The Runners and Injury Longitudinal Study (TRAILS): Part II

People who run strike the ground with a force of as much as 15 times their body weight.

So it's no surprise that the body, particularly joints, don't always react kindly.

Knees wear down, shin splints develop, tissues in the heel inflame.

Stephen Messier, a professor in the health and exercise science department at Wake Forest University, said that up to 65 percent of runners will develop an overuse injury.

It's a problem his department will study more thoroughly in the next few years with the help of a $600,000 grant from the U.S. Army, which has seen a dramatic increase in overuse injuries among its soldiers.

"Running is a way to relieve stress, improve your health and live longer," Messier said. "There is scientific evidence that it does work. But the downside is that people do get injured, and that's what we're trying to prevent."

Wake Forest is looking for 180 runners to participate in the study, which is called The Runners and Injury Longitudinal Study, or TRAILS. To qualify, participants must run at least 5 miles a week, have been injury-free for the past six months and live within 100 miles of Wake Forest.

Participants will be asked to keep a log of their running, correspond with researchers about twice a week and come in a few times for tests that will evaluate strength and gait, among other things. Upon completion, they will receive a $100 gift card from the local New Balance store. Runners will be tracked for a year.

Once the study is completed, researchers will analyze some of the characteristics between those who got injured and those who were injury-free. They will be looking at everything from the types of shoes the participants wear to the surface they like to run on.

"With running injuries, we don't know enough what are the risk factors and where to intervene," Messier said. "This study will give us a better idea of what factors make someone at risk for injury."

The next step, he said, will be a clinical trial where researchers would pick a risk factor and intervene.

"We'll pick something we know we can change," he said. "If it's a major risk factor, say, being female, there's not much we can do."

However, changes to someone's gait or training regimen could be addressed in a clinical trial. Such a trial would not be covered under this grant.

"The whole idea here is it's a progression. Research moves slowly," Messier said.

The Army has a stake in the findings. Medical disability discharge rates have increased more than 600 percent in the past 25 years. Many of those discharges are running-related injuries, Messier said.

"We are trying to decrease the rate of medical discharges," he said.

Researchers will be using some high-tech equipment to study each participant's running mechanics. The other day, Mackenzie Hoops, a graduate student, attached about 20 "markers" all over the body of Greg Billington, an intern and a member of Wake Forest's cross-country team.

As Billington ran down a runway, four cameras picked up signals from the markers. Those signals were then turned into a 3-D image on a nearby laptop. From that image, researchers can pick up important information about each runner's gait, such as the angle of the knee and the placement of the foot.

"We'll be able to compare how people run differently than the other subjects," said Monica Munsey, the project coordinator.

Although other studies have focused on overuse injuries, Messier said, he believes this is the first that will use strictly non-injured runners.

The study has been set up to benefit the military but Messier said he sees public-health consequences coming from it.

"We're all about being able to help people run for the rest of their lives," he said.