Marandure, Tsungai TirivasheSchwellnus, Martin PeterGrant, C.C. (Catharina Cornelia)Jansen van Rensburg, AudreyJordaan, EsmeBoer, Pieter Henk2024-08-012024-08-012023-11Marandure, T.T., Schwellnus, M.P., Grant, C., Jansen van Rensburg, A., Jordaan, E. & Boer, P. Patellofemoral pain syndrome is associated with chronic disease and allergies in 60 997 distance runner race entrants: SAFER XXX study', Clinical Journal of Sport Medicine, vol. 33, no. 6, pp. 603-610, doi : 10.1097/JSM.0000000000001166.1050-642X (print)1536-3724 (online)10.1097/JSM.0000000000001166http://hdl.handle.net/2263/97414OBJECTIVE : Patellofemoral pain syndrome (PFPS) is a common running-related injury. Independent risk factors associated with PFPS have not been described in a large cohort of distance runners. DESIGN : Descriptive, cross-sectional study. SETTING : 21.1 and 56 km Two Oceans Marathon races (2012-2015). PARTICIPANTS : 60 997 race entrants. ASSESSMENT OF RISK FACTORS : Participants completed a compulsory prerace medical screening questionnaire (history of PFPS in the past 12 months, n = 362; no injury history, n = 60 635). Selected risk factors associated with a history of PFPS were explored using univariate & multivariate analyses: demographics, training/running variables, history of chronic diseases (composite chronic disease score), and any allergy. MAIN OUTCOME MEASURES : Prevalence ratios (PRs, 95% confidence intervals). RESULTS : Risk factors associated with PFPS (univariate analysis) were increased years of recreational running (PR = 1.09; P = 0.0107), older age (>50 years), and chronic diseases (PR > 2): gastrointestinal disease (PR = 5.06; P < 0.0001), cardiovascular disease (CVD) (PR = 3.28; P < 0.0001), nervous system/psychiatric disease (PR = 3.04; P < 0.0001), cancer (PR = 2.83; P = 0.0005), risk factors for CVD (PR = 2.42; P < 0.0001), symptoms of CVD (PR = 2.38; P = 0.0397), and respiratory disease (PR = 2.00; P < 0.0001). Independent risk factors (multivariate analysis) associated with PFPS (adjusted for age, sex, and race distance) were a higher chronic disease composite score (PR = 2.68 increased risk for every 2 additional chronic diseases; P < 0.0001) and a history of allergies (PR = 2.33; P < 0.0001). CONCLUSIONS : Novel independent risk factors associated with PFPS in distance runners are a history of multiple chronic diseases and a history of allergies. Identification of chronic diseases and allergies should be considered as part of the clinical assessment of a runner presenting with a history of PFPS.en© 2023 Wolters Kluwer Health, Inc. All rights reserved.Patellofemoral pain syndrome (PFPS)Patellofemoral painEndurance runningRisk factorsChronic diseaseUltramarathonGradual onset running injurySDG-03: Good health and well-beingPostprint Article