Perceptions of Overuse Injury Among Swedish Ultramarathon and Marathon Runners: Cross-Sectional Study Based on the Illness Perception Questionnaire Revised (IPQ-R)

BACKGROUND: Long-distance runners’ understandings of overuse injuries are not well known which decreases the possibilities for prevention. The common sense model (CSM) outlines that runners’ perceptions of a health problem can be described using the categories identity, consequence, timeline, personal control, and cause. The aim of this study was to use the CSM to investigate perceptions of overuse injury among long-distance runners with different exercise loads. METHODS: The study used a cross-sectional design. An adapted version of the illness perception questionnaire revised (IPQ-R) derived from the CSM was used to investigate Swedish ultramarathon and marathon runners’ perceptions of overuse injuries. Cluster analysis was employed for categorizing runners into high and low exercise load categories. A Principal Component Analysis was thereafter used to group variables describing injury causes. Multiple logistic regression methods were finally applied using high exercise load as endpoint variable and CSM items representing perceptions of injury identity, consequence, timeline, personal control, and causes as explanatory variables. RESULTS: Complete data sets were collected from 165/443 (37.2%) runners. The symptoms most commonly associated with overuse injury were pain (80.1% of the runners), stiff muscles (54.1%), and stiff joints (42.0%). Overuse injury was perceived to be characterized by the possibility of personal control (stated by 78.7% of the runners), treatability (70.4%), and that the injury context was comprehensible (69.3%). The main injury causes highlighted were runner biomechanics (stated by 78.3%), the runner’s personality (72.4%), and running surface biomechanics (70.0%). Among men, a belief in that personality contributes to overuse injury increased the likelihood of belonging to the high exercise load category [Odds ratio (OR) 2.10 (95% Confidence interval (95% CI) 1.38–3.19); P = 0.001], while beliefs in that running biomechanics [OR 0.56 (95% CI 0.37–0.85); P = 0.006) and mileage (OR 0.72 (95% CI 0.54–0.96); P = 0.026] causes injury decreased the likelihood. In women, a strong perception that overuse injuries can be controlled by medical interventions decreased the likelihood of high exercise load [OR 0.68 (95% CI 0.52–0.89); P = 0.005]. CONCLUSION: This study indicates that recognition among long-distance runners of the association between own decisions in overuse injury causation is accentuated by increased exercise loads.