Self-Reported Injury in Ultra-Endurance Participants with a Focus on Knee Injuries: An Exploratory Cross-sectional Comparative Study of Running, Cycling, and Triathlon

To investigate the frequency and location of reported injuries among ultra-endurance participants competing in different sports. Cross-sectional Ultra-endurance runners, cyclists and triathletes were recruited via a social media advertisement to participate in a web-based questionnaire. The questionnaire asked for information on demographics, competition history, training characteristics, and self-reported injury. Descriptive analyses and prevalence rates were calculated to determine differences between sports. Of the 258 participants (age:46±11 years; 33% female), 129 (50%) self-reported an injury within the past 12 months. Despite high frequency of reported injury, only 10% of injuries resulted in 'severe' pain and 7% resulted in stopping participation. The lower extremity, and specifically the knee, ankle and foot, were the most common injury locations. Prevalence ratios for injury over the past 12 months was similar across running, cycling, and triathlon, with no statistically significant differences. However, cyclists demonstrated a significantly higher prevalence of knee injuries since starting ultra-endurance participant compared to runners after adjusting for covariates (PR: 1.62; 95% CI: 1.15–2.28, p=0.006). Ultra-endurance participants self-report a considerable number of lower extremity injuries, yet this is similar across sports, and both the level of pain and impact on performance impact is generally low. •Ultra-endurance athletes should be aware of the high frequency of self-reported injury, particularly of the lower extremity.•Age, BMI, and training metrics do not appear to be related to the frequency of self-reported injuries in the previous 12 months among ultra-endurance athletes.•The knee is the location that is most identified as injured, and therefore prevention and rehabilitation strategies should be utilised within ultra-endurance athletes.•Ultra-endurance athletes who engaged in greater amounts of flexibility training reported fewer knee injuries