ReviewOrthopaedic journal of sports medicine2026
Common Risk Factors for Knee Injuries in Runners: A Systematic Review.
Review in Orthopaedic journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Background: Knee injuries account for 25% to 30% of running-related injuries (RRIs). Patellofemoral pain syndrome (PFPS), iliotibial band syndrome (ITBS), and patellar tendinopathy (PT) are the most commonly reported knee injuries. The literature focuses on biomechanical factors, whose predictive value is inconsistent, and exposure-related factors remain underexplored. Purpose: To systematically review and synthesize the evidence on risk factors associated with knee injuries in endurance runners with a focus on both biomechanical and exposure-related factors. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic search of the Medline (PubMed), Embase, and Web of Science was conducted for studies before November 19, 2024. Studies were included if they investigated risk factors for knee injuries in adult endurance runners. Studies were excluded if they were case reports, non-English studies, review articles, studies focusing on nonendurance athletes, or studies focusing on athletes >30 years old. Twenty studies were selected from 1883 articles after screening. Risk factors were categorized as biomechanical or exposure-related. Results: Across PFPS, ITBS, and PT, the strongest and most recurrent risk factors were a history of previous injury (odds ratio [OR] range, 1.36-10.19), increased training load or volume (OR range, 1.07-8.94), and structural malalignment (OR range, 1.89-4.12). For general knee injuries, previous injury was the most frequently reported risk factor, associated with a 12.9% higher incidence of reinjury. PFPS was linked to training load and structural malalignment, indicating small to moderate associations between deviations from optimal load and injury risk. For ITBS, kinematic variables (OR range, 3.02-5.62; Cohen's Conclusion: Knee injuries in endurance runners are influenced by a history of injury, training load, and biomechanical factors. Future injury prevention strategies should integrate biomechanical and contextual factors, including individualized kinematic profiles and conservative training management.
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