Relationships between Running Biomechanics, Hip Muscle Strength, and Running-Related Injury in Female Collegiate Cross-country Runners

BACKGROUND: Female collegiate cross-country (XC) runners have a high incidence of running-related injury (RRI). Limited reports are available that have examined potential intrinsic factors that may increase RRI risk in this population. PURPOSE: To examine the relationships between RRI, hip muscle strength, and lower extremity running kinematics in female collegiate XC runners. STUDY DESIGN: Prospective observational cohort. METHODS: Participants included twenty female NCAA collegiate XC runners from Southern California universities who competed in the 2019-20 intercollegiate season. A pre-season questionnaire was used to gather demographic information. Hip muscle strength was measured with isokinetic dynamometry in a sidelying open-chain position and normalized by the runner’s body weight (kg). Running kinematic variables were examined using Qualisys 3D Motion Capture and Visual 3D analysis. RRI occurrence was obtained via post-season questionnaires. Independent t-tests were used to determine mean differences between injured and non-injured runners for hip abductor muscle strength and selected running kinematics. Pearson correlation coefficients were calculated to examine relationships between hip muscle performance and kinematic variables. RESULTS: End-of-the-season RRI information was gathered from 19 of the 20 participants. During the 2019-20 XC season, 57.9% (11 of 19) of the runners sustained an RRI. There were no significant differences between mean hip abductor normalized muscle strength (p=0.76) or mean normalized hip muscle strength asymmetry (p=0.18) of injured and non-injured runners during the XC season. Similarly, no significant differences were found between mean values of selected kinematic variables of runners who did and who did not report an RRI. Moderate relationships were found between hip abductor strength variables and right knee adduction at footstrike (r=0.50), maximum right knee adduction during stance (r=0.55), left supination at footstrike (r=0.48), right peak pronation during stance (r=-0.47), left supination at footstrike (r=0.51), and right peak pronation during stance (r=-0.54) (all p≤0.05). CONCLUSIONS: Hip abduction muscle strength, hip abduction strength asymmetry, and selected running kinematic variables were not associated with elevated risk of RRI in female collegiate XC runners. LEVEL OF EVIDENCE: