Psychological Profile of Trail Runners Associated With Running-Related Injuries: A Prospective Study
Journal
Sports Health: A Multidisciplinary Approach
ISSN
1941-7381
Date Issued
2025-12-12
Author(s)
Rubén Gajardo-Burgos
Raimundo Sánchez
Carel Viljoen
Dina C. Janse van Rensburg
Claudio Bascour-Sandoval
Type
journal-article
Abstract
<jats:sec>
<jats:title>Background:</jats:title>
<jats:p>Trail running has increased in popularity due to the benefits of physical activity in nature. However, trail running has an inherent risk of running-related injuries (RRI). It is known that athletes with certain psychological traits have a greater tendency to suffer injuries; however, this is unknown in trail runners. The main objective of this study was to identify trail runners’ psychological profiles and to compare the proportion of RRI across these profiles.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Hypothesis:</jats:title>
<jats:p>Trail runners with psychological profiles of high stress, precompetitive anxiety, mental fatigue, competitiveness, and poor sleep quality are at increased risk of RRI.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Study Design:</jats:title>
<jats:p>Prospective cohort study.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Level of Evidence:</jats:title>
<jats:p>Level 2.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods:</jats:title>
<jats:p>A Gaussian mixture model cluster analysis was performed on 202 trail runners (55.5% male; aged 38.7 [33.4-46.2] years) with psychological stress, cognitive and somatic anxiety, self-confidence, mental fatigue, sleep quality, and competitiveness measured 4 weeks before participating in a race. The proportion of RRI during the race was recorded and compared across clusters.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>
Overall RRI proportion during competition was 11.3% (n = 24). The most common RRI were muscle (41.7%) and tendon/bursa (16.7%) injuries, affecting primarily the knee (33.3%) and lower leg (20.8%). Five psychological profiles were identified. Cluster 1 (competitive runners with moderate psychological stress and mental fatigue, low sleep quality and anxiety, and high self-confidence) had a higher RRI proportion than Cluster 3 (similar traits but lower psychological stress, mental fatigue, and higher self-confidence; 21.2% vs 3.2%;
<jats:italic toggle="yes">P</jats:italic>
= 0.02).
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusion:</jats:title>
<jats:p>Certain psychological profiles in trail runners were associated with higher RRI risk.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Clinical Relevance:</jats:title>
<jats:p>The medical team or trail running coaches should monitor runners with psychological profiles with higher psychological stress, mental fatigue, and cognitive anxiety, as well as lower self-confidence and sleep quality, to design strategies to reduce their risk of RRI.</jats:p>
</jats:sec>
<jats:title>Background:</jats:title>
<jats:p>Trail running has increased in popularity due to the benefits of physical activity in nature. However, trail running has an inherent risk of running-related injuries (RRI). It is known that athletes with certain psychological traits have a greater tendency to suffer injuries; however, this is unknown in trail runners. The main objective of this study was to identify trail runners’ psychological profiles and to compare the proportion of RRI across these profiles.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Hypothesis:</jats:title>
<jats:p>Trail runners with psychological profiles of high stress, precompetitive anxiety, mental fatigue, competitiveness, and poor sleep quality are at increased risk of RRI.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Study Design:</jats:title>
<jats:p>Prospective cohort study.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Level of Evidence:</jats:title>
<jats:p>Level 2.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods:</jats:title>
<jats:p>A Gaussian mixture model cluster analysis was performed on 202 trail runners (55.5% male; aged 38.7 [33.4-46.2] years) with psychological stress, cognitive and somatic anxiety, self-confidence, mental fatigue, sleep quality, and competitiveness measured 4 weeks before participating in a race. The proportion of RRI during the race was recorded and compared across clusters.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>
Overall RRI proportion during competition was 11.3% (n = 24). The most common RRI were muscle (41.7%) and tendon/bursa (16.7%) injuries, affecting primarily the knee (33.3%) and lower leg (20.8%). Five psychological profiles were identified. Cluster 1 (competitive runners with moderate psychological stress and mental fatigue, low sleep quality and anxiety, and high self-confidence) had a higher RRI proportion than Cluster 3 (similar traits but lower psychological stress, mental fatigue, and higher self-confidence; 21.2% vs 3.2%;
<jats:italic toggle="yes">P</jats:italic>
= 0.02).
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusion:</jats:title>
<jats:p>Certain psychological profiles in trail runners were associated with higher RRI risk.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Clinical Relevance:</jats:title>
<jats:p>The medical team or trail running coaches should monitor runners with psychological profiles with higher psychological stress, mental fatigue, and cognitive anxiety, as well as lower self-confidence and sleep quality, to design strategies to reduce their risk of RRI.</jats:p>
</jats:sec>