Lower Limb Biomechanical Factors Related to Running Injuries: A Review and Practical Recommendations

Abstract

The objective of this review is to analyze some of the biomechanical factors involved in the most common running injuries: anterior knee pain, iliotibial band syndrome, Achilles tendinopathy, and medial tibial stress syndrome/tibial stress fracture. Eighteen studies met all inclusion criteria. Results showed that there is little consistent evidence in the literature to connect any biomechanical anomaly to any given running injury, except for female runners with patellofemoral pain who have an increased peak hip adduction angle at stance phase. This review suggests that assessing and treating hip mechanics could help to prevent knee injuries in female runners.

Bilateral asymmetries and sex differences in the kinematics of running gait cycle of a group of Andalusian recreational runners (Asimetrías y diferencias por sexo en la cinemática del ciclo de carrera en un grupo de corredores recreativos andaluces)

“…This may be the cause of some overuse running injuries that are more prevalent in females because time to maximum rearfoot eversion has often been linked to overuse running injuries (Ferber, et al, 2009). Women are more prone to tibial stress syndrome and tibial stress fractures (Fernández & Rojano, 2020;Kozinc & Šarabon, 2017;Taunton, et al, 2002) and Becker et al (2017) and Fernández and Rojano (2020) suggest that eversion later in stance may be one of the biomechanical factors related to this type of injury risk. Sakaguchi et al (2014) also found a later occurrence of peak eversion in female runners but the differences between males and females were not significant and effect sizes were small.…”

“…In the last decades running has increased in popularity becoming one of the most important recreational activities (Aminaka, Arthur, Porcari, Foster, Cress, & Hahn, 2018;De Wit, De Clercq, & Aerts, 2000;Fernández & Rojano, 2020;Taunton, Ryan, Clement, McKenzie, Lloyd-Smith, & Zumbo, 2002). The rapid increase in the number of runners has led to an explosion of research and assessment (Novacheck, 1998).…”

“…The rapid increase in the number of runners has led to an explosion of research and assessment (Novacheck, 1998). The health benefits attributed to running include stress and obesity reduction and an improvement in cardiovascular and mental health (Fernández & Rojano, 2020;Lohman, Balan Sackiriyas, & Swen, 2011;Taunton, et al, 2002).…”

“…Despite its benefits, running is also associated with a higher risk of overuse injuries than other aerobic activities (Ferber, Sheerin, & Kendall, 2009;Francis, Whatman, Sheerin, Hume, & Johnson, 2018). One of the most analyzed kinematic variables in previous literature due to its association with running related injuries is peak rearfoot eversion angle (Fernández & Rojano, 2020). During the stance phase of a running gait cycle the subtalar joint moves in a triaxial plane, contributing to the motions of pronation and supination.…”

“…However, proportions of injury in the knee and the hip are greater in women and proportions of injury in the ankle and the shank are greater in men (Francis et al, 2018). Most studies analyzing sex differences in lower extremity mechanics during running showed that female runners demonstrated a significant greater peak hip adduction angle than men (Chumanov, Wall-Scheffler, & Heiderscheit, 2008;Ferber, McKlay-Davis, Williams, 2003;Fernández & Rojano, 2020). Nevertheless, results are not so conclusive regarding peak rearfoot eversion angle (Fukano, Fukubayashi, & Banks, 2018;Sinclair & Taylor, 2014;Takabayashi, Edama, Nakamura, Nakamura, Inai, & Kubo, 2017).…”