Original Article
Utilisation of CAM by runners in the UK: A retrospective survey among non-elite marathon runners

https://doi.org/10.1016/j.clch.2009.08.004Get rights and content

Summary

Objective

There are over 30 million runners worldwide, with high levels of injury reported. However, there is little evidence regarding utilisation levels or perceived benefit of CAM, including chiropractic, among runners. This study investigated utilisation and perceived effectiveness of CAM in non-elite marathon runners in the UK, aiming to enhance understanding of healthcare and treatment preferences in this population. An additional aim was to generate preliminary data on modalities chosen to treat specific running injuries.

Method

A retrospective, non-experimental survey was distributed to 100 non-elite runners participating in the 2007 Flora London Marathon.

Results

Ninety-nine completed questionnaires were analysed (response rate = 99%). Forty-three per cent of participants sustained running-related injuries in the past year, predominantly to the knee/lower leg (48%) and back (21%). Thirty-seven per cent used CAM or non-CAM modalities alongside orthodox medical care. A further 37% used these without consulting their GP. CAM utilisation was 21%, with chiropractic (11%), massage (12%) and acupuncture (9%) being most utilised, particularly for back/low back pain, knee/ankle and lower limb soft tissue injuries. Most users recommended treatments received, and 84% would like to see CAM available on the NHS. The majority perceived CAM, including chiropractic, as beneficial and reasonable in cost.

Results

Runners use CAM for treatment of specific running injuries, as well as injury prevention and enhancement of general well-being. Utilisation appears higher than reported levels for the general population and there is a high level of satisfaction with CAM. Further research is indicated to investigate clinical efficacy of CAM modalities for specific running-related injuries.

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

References (18)

There are more references available in the full text version of this article.

Cited by (7)

View all citing articles on Scopus
View full text