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== Introduction ==
== Introduction ==
The popularity of running as a sport has increased widely over the last few decades <ref name=":0">Nikolaidis PT, Rosemann T, Knechtle B. Sex differences in the age of peak marathon race time. Chin. J. Physiol. 2018 Apr 30;61:85-91.</ref>. It is not uncommon to hear that <nowiki>''running a marathon'' is one of someone'</nowiki>s life goals or on their bucket list. The belief that running a marathon is an important life event is adapted by many people and could have significant effects on their beliefs, behaviours and attitudes in general<ref>Gorczyca A, Jankowski T, Oles P. Does running a first marathon influence general self-efficacy and positive orientation. Int. J. Sport Psychol. 2016 Sep 1;47:466-82.</ref>
[[File:Running-1705716 1920.jpg|thumb]]
[[File:Running-1705716 1920.jpg|thumb]]
Running is a sport that comes with huge physical and psychological demands. People run for many reasons, to compete, to get fit, to socialise with other runners, some run to improve their mental health and others just love to run<ref name=":1">Nunes D.An Introduction to Understanding Your Runner.Physioplus Course 2020</ref>.   
The popularity of running as a sport has increased widely over the last few decades <ref name=":0">Nikolaidis PT, Rosemann T, Knechtle B. Sex differences in the age of peak marathon race time. Chin. J. Physiol. 2018 Apr 30;61:85-91.</ref>. It is not uncommon to hear that <nowiki>'' running a marathon'' is one of someone's </nowiki>s life goals or on their bucket list. The belief that running a marathon is an important life event is adopted by many people and could have significant effects on their beliefs, behaviours and attitudes in general. <ref>Gorczyca A, Jankowski T, Oles P. Does running a first marathon influence general self-efficacy and positive orientation? Int. J. Sport Psychol. 2016 Sep 1;47:466-82.</ref><ref>Pereira HV, Palmeira AL, Encantado J, Marques MM, Santos I, Carraa EV, Teixeira PJ. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8139406/pdf/fpsyg-12-624783.pdf Systematic Review of Psychological and Behavioral Correlates of Recreational Running.] Front Psychol. 2021 May 7;12:624783.</ref>
Among the amateur runners, the primary motivation to participate was goals related to general health, personal goal achievement and self-esteem.<ref>Malchrowicz-Mośko E, Gravelle F, Dąbrowska A, León-Guereño P. [https://www.mdpi.com/1660-4601/17/2/585 Do years of running experience influence the motivations of amateur marathon athletes?] International journal of environmental research and public health. 2020 Jan;17(2):585.</ref><br>
<blockquote>
<nowiki> ''If you want to run, run a mile. If you want to experience a different life, run a marathon.''</nowiki> – Emil Zatopek, the only person to ever win the 5000, 10,000 m, and marathon at the same Olympics</blockquote>Running is a sport that comes with huge physical and psychological demands. People run for many reasons, to compete, to get fit, to socialise with other runners, some run to improve their [[Mental Health|mental health]], and others love to run<ref name=":1">Nunes D.An Introduction to Understanding Your Runner. Plus Course 2020</ref>.   


[https://physio-pedia.com/Running_Mechanics_for_Clinicians?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal Running related injuries] are part of the running experience. Runners present with a variety of musculoskeletal injuries including:  
[https://physio-pedia.com/Running_Mechanics_for_Clinicians?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal Running-related injuries] are part of the running experience. Runners present with a variety of musculoskeletal injuries, including:  
*[https://physio-pedia.com/Patellofemoral_Pain_Syndrome Patellofemoral pain]
*[https://physio-pedia.com/Patellofemoral_Pain_Syndrome Patellofemoral pain]
*[https://physio-pedia.com/Shin-splints Medial tibial stress syndrome (shin splints)]
*[https://physio-pedia.com/Shin-splints Medial tibial stress syndrome (shin splints)]
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*[[Iliotibial Band Syndrome|Iliotibial band syndrome]]
*[[Iliotibial Band Syndrome|Iliotibial band syndrome]]
*[[Plantar Fasciitis|Plantar fasciitis]]
*[[Plantar Fasciitis|Plantar fasciitis]]
*Stress fractures of the [[Metatarsal Fractures|metatarsals]] and [[Leg and Foot Stress Fractures|tibia]]
*[[Stress Fractures|Stress fractures]] of the [[Metatarsal Fractures|metatarsals]] and [[Leg and Foot Stress Fractures|tibia]]
When it comes to the assessment of injuries, a holistic assessment approach is recommended to understand the needs of the runners and help them to manage their injuries successfully.   
When it comes to the assessment of injuries, a holistic assessment approach is recommended to understand the runners' needs and help them manage their injuries successfully.   


The published evidence is heavily focused on the physical aspects of running but the psychological factors also need to be well understood and investigated.   
The published evidence is heavily focused on the physical aspects of running, but the psychological factors also need to be well understood and investigated.   


. 
== The Personality of the Runner ==
 
[[File:Emil Zátopek, Erik Ahldén, Willem Slijkhuis 1948.jpeg|thumb|Emil Zátopek, Erik Ahldén, Willem Slijkhuis 1948]]
== The Personality of the runner ==
Personality is the sum of characteristics that make a person unique<ref>Weinberg RS, Gould D. Foundations of sport and exercise psychology. Human Kinetics; 2014 Nov 11.</ref>. Running is not only a physical task; it influences the characteristics of the individual, particularly when done professionally and competitively. Personality traits are the differences among people that determine how the person perceives the world and reacts or responds to situations in a specifiable manner that could be predicted<ref name=":3">Raglin JS. The psychology of the marathoner. Sports Medicine. 2007 Apr 1;37(4-5):404-7.</ref>.  
Personality is defined as the sum of characteristics that make a person unique<ref>Weinberg RS, Gould D. Foundations of sport and exercise psychology. Human Kinetics; 2014 Nov 11.</ref> Running is not only a physical task; it influences the characteristics of the individual particularly when done professionally. Personality traits are the differences among people that determine how the person perceives the world and reacts or responds to situations is a specifiable manner that could be predicted<ref name=":3">Raglin JS. The psychology of the marathoner. Sports Medicine. 2007 Apr 1;37(4-5):404-7.</ref>.  


Marathoners are generally less introverted than non-athletes<ref name=":3" />. Different studies that looked at the personality of runners found that marathon runners showed cognitive anxiety, arousal, self-confidence, motivation and perception of the physical state<ref>Zabala E.L., Rueda M.C.P.L., De La Llave Rodríguez A.L. Characteristics of the psychological state of popular marathon runners. Rev. Psicol. Deporte. 2009;18:151–163.</ref>. In addition, hardy personality (i.e. a group of characteristics related to personal perception of control, commitment and challenges), intelligence and imaginations<ref>Hartung GH, Farge EJ. Personality and physiological traits in middle-aged runners and joggers. Journal of Gerontology. 1977 Sep 1;32(5):541-8.</ref> were found to be higher among marathon runners when compared to the general population <ref name=":0" />
Marathoners are generally less introverted than non-athletes<ref name=":3" />. Different studies that looked at the personality of runners found that marathon runners showed cognitive anxiety, arousal, self-confidence, motivation and perception of the physical state<ref>Zabala E.L., Rueda M.C.P.L., De La Llave Rodríguez A.L. Characteristics of the psychological state of popular marathon runners. Rev. Psicol. Deporte. 2009;18:151–163.</ref>. In addition, hardy personality (i.e. a group of characteristics related to personal perception of control, commitment and challenges), intelligence and imaginations<ref>Hartung GH, Farge EJ. Personality and physiological traits in middle-aged runners and joggers. Journal of Gerontology. 1977 Sep 1;32(5):541-8.</ref> were found to be higher among marathon runners when compared to the general population <ref name=":0" />


Increased pain tolerance was reported to be high in long-distance runners<ref>Freund W, Weber F, Billich C, Birklein F, Breimhorst M, Schuetz UH. Ultra‐M arathon R unners A re D ifferent: I nvestigations into P ain T olerance and P ersonality T raits of P articipants of the TransEurope FootRace 2009. Pain practice. 2013 Sep;13(7):524-32.</ref>. using various psychological instruments, marathoners other distance event athletes scored lower in depression, anxiety and neuroticism and higher in psychic vigour<ref name=":4">Raglin JS. Psychological factors in sport performance: the mental health model revisited. Sports Med 2001; 31: 875-90</ref> and measures of achievement motivation and are primarily driven by intrinsic rewards<ref>Foster S, Walker B. Motivation. In: J Taylor, Wilson GS, editors. Applying sport psychology: four perspectives. Champaign (IL): Human Kinetics, 2005: 3-19</ref>. Successful competitors tend to show the personality traits of what is known as the <nowiki>''Iceberg Profile''</nowiki> scoring less in anger, fatigue, depression, confusion and high in emotional stability<ref name=":3" />.  
Mental toughness is a characteristic of individuals who can endure physical exertion for longer periods.<ref>Brace AW, George K, Lovell GP. [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241284 Mental toughness and self-efficacy of elite ultra-marathon runners]. Plos one. 2020 Nov 4;15(11):e0241284.</ref> Increased [[Pain Behaviours|pain]] tolerance was reported to be high in long-distance runners<ref>Freund W, Weber F, Billich C, Birklein F, Breimhorst M, Schuetz UH. Ultra‐M arathon R unners A re D ifferent: I nvestigations into P ain T olerance and P ersonality T raits of P articipants of the TransEurope FootRace 2009. Pain practice. 2013 Sep;13(7):524-32.</ref>. Using various psychological instruments, marathoners and other distance event athletes scored lower in [[depression]], anxiety and neuroticism and higher in psychic vigour<ref name=":4">Raglin JS. Psychological factors in sports performance: the mental health model revisited. Sports Med 2001; 31: 875-90</ref> and measures of achievement motivation are primarily driven by intrinsic rewards<ref>Foster S, Walker B. Motivation. In: J Taylor, Wilson GS, editors. Applying sport psychology: four perspectives. Champaign (IL): Human Kinetics, 2005: 3-19</ref>. Successful competitors tend to show the personality traits of what is known as the <nowiki>'' Iceberg Profile''</nowiki>, scoring less in anger, fatigue, depression, confusion and high in emotional stability<ref name=":3" />.  


Runners achieved high scores on boldness, warmth, conformity, sensitivity, dominance, and high drive with tension, self-discipline and emotional stability<ref>Nudel DB, Hassett I, Gurian A, Diamant S, Weinhouse E, Gootman N. Young long distance runners: Physiological and psychological characteristics. Clinical pediatrics. 1989 Nov;28(11):500-5.</ref>.
Runners achieved high scores on boldness, warmth, conformity, sensitivity, dominance, and high drive with tension, self-discipline and emotional stability<ref>Nudel DB, Hassett I, Gurian A, Diamant S, Weinhouse E, Gootman N. Young long-distance runners: Physiological and psychological characteristics. Clinical paediatrics. 1989 Nov;28(11):500-5.</ref>.


== Why People Run? ==
== Why People Run? ==
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An essential question to ask runners when assessing running injuries: '''why do you run?'''<ref name=":1" />  
An essential question to ask runners when assessing running injuries: '''why do you run?'''<ref name=":1" />  


Understanding runners' motivation can help in exploring their personalities and therefore essential when addressing running injuries or helping runners for better performance<ref name=":1" />.  
Understanding runners' motivation can help in exploring their personalities and is therefore essential when addressing running injuries or assisting runners to for better performance<ref name=":1" />.
 
'''Motivation''' has been characterised as a matter of positive thinking, a high level of arousal, or a sense of confidence in one’s ability to achieve a goal. It is a process that characterizes one’s effort in terms of direction, intensity, and persistence towards achieving (or avoiding) an outcome. The direction refers to “what” the person is motivated to achieve, while the intensity dimension refers to how much effort one puts forward in pursuit of a goal. The persistence dimension refers to how long an individual continues to strive towards their goal in the face of challenge, difficulty or setbacks<ref name=":5">Hammer C, Podlog L. Motivation and marathon running. InMarathon running: Physiology, psychology, nutrition and training aspects 2016 (pp. 107-124). Springer, Cham.</ref>.
 
The motivation to manage weight, affiliation, coping with psychological distress or day-to-day life and self-esteem were expressed by female marathon finishers. However, there weren't highly motivated to compete with others.<ref>Waśkiewicz Z, Nikolaidis PT, Gerasimuk D, Borysiuk Z, Rosemann T, Knechtle B. [https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01671/full What Motivates Successful Marathon Runners? The Role of Sex, Age, Education, and Training Experience in Polish Runners]. Frontiers in psychology. 2019;10.</ref>
 
Intrinsic motives refer to the inherent enjoyment driven by the act of running and have been found to be associated with more positive emotions and enhanced sports performance. Extrinsic reasons such as achieving a specific time, and receiving tangible rewards have consistently predicted more negative health and well-being outcomes<ref name=":5" />,
 
Motivations of Marathoners Scale (MOMS), an instrument designed to assess individuals’ motives for undertaking marathon training that includes four broad categories or reasons for running were identified<ref name=":5" />:
* Psychological: providing a sense of life meaning, enhancing self-esteem, and psychological coping
* Achievement of personal goals and competing with other runners
* Social: the desire to receive recognition and approval from others and the desire to affiliate with other runners
* Physical motives: general well-being and weight management 
The MOMS scale could predict the runner's likelihood of finishing a marathon. Pre-dropouts had higher tendencies towards weight concern, social recognition, and affiliation motives than marathon finishers.
 
Runners with competitive motivations had the fastest average marathon finish times in a 1993 study <ref>Masters KS, Ogles BM, Jolton JA (1993) The development of an instrument to measure motivation for marathon running: the motivations of marathoners scales (MOMS). Res Q Exerc Sport 64:134–143</ref> by Masters et al.


The motivation to manage weight, affiliation, coping with psychological distress or day to day life and self-esteem were expressed by female marathon finishers however, there weren't highly motivated to compete with others.<ref>Waśkiewicz Z, Nikolaidis PT, Gerasimuk D, Borysiuk Z, Rosemann T, Knechtle B. What Motivates Successful Marathon Runners? The Role of Sex, Age, Education, and Training Experience in Polish Runners. Frontiers in psychology. 2019;10.</ref>
It is essential to consider that running is a great personal challenge and gives the runner a sense of achievement <ref>Summers J. J., Sargent G. I., Levey A. J., Murray K. D. (1982). Middle-aged, non-elite marathon runners: a profile. ''Percept. Mot. Skills'' 54 963–969. 10.2466/pms.1982.54.3.963</ref>, which could explain the difficulty for some runners to refrain from the sport when asked by their physiotherapists or doctors as part of their recovery plan<ref name=":1" />. 


Many runners are motivated to stay fit and/or manage long term conditions.  
While motivation might be a desirable quality in general, there are instances when it can become excessive and compulsive leading to significant psychosocial and health consequences. The term '''<nowiki/>'obligatory runners'''' is a form of compulsive exercise behaviour and refers to those who run at all costs, often despite negative consequences such as injuries or damaging effects on interpersonal relationships. Recognizing overtraining patterns in miles, days, and hours per week, often despite an injury, can help distinguish the obligatory runners. Studies reported several personality traits associated with this behaviour, such as anxiety, perfectionist tendencies, a high exercise identity, and internalization of the thin/athletic-ideal body shape<ref>Karr TM, Zunker C, Thompson RA, Sherman RT, Erickson A, Cao L, Crosby RD, Mitchell JE. Moderators of the association between exercise identity and obligatory exercise among participants of an athletic event. Body Image. 2013 Jan 1;10(1):70-7.</ref><ref>Hall HK, Kerr AW, Kozub SA, Finnie SB. Motivational antecedents of obligatory exercise: The influence of achievement goals and multidimensional perfectionism. Psychology of Sport and Exercise. 2007 May 1;8(3):297-316.</ref>. They also feared making mistakes and doubts about the quality of their training<ref name=":5" />.


It is important to consider that running is a great personal challenge and gives the runner a sense of achievement <ref>Summers J. J., Sargent G. I., Levey A. J., Murray K. D. (1982). Middle-aged, non-elite marathon runners: a profile. ''Percept. Mot. Skills'' 54 963–969. 10.2466/pms.1982.54.3.963</ref> which could explain the difficulty for some runners to refrain from the sport when asked by their physiotherapists or doctors as part of their recovery plan<ref name=":1" />.   
Passion is a distinguished concept from motivation as not all aspects of motivation entitle liking. Passion is defined as a 'strong inclination toward a self-defining activity one loves, values, and devotes a significant amount of time and energy to'. There are two types of passion harmonious and obsessive. The two types affect running and sports performance differently, leading to distinct cognitive, affective, behavioural, social, and performance outcomes<ref name=":5" />.   


== Psychological factors and running injuries ==
== Psychological Factors and Running Injuries ==
The psychological and emotional response of the runners may fluctuate over time depending on their level of participation and performance. Beginner marathon runners are often unprepared for the mental and emotional demands of training and competing in a marathon<ref name=":2">Carter L, Coumbe-Lilley J, Anderson B. Strategies for working with first time marathon runners. Sport J. 2016 Apr 29:1-7.</ref>.  
The psychological and emotional responses of the runners may fluctuate over time depending on their level of participation and performance. Beginner marathon runners are often unprepared for the mental and emotional demands of training and competing in a marathon<ref name=":2">Carter L, Coumbe-Lilley J, Anderson B. Strategies for working with first-time marathon runners. Sport J. 2016 Apr 29:1-7.</ref>.  


Psychology influence sports performance and rate of injuries and plays an important role in the recovery. The mental health model’ of sports performance states that that psychopathology is negatively correlated with athletic success<ref name=":3" />. 70–85% of successful athletes can be identified solely on the basis of the psychological data<ref name=":4" />   
Psychology influences sports performance and the rate of injuries and plays a vital role in recovery. The mental health model of sports performance states that psychopathology negatively correlates with athletic success<ref name=":3" />. 70–85% of successful athletes can be identified solely based on the psychological data<ref name=":4" />   


Anxiety levels could impact the performance and the return to running after an injury reducing the runner's sport-specific self-confidence and trigger a fear response. Therefore, psychological assessment should be integrated into clinical care throughout the entire recovery process.  
Anxiety levels could impact the performance and the return to running after an injury reducing the runner's sport-specific self-confidence and triggering a fear response. Therefore, psychological assessment should be integrated into clinical care throughout recovery. Reinjury anxiety during the return to sport phase can increase the risk of reinjury or secondary injury<ref>Podlog L, Dimmock J, Miller J. A review of return to sport concerns following injury rehabilitation: practitioner strategies for enhancing recovery outcomes. Physical Therapy in Sport. 2011 Feb 1;12(1):36-42.</ref>.  


Competitions greatly increase levels of anxiety. Anxiety is <nowiki>''an emotional reaction to a situation or stimuli perceived to be threatening or dangerous, anxiety has also been considered as both a state and trait''</nowiki><ref name=":3" />. A low to moderate anxiety level is believed to benefit the runner but some studies found high anxieties to be helpful for marathoners. The individual zones of optimal functioning (IZOF) state that for an athlete in any sport, optimal anxiety intensities may range from very low to extremely high. According to the IZOF, a 30-40% of skilled marathoners are predicted to perform better under higher levels of anxiety<ref>Raglin JS, Hanin YL. Competitive anxiety. In: Hanin YL, editor. Emotions in sport. Champaign (IL): Human Kinetics, 2000: 93-111</ref>.  
Competitions significantly increase levels of anxiety. Anxiety is <nowiki>'' an emotional reaction to a situation or stimuli perceived to be threatening or dangerous. Anxiety has also been considered as both a state and trait''</nowiki><ref name=":3" />. A low to moderate anxiety level is believed to benefit the runner, but some studies found high anxiety helpful for marathoners. The individual zones of optimal functioning (IZOF) state that optimal anxiety intensities may range from very low to extremely high for an athlete in any sport. According to the IZOF, 30-40% of skilled marathoners are predicted to perform better under higher anxiety levels <ref>Raglin JS, Hanin YL. Competitive anxiety. In: Hanin YL, editor. Emotions in sport. Champaign (IL): Human Kinetics, 2000: 93-111</ref>.  


Runners adopt various strategies to cope with their stresses. Skilled marathoners actively engage their senses by paying close attention to internal signs such as muscular pain, muscular fatigue, hydration, body temperature and respiration to optimise the efficiency and pace of running. This is referred to as the “association” strategy.  Less-skilled runners use the <nowiki>''</nowiki>dissociation<nowiki>''</nowiki> strategy to intentionally distract themselves from the discomfort of intense physical exertion. This method involves different distracting techniques such as conducting complicated mathematical calculations, mentally designing and building a house, and reliving past experiences, each done in to diminish the painful sensations of the marathon. The dissociation method is believed to increase the runner's risk of injury and has been associated with low performance<ref name=":3" />.  
Runners adopt various strategies to cope with their stresses. Skilled marathoners actively engage their senses by paying close attention to internal signs such as muscular pain, [[Muscle Fatigue|muscular fatigue]], hydration, body temperature and respiration to optimise the efficiency and pace of running. This is referred to as the “association” strategy.  Less-skilled runners use the <nowiki>''</nowiki>dissociation<nowiki>''</nowiki> strategy to intentionally distract themselves from the discomfort of intense physical exertion. This method involves different distracting techniques such as conducting complicated mathematical calculations, mentally designing and building a house, and reliving past experiences, each done to diminish the painful sensations of the marathon. The dissociation method is believed to increase the runner's risk of injury and has been associated with low sports performance<ref name=":3" />.  


They type of running and the performance level has different influences on the runner'spsychology<ref>Jerome W.C., Valliant P.M. Comparison of personalities between marathon runners and cross-country skiers. Percept. Mot. Skills. 1983;56:35–38. doi: 10.2466/pms.1983.56.1.35.</ref>. Periods of intensive training and Insufficient recovery can place high physical and emotional demands on the athlete. Female ultra-marathon runners experienced a range of food disorders<ref name=":0" /> and menstrual irregularity during periods of intensive training due to emotional stresses but their menstrual patterns were normalised once these stresses were removed<ref>van Gend TD. Menstrual patterns in ultramarathon runners. South African Medical Journal. 1987 Dec 1;72(11):788-93.</ref>.   
The running and the performance level have different influences on the runner's psychology<ref>Jerome W.C., Valliant P.M. Comparison of personalities between marathon runners and cross-country skiers. Percept. Mot. Skills. 1983;56:35–38. doi: 10.2466/pms.1983.56.1.35.</ref>. Periods of intensive training and insufficient recovery can place high physical and emotional demands on the athlete. Female ultra-marathon runners experienced a range of food disorders<ref name=":0" /> and menstrual irregularity during periods of intensive training due to emotional stresses but their menstrual patterns were normalised once these stresses were removed<ref>van Gend TD. Menstrual patterns in ultramarathon runners. South African Medical Journal. 1987 Dec 1;72(11):788-93.</ref>. See [[Female Athlete Triad]]  


Utilising interventions to address negative psychological responses can decrease the time lost due to an injury<ref>Nelson EO. Psychometric Analysis of the University of Wisconsin Running Injury and Recovery Index. The University of Wisconsin-Madison; 2019.</ref>.   
Utilising interventions to address negative psychological responses can decrease the time lost due to an injury<ref>Nelson EO. Psychometric Analysis of the University of Wisconsin Running Injury and Recovery Index. The University of Wisconsin-Madison; 2019.</ref>.   
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<references />
[[Category:Course Pages]]
[[Category:Course Pages]]
[[Category:Plus Content]]
[[Category:Running]]
[[Category:Running]]
[[Category:Assessment]]
[[Category:Assessment]]

Latest revision as of 22:41, 31 December 2022

Original Editor - Mariam Hashem

Top Contributors - Mariam Hashem, Kim Jackson, Ewa Jaraczewska, Lucinda hampton, Olajumoke Ogunleye and Tarina van der Stockt  

Introduction[edit | edit source]

Running-1705716 1920.jpg

The popularity of running as a sport has increased widely over the last few decades [1]. It is not uncommon to hear that '' running a marathon'' is one of someone's s life goals or on their bucket list. The belief that running a marathon is an important life event is adopted by many people and could have significant effects on their beliefs, behaviours and attitudes in general. [2][3] Among the amateur runners, the primary motivation to participate was goals related to general health, personal goal achievement and self-esteem.[4]

''If you want to run, run a mile. If you want to experience a different life, run a marathon.'' – Emil Zatopek, the only person to ever win the 5000, 10,000 m, and marathon at the same Olympics

Running is a sport that comes with huge physical and psychological demands. People run for many reasons, to compete, to get fit, to socialise with other runners, some run to improve their mental health, and others love to run[5].

Running-related injuries are part of the running experience. Runners present with a variety of musculoskeletal injuries, including:

When it comes to the assessment of injuries, a holistic assessment approach is recommended to understand the runners' needs and help them manage their injuries successfully.

The published evidence is heavily focused on the physical aspects of running, but the psychological factors also need to be well understood and investigated.

The Personality of the Runner[edit | edit source]

Emil Zátopek, Erik Ahldén, Willem Slijkhuis 1948

Personality is the sum of characteristics that make a person unique[6]. Running is not only a physical task; it influences the characteristics of the individual, particularly when done professionally and competitively. Personality traits are the differences among people that determine how the person perceives the world and reacts or responds to situations in a specifiable manner that could be predicted[7].

Marathoners are generally less introverted than non-athletes[7]. Different studies that looked at the personality of runners found that marathon runners showed cognitive anxiety, arousal, self-confidence, motivation and perception of the physical state[8]. In addition, hardy personality (i.e. a group of characteristics related to personal perception of control, commitment and challenges), intelligence and imaginations[9] were found to be higher among marathon runners when compared to the general population [1]

Mental toughness is a characteristic of individuals who can endure physical exertion for longer periods.[10] Increased pain tolerance was reported to be high in long-distance runners[11]. Using various psychological instruments, marathoners and other distance event athletes scored lower in depression, anxiety and neuroticism and higher in psychic vigour[12] and measures of achievement motivation are primarily driven by intrinsic rewards[13]. Successful competitors tend to show the personality traits of what is known as the '' Iceberg Profile'', scoring less in anger, fatigue, depression, confusion and high in emotional stability[7].

Runners achieved high scores on boldness, warmth, conformity, sensitivity, dominance, and high drive with tension, self-discipline and emotional stability[14].

Why People Run?[edit | edit source]

Runner surface and shoes.jpg

An essential question to ask runners when assessing running injuries: why do you run?[5]

Understanding runners' motivation can help in exploring their personalities and is therefore essential when addressing running injuries or assisting runners to for better performance[5].

Motivation has been characterised as a matter of positive thinking, a high level of arousal, or a sense of confidence in one’s ability to achieve a goal. It is a process that characterizes one’s effort in terms of direction, intensity, and persistence towards achieving (or avoiding) an outcome. The direction refers to “what” the person is motivated to achieve, while the intensity dimension refers to how much effort one puts forward in pursuit of a goal. The persistence dimension refers to how long an individual continues to strive towards their goal in the face of challenge, difficulty or setbacks[15].

The motivation to manage weight, affiliation, coping with psychological distress or day-to-day life and self-esteem were expressed by female marathon finishers. However, there weren't highly motivated to compete with others.[16]

Intrinsic motives refer to the inherent enjoyment driven by the act of running and have been found to be associated with more positive emotions and enhanced sports performance. Extrinsic reasons such as achieving a specific time, and receiving tangible rewards have consistently predicted more negative health and well-being outcomes[15],

Motivations of Marathoners Scale (MOMS), an instrument designed to assess individuals’ motives for undertaking marathon training that includes four broad categories or reasons for running were identified[15]:

  • Psychological: providing a sense of life meaning, enhancing self-esteem, and psychological coping
  • Achievement of personal goals and competing with other runners
  • Social: the desire to receive recognition and approval from others and the desire to affiliate with other runners
  • Physical motives: general well-being and weight management

The MOMS scale could predict the runner's likelihood of finishing a marathon. Pre-dropouts had higher tendencies towards weight concern, social recognition, and affiliation motives than marathon finishers.

Runners with competitive motivations had the fastest average marathon finish times in a 1993 study [17] by Masters et al.

It is essential to consider that running is a great personal challenge and gives the runner a sense of achievement [18], which could explain the difficulty for some runners to refrain from the sport when asked by their physiotherapists or doctors as part of their recovery plan[5].

While motivation might be a desirable quality in general, there are instances when it can become excessive and compulsive leading to significant psychosocial and health consequences. The term 'obligatory runners' is a form of compulsive exercise behaviour and refers to those who run at all costs, often despite negative consequences such as injuries or damaging effects on interpersonal relationships. Recognizing overtraining patterns in miles, days, and hours per week, often despite an injury, can help distinguish the obligatory runners. Studies reported several personality traits associated with this behaviour, such as anxiety, perfectionist tendencies, a high exercise identity, and internalization of the thin/athletic-ideal body shape[19][20]. They also feared making mistakes and doubts about the quality of their training[15].

Passion is a distinguished concept from motivation as not all aspects of motivation entitle liking. Passion is defined as a 'strong inclination toward a self-defining activity one loves, values, and devotes a significant amount of time and energy to'. There are two types of passion harmonious and obsessive. The two types affect running and sports performance differently, leading to distinct cognitive, affective, behavioural, social, and performance outcomes[15].

Psychological Factors and Running Injuries[edit | edit source]

The psychological and emotional responses of the runners may fluctuate over time depending on their level of participation and performance. Beginner marathon runners are often unprepared for the mental and emotional demands of training and competing in a marathon[21].

Psychology influences sports performance and the rate of injuries and plays a vital role in recovery. The mental health model of sports performance states that psychopathology negatively correlates with athletic success[7]. 70–85% of successful athletes can be identified solely based on the psychological data[12]

Anxiety levels could impact the performance and the return to running after an injury reducing the runner's sport-specific self-confidence and triggering a fear response. Therefore, psychological assessment should be integrated into clinical care throughout recovery. Reinjury anxiety during the return to sport phase can increase the risk of reinjury or secondary injury[22].

Competitions significantly increase levels of anxiety. Anxiety is '' an emotional reaction to a situation or stimuli perceived to be threatening or dangerous. Anxiety has also been considered as both a state and trait''[7]. A low to moderate anxiety level is believed to benefit the runner, but some studies found high anxiety helpful for marathoners. The individual zones of optimal functioning (IZOF) state that optimal anxiety intensities may range from very low to extremely high for an athlete in any sport. According to the IZOF, 30-40% of skilled marathoners are predicted to perform better under higher anxiety levels [23].

Runners adopt various strategies to cope with their stresses. Skilled marathoners actively engage their senses by paying close attention to internal signs such as muscular pain, muscular fatigue, hydration, body temperature and respiration to optimise the efficiency and pace of running. This is referred to as the “association” strategy. Less-skilled runners use the ''dissociation'' strategy to intentionally distract themselves from the discomfort of intense physical exertion. This method involves different distracting techniques such as conducting complicated mathematical calculations, mentally designing and building a house, and reliving past experiences, each done to diminish the painful sensations of the marathon. The dissociation method is believed to increase the runner's risk of injury and has been associated with low sports performance[7].

The running and the performance level have different influences on the runner's psychology[24]. Periods of intensive training and insufficient recovery can place high physical and emotional demands on the athlete. Female ultra-marathon runners experienced a range of food disorders[1] and menstrual irregularity during periods of intensive training due to emotional stresses but their menstrual patterns were normalised once these stresses were removed[25]. See Female Athlete Triad

Utilising interventions to address negative psychological responses can decrease the time lost due to an injury[26].

[27]

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 Nikolaidis PT, Rosemann T, Knechtle B. Sex differences in the age of peak marathon race time. Chin. J. Physiol. 2018 Apr 30;61:85-91.
  2. ↑ Gorczyca A, Jankowski T, Oles P. Does running a first marathon influence general self-efficacy and positive orientation? Int. J. Sport Psychol. 2016 Sep 1;47:466-82.
  3. ↑ Pereira HV, Palmeira AL, Encantado J, Marques MM, Santos I, Carraa EV, Teixeira PJ. Systematic Review of Psychological and Behavioral Correlates of Recreational Running. Front Psychol. 2021 May 7;12:624783.
  4. ↑ Malchrowicz-Mośko E, Gravelle F, Dąbrowska A, León-Guereño P. Do years of running experience influence the motivations of amateur marathon athletes? International journal of environmental research and public health. 2020 Jan;17(2):585.
  5. ↑ 5.0 5.1 5.2 5.3 Nunes D.An Introduction to Understanding Your Runner. Plus Course 2020
  6. ↑ Weinberg RS, Gould D. Foundations of sport and exercise psychology. Human Kinetics; 2014 Nov 11.
  7. ↑ 7.0 7.1 7.2 7.3 7.4 7.5 Raglin JS. The psychology of the marathoner. Sports Medicine. 2007 Apr 1;37(4-5):404-7.
  8. ↑ Zabala E.L., Rueda M.C.P.L., De La Llave Rodríguez A.L. Characteristics of the psychological state of popular marathon runners. Rev. Psicol. Deporte. 2009;18:151–163.
  9. ↑ Hartung GH, Farge EJ. Personality and physiological traits in middle-aged runners and joggers. Journal of Gerontology. 1977 Sep 1;32(5):541-8.
  10. ↑ Brace AW, George K, Lovell GP. Mental toughness and self-efficacy of elite ultra-marathon runners. Plos one. 2020 Nov 4;15(11):e0241284.
  11. ↑ Freund W, Weber F, Billich C, Birklein F, Breimhorst M, Schuetz UH. Ultra‐M arathon R unners A re D ifferent: I nvestigations into P ain T olerance and P ersonality T raits of P articipants of the TransEurope FootRace 2009. Pain practice. 2013 Sep;13(7):524-32.
  12. ↑ 12.0 12.1 Raglin JS. Psychological factors in sports performance: the mental health model revisited. Sports Med 2001; 31: 875-90
  13. ↑ Foster S, Walker B. Motivation. In: J Taylor, Wilson GS, editors. Applying sport psychology: four perspectives. Champaign (IL): Human Kinetics, 2005: 3-19
  14. ↑ Nudel DB, Hassett I, Gurian A, Diamant S, Weinhouse E, Gootman N. Young long-distance runners: Physiological and psychological characteristics. Clinical paediatrics. 1989 Nov;28(11):500-5.
  15. ↑ 15.0 15.1 15.2 15.3 15.4 Hammer C, Podlog L. Motivation and marathon running. InMarathon running: Physiology, psychology, nutrition and training aspects 2016 (pp. 107-124). Springer, Cham.
  16. ↑ Waśkiewicz Z, Nikolaidis PT, Gerasimuk D, Borysiuk Z, Rosemann T, Knechtle B. What Motivates Successful Marathon Runners? The Role of Sex, Age, Education, and Training Experience in Polish Runners. Frontiers in psychology. 2019;10.
  17. ↑ Masters KS, Ogles BM, Jolton JA (1993) The development of an instrument to measure motivation for marathon running: the motivations of marathoners scales (MOMS). Res Q Exerc Sport 64:134–143
  18. ↑ Summers J. J., Sargent G. I., Levey A. J., Murray K. D. (1982). Middle-aged, non-elite marathon runners: a profile. Percept. Mot. Skills 54 963–969. 10.2466/pms.1982.54.3.963
  19. ↑ Karr TM, Zunker C, Thompson RA, Sherman RT, Erickson A, Cao L, Crosby RD, Mitchell JE. Moderators of the association between exercise identity and obligatory exercise among participants of an athletic event. Body Image. 2013 Jan 1;10(1):70-7.
  20. ↑ Hall HK, Kerr AW, Kozub SA, Finnie SB. Motivational antecedents of obligatory exercise: The influence of achievement goals and multidimensional perfectionism. Psychology of Sport and Exercise. 2007 May 1;8(3):297-316.
  21. ↑ Carter L, Coumbe-Lilley J, Anderson B. Strategies for working with first-time marathon runners. Sport J. 2016 Apr 29:1-7.
  22. ↑ Podlog L, Dimmock J, Miller J. A review of return to sport concerns following injury rehabilitation: practitioner strategies for enhancing recovery outcomes. Physical Therapy in Sport. 2011 Feb 1;12(1):36-42.
  23. ↑ Raglin JS, Hanin YL. Competitive anxiety. In: Hanin YL, editor. Emotions in sport. Champaign (IL): Human Kinetics, 2000: 93-111
  24. ↑ Jerome W.C., Valliant P.M. Comparison of personalities between marathon runners and cross-country skiers. Percept. Mot. Skills. 1983;56:35–38. doi: 10.2466/pms.1983.56.1.35.
  25. ↑ van Gend TD. Menstrual patterns in ultramarathon runners. South African Medical Journal. 1987 Dec 1;72(11):788-93.
  26. ↑ Nelson EO. Psychometric Analysis of the University of Wisconsin Running Injury and Recovery Index. The University of Wisconsin-Madison; 2019.
  27. ↑ The connection between running and the brain: By Neuroscientist Ben Martynoga. Available from:https://www.youtube.com/watch?v=BRD-FDIZzUA[last accessed 24/11/2020]
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