THE RUNNING CLUB EFFECT: A SOCIAL AND BEHAVIORAL MODULATOR FOR THE RUNNING-RELATED INJURIES IN AMATEUR BRAZILIAN RUNNERS
Abstract
Musculoskeletal injuries are prevalent among amateur runners, and although traditionally attributed to external training overload, evidence suggests that social, behavioral, and organizational factors may influence actual exposure to exertion. This study investigated the association between participation in running clubs and injury risk, considering traditional training load variables and systemic interactions between training components. This cross-sectional study included 97 runners, from whom sociodemographic data, training characteristics, and self-reported injury history in the previous year were collected. Running club participation showed the largest magnitude of association with injury occurrence (OR = 3.09; 95% CI 0.99–9.68), with borderline statistical significance (p = 0.053), while traditional load variables were not independently associated with the outcome. Mediation analysis indicated that training load did not mediate the relationship between club participation and injury occurrence. Network analysis revealed greater structural instability among variables related to load, competition participation, and age in the injured group, with participation in running clubs emerging as a central node in the network. Participation in running clubs showed an association with injury occurrence in recreational runners, while training load variables were not independently related to the outcome. These results should be interpreted cautiously due to the cross-sectional design.
Author Biographies
Physiotherapy undergraduate student, State University of Pará (UEPA).
Physiotherapy undergraduate student, State University of Pará (UEPA).
Institute of Primary Care, Switzerland, and Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland.Physician, PhD in Medicine, University of Zurich.
Physiotherapist, Specialist in Orthopedic and Traumatology Physiotherapy, COFFITO.
Physiotherapist, PhD in Biology of Infectious and Parasitic Agents, Federal University of Pará (UFPA).
Physical Education Professional, PhD in Sport Sciences, Faculty of Sport, University of Porto, Portugal.
Physiotherapist, MSc in Health, Society and Endemics in the Amazon, Federal University of Amazonas (UFAM).
References
1. Hulteen RM, Smith JJ, Morgan PJ, Barnett LM, Hallal PC, Colyvas K, Lubans DR. Global participation in sport and leisure-time physical activities: a systematic review and meta-analysis. Preventive Medicine. 2017;95:14–25. https://dx.doi.org/10.1016/j.ypmed.2016.11.027
2. Freire RS, Oliveira FL, Filho JAF, Nepomuceno MO, Silveira MF. Prática regular de atividade física: estudo de base populacional no Norte de Minas Gerais, Brasil. Rev Bras Med Esporte. 2014;20(5):345–349. https://dx.doi.org/10.1590/1517-86922014200502062
3. van Gent RN, Siem D, van Middelkoop M, van Os AG, Bierma-Zeinstra SMA, Koes BW. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med. 2007;41:469–480. https://dx.doi.org/10.1136/bjsm.2006.033548
4. Lopes AD, Hespanhol LC, Yeung SS, Costa LOP. What are the main running-related musculoskeletal injuries? Sports Med. 2012;42:891–905. https://dx.doi.org/10.2165/11631170-000000000-00000
5. Kakouris N, Yener N, Fong DTP. A systematic review of running-related musculoskeletal injuries in runners. J Sport Health Sci. 2021;10:513-22 https://dx.doi.org/10.1016/j.jshs.2021.04.001
6. Borel WP, Filho JE, Diz JBM, Moreira PF, Veras PM, Catharino LL, Rossi BP, Felício DC. Prevalence of injuries in Brazilian recreational street runners: meta-analysis. Rev Bras Med Esporte. 2019;52:e214466. https://dx.doi.org/10.1590/1517-869220192502214466
7. Sleeswijk Visser TSO, van Middelkoop M, Fokkema T, de Vos RJ. The socio-economic impact of running-related injuries: a large prospective cohort study. Scand J Med Sci Sports. 2021;31:2002–2009. https://dx.doi.org/10.1111/sms.14016
8. Linton L, Culpan J, Lane J. Running-centred injury prevention support: a scoping review on current injury risk reduction practices for runners. Translational Sports Medicine. 2025;2025:3007544. https://dx.doi.org/10.1155/tsm2/3007544
9. Impellizzeri FM, Shrier I, McLaren S, Coutts AJ, McCall A, Slattery K, Jeffries AC, Kalkhoven JT. Understanding training load as exposure and dose. Sports Med. 2023;53:1667–1679. https://dx.doi.org/10.1007/s40279-023-01833-0
10. Nielsen RO, Parner ET, Nohr EA, Srensen H, Lind M, Rasmussen S. Excessive progression in weekly running distance and risk of running-related injuries: an association which varies according to type of injury. J Orthop Sports Phys Ther. 2014;44(10):739–747. https://www.jospt.org/doi/10.2519/jospt.2014.5164
11. Gabbett TJ. The training–injury prevention paradox: should athletes be training smarter and harder? Br J Sports Med. 2016;50(5):273–280. https://bjsm.bmj.com/content/50/5/273
12. Kalkhoven JT, Watsford ML, Coutts AJ, Brent Edwards W, Impellizzeri FM. Training load and injury: causal pathways and future directions. Sports Med. 2021;51(6):1137–1150. https://dx.doi.org/10.1007/s40279-020-01413-6
13. Correia CK, Machado JM, Dominski FH, Castro MP, Brito Fontana H, Ruschel C. Risk factors for running-related injuries: An umbrella systematic review. J Sport Health Sci. 2024;13(6):793-804. https://dx.doi.org/10.1016/j.jshs.2024.04.011
14. Thuany M, Vieira D, de Paula H, Nikolaidis PT, Scheer V, Weiss K, Cuk I, Knechtle B, Gomes TN. The relative importance of training and social support for runners’ performance: a cross-sectional study. Sports Med Open. 2023;9:17. https://dx.doi.org/10.1186/s40798-023-00557-9
15. Sakalidis KE, Menting SGP, Elferink-Gemser MT, Hettinga FJ. The role of the social environment in pacing and sports performance: a narrative review from a self-regulatory perspective. Int J Environ Res Public Health. 2022;19(23):16131. https://dx.doi.org/10.3390/ijerph192316131
16. Brick NE, Campbell MJ, Metcalfe RS, Mair JL, MacIntyre TE. Altering pace control and pace regulation: attentional focus effects during running. Medicine and Science in Sports and Exercise. 2016;48(5):879–886. https://dx.doi.org/10.1249/MSS.0000000000000843
17. Bittencourt NFN, Meeuwisse WH, Mendonça LD, Nettel-Aguirre A, Ocarino JM, Fonseca ST. Complex systems approach for sports injuries: moving from risk factor identification to injury pattern recognition. Br J Sports Med. 2016;50(21):1309–1314. https://dx.doi.org/10.1136/bjsports-2015-095850
18. Windt J, Gabbett TJ. How do training and competition workloads relate to injury? The workload-injury aetiology model. Br J Sports Med. 2017;51(5):428–435. https://doi.org/10.1136/bjsports-2016-096040
19. Thuany M, Vieira D, Viljoen C, Weiss K, Knechtle B, Gomes, TN. Using complex systems to understand running-related injuries. Research in Sports Medicine, 2025;33(1), 97–106. https://dx.doi.org/10.1080/15438627.2024.2428597
20. Buist I, Bredeweg SW, Lemmink KAPM, van Mechelen W, Diercks RL. Predictors of Running-Related Injuries in Novice Runners Enrolled in a Systematic Training Program: A Prospective Cohort Study: A Prospective Cohort Study. The American Journal of Sports Medicine. 2009;38(2):273-280. https://dx.doi.org/10.1177/0363546509347985
21. Besomi M, Roa-Alcaino S, Lombardi Á, Vélez-Rivera R, Leppe Zamora J, Bolling C. Exploring contextual factors for management and prevention of running-related injuries: runners and experts’ perspectives. BMJ Open Sport Exerc Med. 2025;11(2):e002413. https://dx.doi.org/10.1136/bmjsem-2024-002413
22. Silva GV, Alves GR, Oliveira HDGS, Carvalho KR, Aguiar PCR, Jurema HC. ATUAÇÃO FISIOTERAPÊUTICA NO TRATAMENTO DE LESÕES EM CORREDORES AMADORES. REASE. 2025;11(9):1606-18. https://dx.doi.org/10.51891/rease.v11i9.20992
23. Nikolaidis PT, Knechtle B. Validity of recreational marathon runners’ self-reported anthropometric data. Perceptual and Motor Skills. 2020;127(6):1068–1078. https://doi.org/10.1177/0031512520930159
