The habitual motion path theory: Evidence from cartilage volume reductions in the knee joint after 75 minutes of running

Abstract

the habitual motion path theory predicts that humans tend to maintain their habitual motion path (HMP) during locomotion. The HMP is the path of least resistance of the joints defined by an individual's musculoskeletal anatomy and passive tissue properties. Here we tested whether participants with higher HMp deviation and whether using footwear that increases HMp deviation during running show higher reductions of knee joint articular cartilage volume after 75 minutes of running. We quantified knee joint articular cartilage volumes before and after the run using a 3.0-Tesla MRI. We performed a 3D movement analysis of runners in order to quantify their HMP from a two-legged squat motion and the deviation from the HMP when running in different footwear conditions. We found significantly more cartilage volume reductions in the medial knee compartment and patella for participants with higher HMp deviation. We also found higher cartilage volume reductions on the medial tibia when runners wore a shoe that maximized their HMp deviation compared with the shoe that minmized their HMp deviation. Runners might benefit from reducing their HMP deviation and from selecting footwear by quantifying HMP deviation in order to minimize joint cartilage loading in sub-areas of the knee.Overuse injuries in distance running occur with gradual onset over time and result from the repetitive stress of biological tissues and associated cumulative trauma 1 . The knee joint is the most common site for running-related overuse injuries (RROIs) 2 . Nigg et al. have proposed that the neural control of running is tuned towards minimizing mechanical stress of biological tissues, resulting in an optimal path of lower extremity joint movement for each individual and every specific movement 3 . Recently, we proposed a redefinition of this theory by assuming that the neural control of running is tuned towards keeping the individual's habitual joint motion path (HMP), which we define as the joints' path of least resistance, and a function of an individual's anatomy and passive tissue mechanical properties 4 . As such, the HMP is the set of joint kinematics during motions which minimizes loading of lower extremity joints relative to the loads during running. Examples for these relatively low loading motions are walking, stair climbing, sitting down or standing up from a chair. Consequently, we have developed a simple method to estimate the HMP for individuals from a basic half-squat movement 4 .Running at typical distance running speeds requires greater force application to the ground in order to satisfy the body weight support requirement during shorter ground contact times compared to walking 5,6 . Therefore, runners must generate amplified lower extremity joint moments when running in order to maintain the HMP and to optimize the load distribution to regions that have been adapted to carry these loads. Based on the HMP theory, deviating from the HMP leads to loading of less adapted structures of lower extremity joints, resulting in a greater risk of s...

2021 ISB World Athletics Award for Biomechanics: The Subtalar Joint Maintains “Spring-Like” Function While Running in Footwear That Perturbs Foot Pronation

“…49 Thus, we speculate that the subtalar joint's "spring-like" function may also help support a person's "habitual joint motion path," 50 allowing this joint and others to move in their "path of least resistance" to reduce tissue loading while also decreasing energetic cost. [50][51][52] The findings from this research have applications to running and footwear-related research. The first application is the important role of subtalar joint in responding to changes in frontal plane (ie, mediolateral) foot-surface interactions and a potential important role for energy storage and return at the subtalar joint during running to remain stable and upright, mediated by the tibialis posterior.…”

Running Injury Paradigms and Their Influence on Footwear Design Features and Runner Assessment Methods: A Focused Review to Advance Evidence-Based Practice for Running Medicine Clinicians

“…The magnitude of the joint motion may fluctuate, but the trajectory, or path, is stable. Alterations in footwear that resist or do not allow for skeletal movement along this path may increase tissue stress—either from a deviation from their pathway or from increased muscle activity to keep their individual habitual joint path—which in turn increases the risk of injury (Nigg, 2001 ; Enders et al, 2013 ; Willwacher et al, 2020 ). Originally called the Preferred Movement Path, this paradigm has since been updated and renamed the “habitual joint (motion) path,” adding that joint motion takes the path of least resistance due to an individual's anatomy and passive tissue properties (Trudeau et al, 2019 ).…”

“…To our knowledge, no studies have directly tested the effect of matching footwear to minimize biomechanical variability and/or deviation from a specific motion path on running related injury. However, one study (Willwacher et al, 2020 ) suggested that increased time outside one's habitual motion path was associated with tissue-related changes in the knee joint. In this study of 12 healthy recreational runners, medial femur, medial tibia, and patella cartilage volume reductions were larger after 75 min of running in a shoe that increased a runner's deviation from their habitual joint path compared to one that reduced the deviation.…”

Towards functionally individualized designed footwear recommendation for overuse injury prevention: A Scoping Review

“…Researchers and footwear manufacturers are moving away from holistic toward individualized footwear solutions. New approaches, e.g., the comfort lter, habitual motion path theory, and the preferred movement path theory, are becoming increasingly established in the running community and may serve as an opportunity to reduce injuries in the future (13,20,21). These new concepts have in common that they try to shed light on the frequently reported subject-speci c response to footwear.…”