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Overuse injuries are generally defined as a repetitive micro-trauma to tissue. Many researchers have associated particular biomechanical parameters as an indicator of such injuries. However, while these parameters have been reported in single studies, in many instances, it has been difficult to verify these parameters as causative to the injury. We have investigated overuse injuries, such as patella-femoral pain syndrome, using a dynamical systems approach. Using such methods, the importance of the structure of coordinative variability (i.e. the variability of the interaction between segments or joints) becomes apparent. We view coordinative variability as functionally important to the movement and different from end-point or goal variability. Using concepts derived from the work of Bernstein, we conducted studies using a continuous relative phase and/or modified vector coding approaches to investigate the coordinative variability of overuse injuries. Consistently, we have found that the higher variability state of a coordinative structure is the healthy state while the lower variability state is the unhealthy or pathological state. It is clear that very high coordinative variability could also result in injury and that there must be a window of ‘higher variability’ in which non-injured athletes function. While this finding that coordinative variability is functional has been shown in several studies, it is still not clear if reduced variability contributes to or results from the injury. Studies are currently underway to determine the potential reasons for the reduced variability in injured athletes. Nevertheless, our laboratory believes that this understanding of how joints interact can be important in understanding overuse injuries.

The purpose of this investigation was to determine whether individuals with patellofemoral pain (PFP) display a reduction in intralimb joint coordination variability compared to nonimpaired persons. In addition, it was hypothesized that the variability of the stride characteristics would be similar between groups. Eight individuals with unilateral PFP and 8 nonimpaired participants ran on a treadmill at a fixed (2.68 m·s–1) and preferred speed while stride characteristics and 3-D kinematics of the bilateral lower extremities were recorded. Intralimb coordination variability was measured using a vector coding technique applied to relative motion plots of various joint couplings. The PFP group displayed greater stride length variability during running at the preferred speed. However, this was not the case during running at the fixed speed. When averaging across the entire stride cycle, coordination variability for all joint couplings was consistent between the two groups. However, further analysis about heel-strike revealed reduced joint coordination variability for the thigh rotation/leg rotation coupling of the PFP group’s injured limb compared to that of the nonimpaired group. With the exception of the transverse plane rotations at heel-strike, it would appear that the level of pain experienced by the PFP participants may not be great enough to produce a change in the intralimb coordination patterns during running.

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These data provide new evidence of a potential role for KE strength asymmetries in the symptomatic fatigue and physical dysfunction of persons with MS, possibly through an effect on postural stability.