Characteristics of Lower Limb Running-Related Injuries in Trail Runners: A Systematic Review

Trail running is becoming a more popular sport, offering many health advantages, though it also has a significant risk of injury. Due to a lack of data on trial runners' injury characteristics, there is a need for focused research to inform prevention strategies. The objective of this review was to outline the injury characteristics observed in trail runners. We performed an extensive search of the literature across PubMed, Web of Science, Scopus, and Google Scholar. We thoroughly examined titles, abstracts, and full texts to select studies that detailed injury characteristics specific to trail runners. The review included 24 articles, encompassing a total of 17,664 runners. The findings reveal significant variability in the prevalence of lower limb injuries among trail runners, ranging from 12.3% to 100%. The incidence of injuries varied from 2.2 to 65 per 1000 hours of running. We identified the knee as the most frequently injured region, followed by the ankle and Achilles tendon. Running-related injuries have a multifaceted etiology and are influenced by multiple factors. The insights gained from this review provide a foundation for developing targeted injury prevention strategies that should also integrate clinical expertise and practical experience to enhance both safety and enjoyment for participants. Keywords: trail runner, ultra running, injury, lower extremity, prevalence