Health and Wellbeing in Competitive Adolescent Distance Runners: Training Load, Health Problems, and Psychosocial Response to Injury

Abstract

Although distance running is associated with multiple health benefits, adult-based research indicates that participation is also associated with unfavourable health outcomes, such as running-related injury (RRI). As there is limited literature related to the health problems (i.e., injury and illness) that competitive adolescent distance runners (13-18 years) experience, this research aimed to describe and evaluate the extent of the injury and illness problem in competitive adolescent distance runners in England. The first study (Chapter 4) demonstrates that session rating of perceived exertion (sRPE), whether reported 0, 15, or 30 minutes following session completion, provides a valid measure of internal training load in adolescent distance runners. This allows sRPE to be used during training and future epidemiological studies. The second study (Chapters 5 and 6) employed a mixed-methods study design. Chapter 5 presents a retrospective epidemiological study (n = 113), whereby the incidence of RRI was 6.3 per 1,000 hours of exposure and the most commonly injured body areas were the knee, foot/toes, and lower leg. Exploratory univariate analyses indicated that a larger number of training sessions per week (volume) and higher specialisation (i.e., intense, year-round training in a single sport with the exclusion of other sports) were both associated with a lower risk of RRI. Chapter 6 investigated psychosocial responses to RRI in those athletes (n = 19) who self-reported a serious RRI (>28 days-6 months of time loss). Based upon a reflexive thematic analysis of interview data, fifteen codes and three themes were developed. These data indicate that serious RRI acts to ‘destabilise athletic identity’ in competitive adolescent distance runners. The third study (Chapter 7) presents a prospective cohort study (n = 136), whereby the incidence of RRI was 25 per 1,000 hours of exposure. At any time, the mean weekly prevalence of all health problems was 24%, regardless of type or sex, reducing to 11% and 4% for substantial and time loss health problems, respectively. These data show that competitive adolescent distance runners are likely to be training and/or competing whilst concurrently experiencing one or more health problems. Also, female athletes self-reported more illnesses, when compared to male athletes. Collectively, these studies provide valuable and novel insight into the health and wellbeing of competitive adolescent distance runners in England. In turn, this thesis will support the development of injury and illness prevention measures.