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Questionnaire

Date of Birth
Sex
- Male
- Female
Do you have family members who participate in running sports? (check all that apply)
- Father
- Mother
- Sibling(s)
Number of male siblings participating in running sports
Number of female siblings participating in running sports
Indicate any family member you know to have received from a physician or podiatrist a diagnosis of plantar fasciitis (check all that apply)
- Father
- Mother
- Male sibling
- Female sibling
Indicate any family member you know to have received from a physician or podiatrist a diagnosis of iliotibial band syndrome (check all that apply)
- Father
- Mother
- Male sibling
- Female sibling
Indicate any family member you know to have received from a physician or podiatrist a diagnosis of patellar tendonitis (check all that apply)
- Father
- Mother
- Male sibling
- Female sibling
Indicate any family member you know to have received from a physician or podiatrist a diagnosis of Achilles tendonitis (check all that apply)
- Mother
- Father
- Female sibling
- Male sibling
How many years have you been running?
How many 10 Kilometer races have you run in your lifetime?
How many half-marathons have your run in your lifetime?
How many marathons have you run in your lifetime?
How many ultramarathons have you run in your lifetime?
How many 10 kilometer races have you run in the last year?
How many half-marathons have you run in the last year?
How many marathons have you run in the last year?
How many ultramarathons have you run in the last year?
At what age did you start running?
At what age did you start competing in races?
How many hours do you train a week? (insert number)
How many hours do you cross train a week? (insert number)
Methods of cross-training (check all that apply)
- Pilates
- Yoga
- Strength Training
- Crossfit
- TRX
- The methods my personal trainer suggests
- My own methods
How many miles per week do you run? (insert number)
How many days per week do you run? (insert number)
What distance race do you primarily train for?
- 10 K
- Half-marathon
- Marathon
- Ultramarathon
After how many miles of running do you replace your shoes? (insert number)
What kind of terrain do you train on? (check all that apply)
- Paved road
- Trail
- Treadmill
- Track
Do you stretch before runs?
Do you stretch after runs?
I statically stretch the following areas before running (check all that apply)
- Hamstrings
- Quadriceps
- Achilles
- Hips
- I don't statically stretch before running
I dynamically stretch the following areas before running (check all that apply)
- Hamstrings
- Quadriceps
- Achilles
- Hips
- I don't dynamically stretch before running
I statically stretch the following areas after running
- Hamstrings
- Quadriceps
- Achilles
- Hips
- I don't statically stretch after running
I dynamically stretch the following areas after running
- Hamstrings
- Quadriceps
- Achilles
- Hips
- I don't dynamically stretch after running
Have you ever run through pain?
If you have run through pain, which injuries have you run through? (check all that apply)
- Plantar fasciitis
- Iliotibial band syndrome
- patellar tendonitis
- Achilles tendonitis
Have you ever seen a professional about a running injury?
- Yes
- No
If you checked yes to the previous question, which injuries were you seen for? (check all that apply)
- Plantar fasciitis
- Iliotibial band syndrome
- patellar tendonitis
- Achilles tendonitis
What professional have you been seen by for a running injury? (check all that apply)
- Podiatrist
- MD
- Physical therapist
- Chiropractor
- Athletic trainer
Have you ever received a cortisone shot?
- Yes
- No
If you checked yes to the previous question, what injury did you receive a cortisone shot for? (check all that apply)
- Plantar fasciitis
- Iliotibial band syndrome
- Patellar tendonitis
- Achilles tendonitis
Did the injury every recur? (check all that apply)
- Plantar fasciitis
- Iliotibial band syndrome
- Patellar tendonitis
- Achilles tendonitis
Have you ever had an injury prevent you from running?
- Yes
- No
If you checked yes to the previous question, list the injuries that have prevented you from running (check all that apply)
- Plantar fasciitis
- Iliotibial band syndrome
- Patellar tendonitis
- Achilles tendonitis
If you were sidelined by plantar fasciitis, what is the longest period of time you were sidelined?
If you were sidelined by iliotibial band syndrome, what is the longest period of time you were sidelined?
If you were sidelined by patellar tendonitis, what is the longest period of time you were sidelined for
If you were sidelined by Achilles tendonitis, what is the longest period of time you were sidelined for?
Has a physician or podiatrist ever diagnosed you with plantar fasciitis?
- Yes
- No
Have you even had a condition without a specific diagnosis of plantar fasciitis, as characterized by having all of the following symptoms? (check all that apply)
- Weight bearing heel pain
- Numbness or tingling in the sole of the foot
- Worse pain in the morning
- Pain syndrome is consistent over days to weeks
Did your injury occur in the location marked by the region 'plantar fasciitis' below? [Note: Image to be inserted]
- Yes
- No
Has a physician or podiatrist ever diagnosed you with iliotibial band syndrome?
- Yes
- No
Have you ever had a condition without a specific diagnosis of iliotibial band syndrome, as characterized by having all of the following symptoms? (check all that apply)
- Diffuse pain over the lateral knee that is difficult to locate in one spot, however, over time, the pain does localize to the lateral bone just below the knee and is painful to the touch
- Inflammation in the knee
- Pain at the end of a run or shortly into a run, but over time, pain can persist continuously
- More pain running down hills
Did you injury occur in the region marked 'iliotibial band' below? [Note: image to be inserted]
- Yes
- No
Has a physician or podiatrist ever diagnosed you with patellar tendonitis?
- Yes
- No
Have you ever had the following condition without a specific diagnosis of patellar tendonitis, as by having all of the following symptoms? (check all that apply)
- Pain in the front part of the knee, just under the kneecap
- Pain to the touch in the area between the kneecap and shinbone
Did the injury occur in the location marked 'patellar tendon' below? [Note: image to be inserted]
- Yes
- No
Has a physician or podiatrist ever diagnosed you with Achilles tendonitis?
- Yes
- No
Have you ever had the following condition as characterized by having all of the following symptoms, without a specific diagnosis of Achilles tendonitis? (check all that apply)
- Mild Pain after exercise that gradually worsens
- Episodes of diffuse or localized pain, sometimes severe, along the Achilles tendon during or a few hours after running
- Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone
- Stiffness that generally diminishes as the tendon warms up with use
- Some swelling
Did the injury occur at the region marked Achilles tendon? [Note: image to be inserted]
- Yes
- No
I am currently active in the following running events: (check all that apply)
- 10 Kilometer
- 1/2 Marathon
- Marathon
- Ultramarathon
- Sprint triathlon
- Olympic triathlon
- Ultra triathlon
Are you willing to be re-contacted to test additional genes?
- Yes
- No

The Relationship of COL5A1 Genotype to Lower Extremity Soft Tissue Injuries in a Cohort of Endurance Runners

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