Lower step rate is associated with a higher risk of bone stress injury: a prospective study of collegiate cross country runners

Kliethermes, Stephanie; Stiffler-Joachim, Mikel R.; Wille, Christa M.; Sanfilippo, Jennifer; Zavala, Pedro; Heiderscheit, Bryan C.

doi:10.1136/bjsports-2020-103833

Cited by 40 publications

(32 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is worth noting for the average slope from 20% to 80% of the vGRF magnitude at IP method that methodological discrepancies exist with some studies calculating LR using the region between 20% and 80% of the vGRF magnitude at IP (8,26,27) and others using the region between 20% and 80% of the time to IP (4,7,10). These methods are not interchangeable, and due to unclear verbiage, it is at times difficult to determine which calculation method was used.…”

Section: Discussionmentioning

confidence: 99%

“…Despite vGRF being only one of the many forces contributing to the complex internal loading patterns associated with injury, LR is often used as a simplified measure of this loading. However, the role of LR in running-related injuries is unclear, with some studies demonstrating an association between high LR and injury (1-3), particularly bone stress injuries (BSI) (4)(5)(6), and others finding no relationship (7)(8)(9)(10). Inconsistent findings regarding the association of LR and injury may be related to the varying methods used to calculate LR, data collections occurring at different running speeds, and study design limitations.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Vertical Loading Rate Is Not Associated with Running Injury, Regardless of Calculation Method

Schmida

Wille

Stiffler-Joachim

et al. 2022

Medicine &Amp; Science in Sports &Amp; Exercise

View full text Add to dashboard Cite

Introduction: Loading rate (LR), the slope of the vertical ground reaction force (vGRF), is commonly used to assess runningrelated injury risk. However, the relationship between LR and running-related injuries, including bone stress injuries (BSI), is unclear. Inconsistent findings may result from the numerous LR calculation methods that exist and their application across different running speeds. Purpose: This study aimed to assess the influence of calculation method and running speed on LR values and to determine the association of LR during healthy running with subsequent injury. Methods: Healthy preseason running data and subsequent injury records from Division I cross-country athletes (n = 79) over four seasons (2015-2019) at 2.68 m•s −1 , preferred training pace, and 4.47 m•s −1 were collected. LR at each speed was calculated four ways: 1) maximum and 2) average slope from 20% to 80% of vGRF magnitude at impact peak (IP), 3) average slope from initial contact to IP, and 4) average slope from 3% to 12% of stance time. Linear mixed effects models and generalized estimation equations were used to assess LR associations. Results: LR values differed depending on speed and calculation method (P value <0.001). The maximum slope from 20% to 80% of the vGRF at 4.47 m•s −1 produced the highest LR estimate and the average slope from initial contact to IP at 2.68 m•s −1 produced the lowest. Sixty-four injuries (20 BSI) were observed. No significant association was found between LR and all injuries or BSI across any calculation method (P values ≥0.13). Conclusions: Calculation method and running speed result in significantly different LR values. Regardless of calculation method, no association between LR and subsequent injury was identified. Thus, healthy baseline LR may not be useful to prospectively assess running-related injury risk.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Vertical Loading Rate Is Not Associated with Running Injury, Regardless of Calculation Method

Schmida

Wille

Stiffler-Joachim

et al. 2022

Medicine &Amp; Science in Sports &Amp; Exercise

View full text Add to dashboard Cite

show abstract

“…A recent trial found that healthy adolescent runners did not modify their footstrike pattern after 10-week running retraining programs designed to promote a transition to a non-rearfoot strike (González et al, 2021), suggesting unique approaches may be necessary in this population. Nonetheless, given the increased risk of shin pain in high school runners and of BSI in collegiate runners using a lower step rate (Luedke et al, 2016;Kliethermes et al, 2021), running retraining in this population may be considered as part of a comprehensive treatment plan.…”

Section: Discussionmentioning

confidence: 99%

Adolescent Running Biomechanics - Implications for Injury Prevention and Rehabilitation

McSweeney

Silbernagel

Gruber

et al. 2021

Front. Sports Act. Living

View full text Add to dashboard Cite

Global participation in running continues to increase, especially amongst adolescents. Consequently, the number of running-related injuries (RRI) in adolescents is rising. Emerging evidence now suggests that overuse type injuries involving growing bone (e.g., bone stress injuries) and soft tissues (e.g., tendinopathies) predominate in adolescents that participate in running-related sports. Associations between running biomechanics and overuse injuries have been widely studied in adults, however, relatively little research has comparatively targeted running biomechanics in adolescents. Moreover, available literature on injury prevention and rehabilitation for adolescent runners is limited, and there is a tendency to generalize adult literature to adolescent populations despite pertinent considerations regarding growth-related changes unique to these athletes. This perspective article provides commentary and expert opinion surrounding the state of knowledge and future directions for research in adolescent running biomechanics, injury prevention and supplemental training.

show abstract

“…The vertical loading rate (VLR), defined as the rate of change of the force application after the impact, has been used as the best indicator to describe ground impact [7]. Additionally, common pathologies in runners (i.e., patellofemoral syndrome, tibial stress fracture, and plantar fasciitis) have been linked to VLR [8], although recent studies reported no relationship between VLR and injury risk in level running [9,10], contrary to lower step rate [11] or lower duty factor [9]. However, downhill running elicits very greater VLR values than in level running and a lower step rate at the same speed as in uphill running [12].…”

Section: Open Accessmentioning

confidence: 99%

Correspondence Between Values of Vertical Loading Rate and Oxygen Consumption During Inclined Running

et al. 2022

View full text Add to dashboard Cite

Purpose The aim of this study was to provide a theoretical model to predict the vertical loading rate (VLR) at different slopes and speeds during incline running. Methods Twenty-nine healthy subjects running at least once a week performed in a randomized order 4-min running trials on an instrumented treadmill at various speeds (8, 10, 12, and 14 km h−1) and slopes (− 20%, − 10%, − 5%, 0%, + 5%, + 10%, + 15%, + 20%). Heart rate, gas exchanges and ground reaction forces were recorded. The VLR was then calculated as the slope of the vertical force between 20 and 80% of the duration from initial foot contact to the impact peak. Results There was no difference in VLR between the four different uphill conditions at given running speeds, but it was reduced by 27% at 5% slope and by 54% at 10% slope for the same metabolic demand (similar $${\dot{\text{V}}\text{O}}_{{2}}$$ V ˙ O 2 ), when compared to level running. The average VLR measured at maximal aerobic intensity during level running would be decreased by 52.7% at + 5%, by 63.0% at + 10%, and by 73.3% at + 15% slope. Moreover, VLR was dependent on the slope in downhill conditions. Conclusion This study highlights the possibility to use uphill running to minimize rate of mechanical load (i.e., osteoarticular load) from foot impact on the ground and as a time-efficient exercise routine (i.e., same energy expenditure than in level running in less time).

show abstract

Lower step rate is associated with a higher risk of bone stress injury: a prospective study of collegiate cross country runners

Cited by 40 publications

References 40 publications

Vertical Loading Rate Is Not Associated with Running Injury, Regardless of Calculation Method

Vertical Loading Rate Is Not Associated with Running Injury, Regardless of Calculation Method

Adolescent Running Biomechanics - Implications for Injury Prevention and Rehabilitation

Correspondence Between Values of Vertical Loading Rate and Oxygen Consumption During Inclined Running

Contact Info

Product

Resources

About