Katherine Fahy MD, Teresita Gomez MD, Carl Carson BS, Joshua Goldman MD MBA, Summer Runestad ATC, Jeffrey Gornbein DrPH, Emily M. Miller, MD
Joint Hypermobility as a Risk Factor for Injury in Adolescent Long-Distance Runners
Name: Daniel Harris Brown
Research Mentor: Dr. Joshua Goldman
Co-Mentors: Dr. Katherine Fahy, Dr. Emily Miller
Prior research shows generalized joint hypermobility (GJH) is associated with knee and ankle injuries though little research examines GJH as a risk factor for running related injuries. This study aims to determine if GJH is a risk factor for the development of running-related injuries in adolescent long-distance runners. Prior data shows that female runners have a higher injury rate than male runners, and this study will also examine if GJH contributes to that difference as GJH is more prevalent in females. Our hypothesis for this study is that a Beighton score greater than 4 (GJH) will be positively-correlated with an increase in running-related injury rate per 1000 miles run in adolescent runners.
Methods and Study Design:
Participants in the study were recruited from current members of the Students Run Los Angeles (SRLA) program. Members of SRLA were eligible to participate in the study if they were between the ages of 14 and 18, and must have participated in the SRLA program during the 2019-2020 training season. If they were no longer participating in SRLA, 13 or younger, or 19 and older, they were excluded. After obtaining informed consent from the participant and their parent, a HIPAA compliant video visit was conducted. During the visit, their Beighton was scored on a scale of 0-9 by one of three medical providers. For the purposes of this study, GJH was defined as a Beighton Score greater than 4. The Beighton score was compared to each participant’s injury data from the 2019-20 SRLA season using a Poisson multivariable regression model to assess whether there was a correlation between joint hypermobility and running-related injury rate per 1000 miles run. A two-sided p-value of 0.05 will be used for this study and its analysis. This study was approved by the UCLA Institutional Review Board.
This retrospective cohort study is currently ongoing, with new participants being enrolled on a daily basis. Currently, 32 participants have been consented and a Beighton score calculated (16 females and 16 males). The participants are between the ages of 14 and 18 years old (mean = 15.91 years old, median = 16 years old). 10 of the 32 participants had a Beighton Score of greater than 4 (31.3%). Of those with a Beighton Score of 5+, 4 were boys (25.0%) and 6 were girls (37.5%).
There are no conclusions at this time as participants are still being enrolled into the study and data collection is still ongoing. We anticipate that there will be a positive correlation between Beighton scores greater than 4 and running-related injuries in both male and female runners (meaning GJH is a risk factor for developing running injuries in adolescent runners). We also expect girls to have a higher percentage of Beighton scores >4 (GJH) than do boys, and we expect to see a higher rate of running-related injuries in girls as compared to boys.
This pilot study will help determine if GJH is a risk factor for the development of running related injuries in adolescent distance runners. This will then improve the injury-prevention counseling and education given to adolescents runners by coaches, physicians and other healthcare providers with the ultimate goal of reducing the number of running-related injuries in this population.
The authors would like to extend a special thanks to Students Run Los Angeles (SRLA) and the Orthopedic Institute for Children (OIC) for their participation and involvement in this study.