Anterior knee pain and its extrinsic risk factors among runners in under-resourced communities in Ekurhuleni, Gauteng, South Africa

Background: Various factors predispose athletes to anterior knee pain (AKP), making a holistic assessment with rehabilitation inevitable. Due to minimal rehabilitation services in under-resourced communities, runners are less likely to report this injury to medical professionals compared to runners in better resourced communities. Objective: The purpose of this study was to report on the prevalence of AKP among runners in under-resourced communities and to determine the extrinsic risk factors for this injury. Methods: This was a cross-sectional study of 347 runners in total. Convenience sampling was used to recruit 183 participants aged between 13 and 55 years with no previous history of knee surgeries, traumatic or degenerative knee conditions. Questionnaires were used to collect data on the prevalence of AKP and extrinsic risk factors. The SPSS (version 25) was used to analyse the data. Data were presented as frequencies and percentages and the results from chi-square and logistic regression tests were provided. Results: Forty percent (40%) of participants presented with AKP, particularly males (n=106, 58%), young runners (n=94, 51%) and those with 3-5 years of running experience (n=57, 31%). Anterior knee pain was associated with age (X2=6.484, p=0.039) and running experience (X2=8.39, p=0.04). The following extrinsic risk factors contributed to AKP significantly: training load (p=0.04, odds ratio [OR]=1.23), warm-up (p=0.04, OR=1.57)' running shoe condition (p=0.04, OR=0.14) and running surface (p=0.05, OR=1.2). Conclusion: A substantial presence of AKP and its extrinsic risk factors were found among all participants. These outcomes suggest that extrinsic risk factors should also be considered when managing AKP among runners.