“Couch-to-5k or Couch to Ouch to Couch!?” Who Takes Part in Beginner Runner Programmes in the UK and Is Non-Completion Linked to Musculoskeletal Injury?

Physical activity has mental and physical health benefits, however globally, three-quarters of the population do not meet physical activity guidelines. The Couch-to-5k is a beginner runners pro-gramme aimed at increasing physical activity. However, this programme lacks an evidence-base and it is unclear who is attracted to the programme, plus running has a high rate of musculoskel-etal (MSK) injuries. The aims of this study were to identify the characteristics of people taking part, the incidence of MSK injuries and to explore the experiences of people who dropped out of a modified 9-week Couch-to-5k programme. 110 runners (average age was 47.1±13.7 years) partic-ipated in the study which involved completion of questionnaires (running experience and foot-wear information, quality of life (EQ-5D-5L), physical activity level (IPAQ-short form), MSK inju-ry history and knee condition (SNAPPS and KOOS-PS)) at the start, middle and end of the pro-gramme collecting socio-demographics (age, gender, social economic status, relationship status, education level), body mass index, running experience , footwear information, quality of life, physical activity levels, MSK injuries and knee condition. Fifteen drop-outs were interviewed to explore experiences of the programme. Runners were mainly females (81.8%) with an average age 47.1-year-olds, average body mass index of 28.1kg.m2, mainly from high socio-economic lev-els, married and educated to degree level. 64% of the sample had previous running experience and were classified as active. Half the sample self-reported pain / discomfort and 37.2% reported anxiety / depression at the start of the programme via the EQ-5D-5L scale. Self-reported health scores increased (p = 0.047) between baseline (73.1±18.8 out of 100) and at the midpoint (81.2±11.6) but were no significant differences between any other time points (end point 79.7±17.5, p>0.05). Twenty-one injuries were reported during the programme (19%). Previous in-jury increased the risk of new injury (OR 7.56 95% CI 2.06 to 27.75). Only 27.3% completed the programme. Three themes emerged from interviews; MSK injury, negative emotions linked to non-completion and design of the programme. The Couch-to-5k may not attract diverse inactive populations, future work with larger sample sizes is needed to substantiate this finding. Drop-ping out was linked to MSK injury and progressive design, future programmes should consider including injury prevention advice and more flexible designs.