Forces that are repeatedly applied to the body could lead to positive remodeling of a structure if the forces fall below the tensile limit of the structure and if sufficient time is provided between force applications. On the other hand, an overuse injury could result if there is inadequate rest time between applied forces. Running is one of the most widespread activities during which overuse injuries of the lower extremity occur. The purpose of this article is to review the current state of knowledge related to overuse running injuries, with a particular emphasis on the effect of impact forces. Recent research has suggested that runners who exhibit relatively large and rapid impact forces while running are at an increased risk of developing an overuse injury of the lower extremity. Modifications in training programs could help an injured runner return to running with decreased rehabilitation time, but it would be preferable to be able to advise a runner regarding injury potential before undertaking a running program. One of the goals of future research should be to focus on the prevention or early intervention of running injuries. This goal could be accomplished if some easily administered tests could be found which would predict the level of risk that a runner may encounter at various levels of training intensity, duration, and frequency. The development of such a screening process may assist medical practitioners in identifying runners who are at a high risk of overuse injury.

These results suggest that runners who have developed stride patterns that incorporate relatively low levels of impact forces, and a moderately rapid rate of pronation are at a reduced risk of incurring overuse running injuries.

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The purpose of the study was to investigate the characteristics of shock attenuation during high-speed running. Maximal running speed was identified for each subject [n = 8 males, 25 (SD 4.6) years; 80 (8.9) kg; 1.79 (0.06) m] as the highest speed that could be sustained for about 20 s on a treadmill. During testing, light-weight accelerometers were securely mounted to the surface of the distal antero-medial aspect of the leg and frontal aspect of the forehead. Subjects completed running conditions of 50, 60, 70, 80, 90, and 100% of their maximal speeds with each condition lasting about 20 s. Stride length, stride frequency, leg and head peak impact acceleration were recorded from the acceleration profiles. Shock attenuation was analyzed by extracting specific sections of the acceleration profiles and calculating the ratio of head to leg power spectral densities across the 10-20 Hz frequency range. Both stride length and stride frequency increased across speeds (P < 0.05) and were correlated with running speed (stride length r = 0.92, stride frequency r = 0.89). Shock attenuation increased about 20% per m x s(-1) across speeds (P< 0.05), which was similar to the 17% increase in stride length per m x s(-1). Additionally, shock attenuation was correlated with stride length (r = 0.71) but only moderately correlated with stride frequency (r = 0.40) across speeds. It was concluded that shock attenuation increased linearly with running speed and running kinematic changes were characterized primarily by stride length changes. Furthermore, the change in shock attenuation was due to increased leg not head peak impact acceleration across running speeds.

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The aim of this study was to examine shock attenuation before and after completing a maximal effort graded exercise test while running on a treadmill. Ten individuals ran before and after a maximal graded exercise test with running speed controlled between conditions. Transfer functions were calculated using surface-mounted accelerometers to represent shock attenuation. An accelerometer was mounted on the distal aspect of the tibia and another on the anterior aspect of the forehead. Ten strides were analysed in each condition for all participants. Paired t-tests were used to compare each dependent variable (shock attenuation, stride length, rate of oxygen consumption) between conditions (running before vs after the exercise test). Oxygen consumption was 16% greater when running after the graded exercise test (47.9 +/- 5.0 ml x kg(-1) x min(-1); mean+/-s) than when running before it (41.1 +/- 2.7 ml x kg(-1) x min(-1)) (P < 0.05). Stride length was similar during running before (2.71 +/- 0.15 m) and after (2.75 +/- 0.17 m) the graded exercise test (P > 0.05). Shock attenuation was, on average, 12% lower during running after (-9.8 +/- 2.6 dB) than before (-11.3 +/- 2.7 dB) the graded exercise test (P < 0.05). We conclude that less shock was attenuated during fatigued than non-fatigued running and that only subtle changes in stride length were made while fatigued.