of interventions to prevent and manage knee injuries in runners. Design: Systematic review and meta-analysis. Data sources: MEDLINE, EMBASE, CINAHL, Web of Science and SPORTDiscus up to May 2022. Eligibility criteria for selecting studies: Randomised controlled trials (RCTs) with a primary aim of evaluating the effectiveness of intervention(s) to prevent or manage running-related knee injury. Results: Thirty RCTs (18 prevention, 12 management) analysed multiple interventions in novice and recreational running populations. Low-certainty evidence (one trial, 320 participants) indicated that running technique retraining (to land softer) reduced the risk of knee injury compared with control treadmill running (risk ratio (RR) 0.32, 95% CI 0.16 to 0.63). Very low-certainty to low-certainty evidence from 17 other prevention trials (participant range: 24 –3287) indicated that various footwear options, multicomponent exercise therapy, graduated running programmes and online and in person injury prevention education programmes did not influence knee injury risk (RR range: 0.55–1.06). In runners with patellofemoral pain, very low-certainty to low-certainty evidence indicated that running technique retraining strategies, medial-wedged foot orthoses, multicomponent exercise therapy and osteopathic manipulation can reduce knee pain in the short-term (standardised mean difference range: −4.96 to −0.90). Conclusion: There is low-certainty evidence that running technique retraining to land softer may reduce knee injury risk by two-thirds. Very low-certainty to low-certainty evidence suggests that running-related patellofemoral pain may be effectively managed through a variety of active (eg, running technique retraining, multicomponent exercise therapy) and passive interventions (eg, foot orthoses, osteopathic manipulation). PROSPERO registration number: CRD42020150630