Original ArticleUtilisation of CAM by runners in the UK: A retrospective survey among non-elite marathon runners
Introduction
Over the last decade running has grown in popularity, with over 30 million runners worldwide and a significant increase in marathon running.1 The level of injury is reported at 37–56%, with most injuries affecting the lower extremity, particularly the knee, with the upper limb and spine being reported as less prone to injury.2, 3 Implications for healthcare services and the economic burden due to incapacity and absence from work are consequently likely to be considerable. Information regarding healthcare choices of runners and efficacy of treatment modalities would therefore be valuable.
Treatment options for running-related injuries include mainstream medicine (orthodox medicine, including general practice, sports medicine and physical therapy), and Complementary and Alternative Medicine (CAM), including chiropractic.4 Individuals in the UK may choose privately funded CAM as an alternative or adjunct to mainstream medicine. It is proposed that treatment should include medical care combined with education, cross-training, rehabilitative exercise and modification of training.5 Provision of this integrated approach is likely to prove challenging for any single healthcare discipline.
The prevalence of CAM use is established in certain sub-populations, e.g. rheumatic diseases, AIDS, cancer and paediatrics6; however, utilisation by other sub-groups, including runners, is unclear. This raises the question of whether CAM treatments offer effective management of running injuries, and to what extent they are, or are not, used by the running population. To date, there is little literature comparing the use by runners of mainstream treatment with chiropractic or other CAM treatments. One previous study reports utilisation of CAM, including chiropractic, by intercollegiate student athletes in the USA7; however, it remains unclear to what extent these treatments are used by non-elite runners in the UK.
This study investigated utilisation of CAM, and its perceived effectiveness, in non-elite marathon runners in the UK. The primary aim was to provide understanding of healthcare and treatment choices of this sub-group and to investigate whether they differ from the general population. An additional aim was to generate preliminary data on types of health care chosen for specific injuries. This will be useful for informing healthcare provision policy and also provide clinicians with understanding of the needs and treatment preferences of runners, with a view to optimising management protocols, and informing further research.
Section snippets
Method
A descriptive non-experimental survey was instigated using a questionnaire, which was distributed to a sample of non-elite runners participating in the 2007 Flora London Marathon. Institutional ethical approval was obtained and all data were anonymous.
A pilot study had been previously conducted with a group of amateur runners. Ease of comprehension and completion were evaluated based on the responses obtained, and feedback from the participants, to ensure that questionnaires were completed
Results
On hundred questionnaires were distributed out of which 99 were completed (66 men, 33 women), the majority in the age ranges 25–34 years (33%) and 35–44 years (42%).
Sixty-two per cent of competitors had been running for at least 2 years (Fig. 1), although there were significant differences in distribution categories between the sexes; generally, males had been running for longer with 46% having over 5 years’ experience. The most common frequency for women was between 6 months and 2 years (37%).
Discussion
Musculoskeletal injuries are prevalent amongst runners but little is known about this population's attitudes towards, and utilisation of, CAM. Among the runners surveyed, levels of injury in the previous year attributed to running (43%) were consistent with previous studies9 (37–56%), but lower than the 90% annual injury incidence rate reported by Fredericson and Misra.1 One explanation for this discrepancy is that some of those injured in training were unable to race and therefore would not
Conclusion
This study aimed to establish healthcare attitudes and treatment choices amongst non-elite marathon runners and additionally to produce initial information of the modalities chosen to treat specific running injuries. Runners’ habits and injuries were generally consistent with previous studies, although there was a greater incidence of back pain and less injury of the knee and lower limb.
For specific injuries runners used both CAM and mainstream healthcare disciplines, either individually or
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2011, Complementary Therapies in MedicineCitation Excerpt :It would appear that forms of CAM that demonstrate a sufficiently strong level of evidence become incorporated into conventional medicine and the line between conventional and complementary becomes a grey area. Recent surveys have indicated the patients with musculoskeletal pain would like to see CAM incorporated into the health service.53 A survey previously conducted by our group found that 47% of patients with low back pain had used CAM to alleviate their symptoms.54
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