Timed-UER events (injury rate of 2.1 injuries/athlete) observed most injuries on the ankle (36%) and knee (19%), with the main diagnosis of tendinitis of the foot dorsiflexors (30%).
Single, continuous UER events differ between a 1005 km road race with almost all of the injuries due to overuse, with the main anatomical site of the knee (31%), ankle (28%) and lower leg (14%) and main diagnosis of PFPS (15.6%), compared to a 65 km trail race, with 32.8% of MSKI, mainly on the foot, ankle and knee. Most MSKI involve the lower leg (35.0%), ankle (16.8%), knee (13.1%) and foot (12.6%), with main diagnosis of medial tibial stress syndrome (30.1%) and patella femoral pain syndrome (PFPS 7.2%). MSKI are observed in 18% of multi-stage events (0.7–1.8 injuries/runner and 7.2 injuries/1000 h). Anatomical site, diagnosis and rate of injuries differ between competition and training as well as between different UER types. Our electronic literature search (PubMed, SPORTDiscus, Web of Science) identified a total of 13 studies (9 in competition, and 4 in training). The aims of this scoping review were therefore: (1) to examine the current evidence of MSKI, providing a synthesis of the most common MSKI by anatomical region and specific diagnosis (2) categorize MSKI by type of UER activity (competition: time-limited multi-stage continuous UER events and training) (3) describe knowledge gaps in the literature and provide advice on potential further research. UER is not a uniform sport and events can differ considerably in distance (over 42.195 km), time (e.g., events over 6 h) and multi-day or multi-stage events on various surfaces (e.g., track, on-road, off-road). Long hours of UER can lead to excessive stress on the body, resulting in musculoskeletal injuries (MSKI). Ultra-endurance running (UER) has seen an important increase in participation over the last few decades. 2University of Washington and Seattle Children’s Sports Medicine, Seattle, WA, United States.1Ultra Sports Science Foundation, Pierre-Bénite, France.
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