Complaints and pain predominance in running-related injuries: A Bayesian inference analyses

INTRODUCTION: Evidence on running-related injuries (RRIs) complaints/symptoms is scarce, raising concerns about defining RRIs by pain alone and highlighting the lack of data on pain's symptoms predominance among runners sustaining injuries. AIMS: To investigate the main complaints/symptoms of RRIs and to investigate how running-related pain is distributed across duration and pain symptoms predominance. METHODS: A total of 346 adult runners with ≥3 months of running experience, with no history of surgery and sustaining running-related injuries were included. The outcomes were the complaints/symptoms of RRIs, and the classifications of running-related pain regarding duration (acute or persistent) and pain symptoms predominance (nociceptive, neuropathic and nociplastic). Bayesian analyses estimated proportions using non-informative priors due to a lack of prior scientific evidence on RRIs complaints/symptoms. RESULTS: The main complaint/symptom of running-related injuries was pain (94.5%, 95% credible interval [CrI] 92.0 to 96.7, n = 327), followed by foot blisters (11.0%, 95% CrI 7.9 to 14.4, n = 38). Persistent pain with nociceptive symptoms (51.1%, 95% CrI 45.6 to 56.5, n = 167) and acute pain with nociceptive symptoms (45.9%, 95% CrI 40.5 to 51.2, n = 150) were the most frequent pain classifications. Cases of 'acute neuropathic-like symptoms' were not reported. DISCUSSION: Study suggests pain is not the sole symptom of running injuries. Broader definitions capturing any complaints may better represent injury burden for runners. CONCLUSION: 'Musculoskeletal pain' is the main complaint of RRIs. A quarter of injured runners also experience additional complaints besides pain. Our study highlighted prevalent pain symptoms predominance, with 'persistent pain with nociceptive symptoms' and 'acute pain with nociceptive symptoms' being the most common.