Influence of Step Rate on Shin Injury and Anterior Knee Pain in High School Runners

Luedke, Lace E.; Heiderscheit, Bryan C.; Williams, D.S. Blaise; Rauh, Mitchell J.

doi:10.1249/mss.0000000000000890

Cited by 89 publications

(75 citation statements)

References 26 publications

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“…A prospective study of high school runners found that those who habitually ran with a higher step rate had a reduced likelihood of shin injury 20 .…”

Section: Discussionmentioning

confidence: 99%

Manipulation of Foot Strike and Footwear Increases Achilles Tendon Loading During Running

Rice

Patel

2017

Am J Sports Med

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Background:The Achilles tendon is the most common site of tendon overuse injury in humans. There has been a recent interest in running with a forefoot strike pattern and in minimal shoes, yet evidence is currently limited regarding the combined influence of foot strike and footwear on Achilles tendon loading.Purpose: To investigate the influence of both foot strike and footwear on Achilles tendon loading in habitual rearfoot strike runners. Study Design: Crossover study designMethods: Synchronised kinematic and force data were collected from 22 habitual rearfoot strikers (11 male), who habitually run in non-minimal running shoes, during overground running at 3.6 m.s -1 . Participants ran in three different footwear conditions (standard running shoe; minimal running shoe; barefoot) with both a rearfoot strike (RFS) and an imposed forefoot strike (FFS) in each footwear condition. Achilles tendon loading was estimated using inverse dynamics, where the Achilles tendon moment arm was determined using a regression equation.Conditions were compared using a two-way repeated measures ANOVA.Results: Achilles tendon impulse was greater when running with a FFS than a RFS in minimal shoes. Achilles tendon loading rates were higher when running either in minimal shoes or barefoot than in standard shoes, regardless of foot strike. Rice and Patel, Accepted in The American Journal of Sports Medicine, 22 Feb 2017 Conclusions:In runners who habitually rearfoot strike in standard running shoes, running in minimal shoes or barefoot increased the rate of tendon loading, and running with a forefoot strike in minimal shoes increased the magnitude of tendon loading. Transitioning to these running conditions may increase the risk of tendinopathy. What is known about this subject?It has been shown that when running with a forefoot strike compared with a rearfoot strike, the internal ankle plantar flexor moment increases, but there are conflicting findings regarding whether this results in an increase in Achilles tendon force. Some of these findings may have been confounded by footwear. What this study adds to existing knowledgeThis study considered the influence of both foot strike and footwear on Achilles tendon loading during running, as well as their interactive effect. It has added to the knowledge in this area by identifying that foot strike influences the magnitude of loading, whereas footwear influences the rate, amongst habitual rearfoot strikers who are accustomed to running in standard running footwear.

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“…A prospective study of high school runners found that those who habitually ran with a higher step rate had a reduced likelihood of shin injury 20 .…”

Section: Discussionmentioning

confidence: 99%

Manipulation of Foot Strike and Footwear Increases Achilles Tendon Loading During Running

Rice

Patel

2017

Am J Sports Med

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“…Levels of evidence are shown with the following symbols: (double asterisks) limited evidence, (asterisk) very limited evidence, (double tagger) no statistical analysis. A detailed description of all significant outcome measures is provided using following superscripts: a in female runners developing patellofemoral pain, b in female runners developing iliotibial band syndrome, c in a mixed-sex population of experienced runners developing patellofemoral pain, d in a mixed-sex population of crosscountry runners developing an RRI, e in a mixed-sex population of recreational runners developing Achilles tendinopathy, f in a mixedsex population of recreational runners developing an RRI, g in male novice runners developing an RRI, h in female recreational runners who required medical attention compared with female recreational runners who never sustained an RRI before, i in male and female novice runners developing an RRI, j in female recreational runners developing an RRI, k in a mixed-sex population of novice runners developing patellofemoral pain, l in a mixed-sex population of novice runners sustaining an RRI, m in a mixed-sex population of novice runners developing Achilles tendinopathy, n in male runners developing Achilles tendinopathy, plantar fasciopathy and medial tibial stress syndrome, o in a mixed-sex population of cross-country runners developing shin injury [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]. MT metatarsal, RRI running-related injury, ↑ greater, ↓ smaller forefoot at forefoot flat (ES = 0.88) [47] in a mixed-sex population of novice runners, while limited evidence indicated a greater medial pressure in recreational male runners developing Achilles tendinopathy, plantar fasciopathy and medial tibial stress syndrome [48].…”

Section: Plantar Pressure Variables Inconsistent Evidencementioning

confidence: 99%

Biomechanical Risk Factors Associated with Running-Related Injuries: A Systematic Review

et al. 2019

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Background Running is a popular form of physical activity with many health benefits. However, the incidence and prevalence of running-related injuries (RRIs) is high. Biomechanical factors may be related to the development of RRIs. Objective This systematic review synthesizes biomechanical risk factors related to the development of RRIs in non-injured runners. Methods PubMed, Web of Science, CINAHL, Embase, and SPORTDiscus were searched in July 2018 for original peerreviewed prospective studies evaluating potential biomechanical factors associated with the development of RRIs. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Two reviewers independently assessed articles for inclusion and methodological quality. Due to methodological heterogeneity across studies, a narrative synthesis of findings was conducted, rather than a meta-analysis. Results Sixteen studies, including 13 of high quality and three of moderate quality, were included. A large number of biomechanical variables were evaluated, producing inconsistent evidence overall. Limited evidence indicated greater peak hip adduction in female runners developing patellofemoral pain and iliotibial band syndrome, but not for a mixed-sex population of crosscountry runners sustaining an RRI. The relationship between vertical loading rate and RRIs was inconsistent. Other kinematic, kinetic and spatiotemporal factors were only studied to a limited extent. Conclusions Current prospective evidence relating biomechanical variables to RRI risk is sparse and inconsistent, with findings largely dependent on the population and injuries being studied. Future research is needed to confirm these biomechanical risk factors and determine whether modification of these variables may assist in running injury prevention and management. Key Points Despite the common belief that biomechanical factors greatly influence running-related injury (RRI) risk, only a limited body of high-quality research, with significant heterogeneity in study populations, methodologies and outcome variables, was identified. Current prospective evidence relating biomechanical variables with the risk to sustain an RRI is inconsistent and largely dependent on the population and injuries being studied. A number of single-study findings related to kinematics, kinetics and spatiotemporal variables require confirmation via further high-quality prospective studies before clinical recommendations can be made.

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“…Along with the popularity of running, the number of people suffering from running-related injuries has steadily increased (Abt et al, 2011;Fields et al, 2010). In an effort to combat this high level of injuries, there has been increased demand for running gait research and a growing body of evidence has examined the influence of stride characteristics on the risk of injury (e.g., spatiotemporal parameters such as step frequency [SF], step length [SL], and ground contact time [CT]) (Luedke et al, 2016;Schubert et al, 2014). However, the relationship between the spatiotemporal parameters of running and both performance and injury risk still remains unclear.…”

Section: Introductionmentioning

confidence: 99%

How Do Spatiotemporal Parameters and Lower-Body Stiffness Change with Increased Running Velocity? A Comparison Between Novice and Elite Level Runners

García‐Pinillos

García-Ramos

Ramírez‐Campillo

et al. 2019

Journal of Human Kinetics

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This study aimed to examine the effect of running velocity on spatiotemporal parameters and lower-body stiffness of endurance runners, and the influence of the performance level on those adaptations. Twenty-two male runners (novice [NR], n = 12, and elite runners [ER], n = 10) performed an incremental running test with a total of 5 different running velocities (10, 12, 14, 16, 18 km/h). Each condition lasted 1 min (30 s acclimatization period, and 30 s recording period). Spatiotemporal parameters were measured using the OptoGait system. Vertical (Kvert) and leg (Kleg) stiffness were calculated according to the sine-wave method. A repeated measures ANOVA (2 x 5, group x velocities) revealed significant adaptations (p < 0.05) to increased velocity in all spatiotemporal parameters and Kvert in both NR and ER. ER showed a greater flight time (FT) and step angle (at 18 km/h) (p < 0.05), longer step length (SL) and lower step frequency (SF) (p < 0.05), whereas no between-group differences were found in contact time (CT) nor in the sub-phases during CT at any speed (p ≥ 0.05). ER also showed lower Kvert values at every running velocity (p < 0.05), and no differences in Kleg (p ≥ 0.05). In conclusion, lower SF and Kvert and, thereby, longer FT and SL, seem to be the main spatiotemporal characteristics of high-level runners compared to their low-level counterparts.

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Influence of Step Rate on Shin Injury and Anterior Knee Pain in High School Runners

Cited by 89 publications

References 26 publications

Manipulation of Foot Strike and Footwear Increases Achilles Tendon Loading During Running

Manipulation of Foot Strike and Footwear Increases Achilles Tendon Loading During Running

Biomechanical Risk Factors Associated with Running-Related Injuries: A Systematic Review

How Do Spatiotemporal Parameters and Lower-Body Stiffness Change with Increased Running Velocity? A Comparison Between Novice and Elite Level Runners

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