Association between the Foot Posture Index and running related injuries: A case-control study


      • There is a significant association between running-related injury and foot posture.
      • Running surface type might be associated with injury in novice runners.
      • The use of one pair of shoes might be associated with injury in novice runners.
      • Body mass index might be associated with the presence of injury in novice runners.
      • Running experience might be associated with injury in novice runners.



      Novice runners are at significantly greater risk of running-related injuries than experienced recreational runners. To develop prevention strategies for this population, it is important to identify predisposing factors that contribute to the incidence of these injuries. This study aims to assess the relationship between running-related injuries, foot posture and other factors in novice runners.


      Case-control study in 600 novice runners, classified as cases or controls based on incidence of running-related injuries. Participants' foot posture was measured using the Foot Posture Index, and we performed a descriptive analysis of the explanatory variables, comparing cases and controls. To assess the association between the injury and the presence of exposure and other explanatory variables, we performed a simple logistic regression for each variable and then fit a multivariable regression model.


      Our regression model showed that high supination was associated with 76.8 times higher odds of injury than a neutral Foot Posture Index score (P < 0.001). High pronation was associated with 20-fold higher odds of injury than neutral foot posture (P < 0.001). Other variables such as running surface, number of shoes used, and body mass index were also associated with injury. The model showed an acceptable predictive capacity, with an area under the ROC curve of 0.7753.


      If the association between Foot Posture Index and running-related injury is confirmed in large prospective studies, running programs for beginners should consider foot posture in efforts to prevent running-related injuries.


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