What are the biopsychosocial risk factors associated with pain in postpartum runners? Development of a clinical decision tool.

<h4>Background</h4>In 2019, a majority of runners participating in running events were female and 49% were of childbearing age. Studies have reported that women are initiating or returning to running after childbirth with up to 35% reporting pain. There are no studies exploring running-r...

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Autores principales:	Shefali Mathur Christopher, Chad E Cook, Suzanne J Snodgrass
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9da0a551c1e14065816e3bd7a81dfa51
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spelling	oai:doaj.org-article:9da0a551c1e14065816e3bd7a81dfa512021-12-02T20:18:19ZWhat are the biopsychosocial risk factors associated with pain in postpartum runners? Development of a clinical decision tool.1932-620310.1371/journal.pone.0255383https://doaj.org/article/9da0a551c1e14065816e3bd7a81dfa512021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255383https://doaj.org/toc/1932-6203<h4>Background</h4>In 2019, a majority of runners participating in running events were female and 49% were of childbearing age. Studies have reported that women are initiating or returning to running after childbirth with up to 35% reporting pain. There are no studies exploring running-related pain or risk factors for this pain after childbirth in runners. Postpartum runners have a variety of biomechanical, musculoskeletal, and physiologic impairments from which to recover from when returning to high impact sports like running, which could influence initiating or returning to running. Therefore, the purpose of this study was to identify risk factors associated with running-related pain in postpartum runners with and without pain. This study also aimed to understand the compounding effects of multiple associative risk factors by developing a clinical decision tool to identify postpartum runners at higher risk for pain.<h4>Methods</h4>Postpartum runners with at least one child ≤36 months who ran once a week and postpartum runners unable to run because of pain, but identified as runners, were surveyed. Running variables (mileage, time to first postpartum run), postpartum variables (delivery type, breastfeeding, incontinence, sleep, fatigue, depression), and demographic information were collected. Risk factors for running-related pain were analyzed in bivariate regression models. Variables meeting criteria (P<0.15) were entered into a multivariate logistic regression model to create a clinical decision tool. The tool identified compounding factors that increased the probability of having running-related pain after childbirth.<h4>Results</h4>Analyses included 538 postpartum runners; 176 (32.7%) reporting running-related pain. Eleven variables were included in the multivariate model with six retained in the clinical decision tool: runner type-novice (OR 3.51; 95% CI 1.65, 7.48), postpartum accumulated fatigue score of >19 (OR 2.48; 95% CI 1.44, 4.28), previous running injury (OR 1.95; 95% CI 1.31, 2.91), vaginal delivery (OR 1.63; 95% CI 1.06, 2.50), incontinence (OR 1.95; 95% CI 1.31, 2.84) and <6.8 hours of sleep on average per night (OR 1.89; 95% CI 1.28, 2.78). Having ≥ 4 risk factors increased the probability of having running-related pain to 61.2%.<h4>Conclusion</h4>The results of this study provide a deeper understanding of the risk factors for running-related pain in postpartum runners. With this information, clinicians can monitor and educate postpartum runners initiating or returning to running. Education could include details of risk factors, combinations of factors for pain and strategies to mitigate risks. Coaches can adapt running workload accounting for fatigue and sleep fluctuations to optimize recovery and performance. Future longitudinal studies that follow asymptomatic postpartum women returning to running after childbirth over time should be performed to validate these findings.Shefali Mathur ChristopherChad E CookSuzanne J SnodgrassPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255383 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Shefali Mathur Christopher Chad E Cook Suzanne J Snodgrass What are the biopsychosocial risk factors associated with pain in postpartum runners? Development of a clinical decision tool.
description	<h4>Background</h4>In 2019, a majority of runners participating in running events were female and 49% were of childbearing age. Studies have reported that women are initiating or returning to running after childbirth with up to 35% reporting pain. There are no studies exploring running-related pain or risk factors for this pain after childbirth in runners. Postpartum runners have a variety of biomechanical, musculoskeletal, and physiologic impairments from which to recover from when returning to high impact sports like running, which could influence initiating or returning to running. Therefore, the purpose of this study was to identify risk factors associated with running-related pain in postpartum runners with and without pain. This study also aimed to understand the compounding effects of multiple associative risk factors by developing a clinical decision tool to identify postpartum runners at higher risk for pain.<h4>Methods</h4>Postpartum runners with at least one child ≤36 months who ran once a week and postpartum runners unable to run because of pain, but identified as runners, were surveyed. Running variables (mileage, time to first postpartum run), postpartum variables (delivery type, breastfeeding, incontinence, sleep, fatigue, depression), and demographic information were collected. Risk factors for running-related pain were analyzed in bivariate regression models. Variables meeting criteria (P<0.15) were entered into a multivariate logistic regression model to create a clinical decision tool. The tool identified compounding factors that increased the probability of having running-related pain after childbirth.<h4>Results</h4>Analyses included 538 postpartum runners; 176 (32.7%) reporting running-related pain. Eleven variables were included in the multivariate model with six retained in the clinical decision tool: runner type-novice (OR 3.51; 95% CI 1.65, 7.48), postpartum accumulated fatigue score of >19 (OR 2.48; 95% CI 1.44, 4.28), previous running injury (OR 1.95; 95% CI 1.31, 2.91), vaginal delivery (OR 1.63; 95% CI 1.06, 2.50), incontinence (OR 1.95; 95% CI 1.31, 2.84) and <6.8 hours of sleep on average per night (OR 1.89; 95% CI 1.28, 2.78). Having ≥ 4 risk factors increased the probability of having running-related pain to 61.2%.<h4>Conclusion</h4>The results of this study provide a deeper understanding of the risk factors for running-related pain in postpartum runners. With this information, clinicians can monitor and educate postpartum runners initiating or returning to running. Education could include details of risk factors, combinations of factors for pain and strategies to mitigate risks. Coaches can adapt running workload accounting for fatigue and sleep fluctuations to optimize recovery and performance. Future longitudinal studies that follow asymptomatic postpartum women returning to running after childbirth over time should be performed to validate these findings.
format	article
author	Shefali Mathur Christopher Chad E Cook Suzanne J Snodgrass
author_facet	Shefali Mathur Christopher Chad E Cook Suzanne J Snodgrass
author_sort	Shefali Mathur Christopher
title	What are the biopsychosocial risk factors associated with pain in postpartum runners? Development of a clinical decision tool.
title_short	What are the biopsychosocial risk factors associated with pain in postpartum runners? Development of a clinical decision tool.
title_full	What are the biopsychosocial risk factors associated with pain in postpartum runners? Development of a clinical decision tool.
title_fullStr	What are the biopsychosocial risk factors associated with pain in postpartum runners? Development of a clinical decision tool.
title_full_unstemmed	What are the biopsychosocial risk factors associated with pain in postpartum runners? Development of a clinical decision tool.
title_sort	what are the biopsychosocial risk factors associated with pain in postpartum runners? development of a clinical decision tool.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/9da0a551c1e14065816e3bd7a81dfa51
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What are the biopsychosocial risk factors associated with pain in postpartum runners? Development of a clinical decision tool.

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